Diabetes—is a condition in which the body either does not produce enough insulin, or does not properly respond to insulin a hormone produced in the pancreas.
Insulin enables cells to absorb glucose in order to turn it into energy. Any disturbance in this causes glucose to accumulate in the blood (hyperglycemia), leading to various complications.
TYPES OF DIABETES:
1) Type 1 diabetes
Type 1 Diabetes is autoimmune disease. It is result of destruction of beta cells due to aggressive nature of cells present in the body.

2) Type 2 diabetes
Type 2 Diabetes is also called non insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. It occurs when the body produces enough insulin but cannot utilize it effectively. This type of diabetes usually develops in middle age. more common among older; obese; have a family history of diabetes; have had gestational diabetes.
3) Gestational diabetes:
It is a form of diabetes which affects pregnant women. Hormones involved in development of placenta, also blocks the action of the mother's insulin in her body. This is called insulin resistance. During pregnancy a mother may need up to three times more insulin for glucose to leave the blood and transform to energy. When body is not able to use insulin due to insulin resistance it develops into Gestational Diabetes. Glucose builds up in the blood to high level, it is called hyperglycemia.
Causes of Diabetes
• Hereditary or Inherited Traits : It depends upon closeness of blood relationship as mother is diabetic, the risk is 2 to 3%, father is diabetic, the risk is more than the previous case and if both the parents are diabetic, the child has much greater risk for diabetes.
• Age : Increased age is a factor which gives more possibility than in younger age.
• Poor Diet (Malnutrition Related Diabetes) : low protein and fiber intake, high intake of refined products are the expected reasons for developing diabetes.
• Obesity and Fat Distribution : Being overweight means increased insulin resistance.
• Sedentary Lifestyle
• Stress : physical injury or emotional disturbance is the initial cause of the disease..
• Drug induced: Clozapine, olanzapine , risperidone , quetiapine and ziprasidone induce this lethal disease.
• Infection : strephylococci that infects pancreas.
• Sex : commonly seen in elderly especially males but, strongly in women
• Hypertension : there is direct relation between high systolic pressure and diabetes.
• Serum lipids and lipoproteins : High triglyceride and cholesterol level in the blood is related to high blood sugars.
SIGNS AND SYMPTOMS:
Diabetes Type 1:
• Primary stage : nausea and vomiting.
• Later stage : ketoacidosis, fast weight loss
• Advanced stage : Coma and death.

Diabetes Type 2:
• Increased fatigue
• Polydipsia
• Polyuria
• Polyphegia
• Weight flactuation
• Blurry vision
• Irritability
• Infections
• Poor wound healing
Complications
• Diabetic retinopathy: pain in the eyes and may even result in loss of vision.
• Diabetic nephropathy: kidney disease shows symptoms of swelling (edema) in the feet and legs. blood pressure also increases.
• Diabetic neuropathy: Tingling, burning, numbness, tightness, shooting or stabbing pain in the hands, feet or other parts of body
• Diabetic foot: Any injury leads to gangrene if neglected
• Cardiac complaints: Chest pain ,shortness of breath, dizziness ,light headache, shoulder or stomach pain, fast heartbeat, heart attack or stroke
• Others: scanty or profuse sweating, difficulty of sensing when your bladder is full, increased sexual problems, weakness.
Prevention & management:
• Control weight to normal or near-normal levels by eating a healthy low-fat, high-fiber diet.
• Regular exercise is crucial to the prevention of type 2 diabetes.
• Keep alcohol consumption low.
• Quit smoking.
• If you have high blood fat levels (such as high cholesterol) or high blood pressure, take your medication as directed
• Lifestyle modification
• If you already have diabetes, your focus should be on preventing the complications
• Tight glucose control.
• Maintain a healthy weight
• Increase physical activity levels
• Drink an adequate amount of water and avoid taking too much salt.
• The skin should be taken care of; avoid sores and cracks that can become severely infected.
• Brush and floss the teeth every day to prevent gum disease.
• The feet should be washed and examined daily, looking for small cuts, sores, or blisters that may cause



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Dr Gayathri is Faculty for medical billing training and author for CPC Sample papers

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