Frequently Asked Questions (FAQs) on diabetes-mellitus | HospitalKhoj

DIABETES MELLITUS

DIABETES MELLITUS

Ques. 1  What is Diabetes Mellitus?

Ans.       This is a clinical syndrome characterised mainly by polyuria, polydipsia and polyphagia due to relative or absolute deficiency of insulin.

Aetiology : Age – middle age group, Sex-both sexes. Exact cause is unknown. The associate factors are:

  1. Hepatic disorders.
  2. Stress & strain-both physical and mental.
  3. Various drugs, steroids, thiazide diuretics etc.
  4. Destruction of insulin secreting basophilism, thyrotoxicosis etc.
  5. Pregnancy-due to hormories antagonizing insulin or due to lowering of renal threshold level of sugar.
  6. Habits-overeating (fats etc.).

Types :

  • Potential diabetics-hereditory.
  • Latent diabetics- abnormal glucose tolerance persons.
    • Resistant diabetics.
  • Juvenile onset type-insulin dependent.
  • Adult or maturity onset type- usually not insulin dependent.
  • Brittle diabetics.
  • Pathology : Insulin is secreted by Beta-islets of Langerhans in pancreas. Sufficient secretion of this hormone keeps blood sugar level well the renal threshold so that little sugar is normally excreted in urine. In the deficiency of insulin blood sugar level becomes higher, partly by conversion of fats and proteins into sugar and partly by hampered utilization at cellular level. When raised level does not cross renal threshold, no sugar is excreted. This state is called latent diabetes. When blood sugar level crosses the renal threshold, sugar appears in the urine thus making condition clinically existent.

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    This state is known as manifest diabetes or clinical diabetes.

    Note:- Normally more  glucose n blood means more insulin and vice versa, fall in blood sugar liberates adrenalin which restores normal blood sugar level by glycogenolysis in liver, ACTH and cortical steroids also help in the maintence of normal blood sugar level.

    Clinical Features : Onset – usually gradual (rarely acute).

    Symptoms are: –

  • Polyphagia-voracious appetite, particularly for sweets, feeling hungey within a short time of a full meal.
  • Pain in extremities.
  • Recurrent boils, carbuncles and other infections.
  • Amenorrhoea in women and imprtency in males.
  • Coma, severe neuropathy of retinopathy may be the first symptoms.
  • Non-healing of wounds.
  • Lassitude, general weakness, progressive loss of weight, strength and general weakness, progressive loss of weight, strength and energy and ready fatigue due to loss of glucose and tissue protein breakdown.
  • Polyuria – pale, clear large quantities of urine of high Sp. Gr. (1030-1050) ; nocturia.
  • Polydipsia due to dehydration.
  • Pruritus vulvae or balanitis.
  • Failing vision, cataract formation.
  • Failing memory, inability to concentrate.
  • Signs – There may  be absence of physical signs in cases of mild and moderate severity, otherwise –

  • Skin – loose, shallow, often a yellow tint, specially on hands and face,
  • Tongue –dry (index of dehydration ). Later red and beefy,
  • Diminution or absence of tendon reflexes or vibration sense,
  • Complications – may provide the first sign.
  • Patient appears debilitated and wasted or obese,
  • Face – pinched and pale,
  • Diagnosis :

  • Urine test : Sp. Gr. Usually over 1020, Reaction-acidic, Benedict’s test positive. Sodium nitroprusside test-acetone may or may not be present.
  • Blood test : Alkali reserve – lowered. Sugar – Above 120 mg/100 ml (latent) : above 180 mg / 100ml. (clinical).
  • Confirmed by glucose tolerance test or more easily by post prandial blood sugar estimation.
  • Complications:

  • Sexual and genital-impotency and sterility.
  • Pulmonary – T.B.
  • Pregnancy- Dystocia, repeated abortions, still-births, deformed body, eclampsia.
  • Skin – infections i.e- Glycosuria when lungs are implicated. Polyuria, which weakness, much thirst, dry mouth and tongue ; flabby, sunken abdomen ; craves bacon and salt.
  • FERRUM PHOS –Diabetes mellitus, when there is a quickened pulse or when there exists pain, heat or congestion in any part of the system.
  • Indication of a diet chart for a diabetic patient (for an adult)

    Vegetarian

  • Breakfast : Toast 2. or Atta-60gm.; Chhana-50gm. ; Boiled vegetables-100gm. : Tea with Sorbitol (saccharine)-1 cup; Milk (skimmed)-1 glassful. Lunch : Rice or Atta-70gm.; Dal-1 cup. ; Chhana curry-100 gm.; Green vegetables-250gm.; Sour curd-1 cup.
  • Afternoon tiffin : Cream cracker biscuits – 2; Cucumber-1 ; Tea with sorbitol -1 cup.
  • Dinner : Atta-70gm.; Green vegetables – 250 gm. ; Channa curry-50gm.
  • Non-Vegetarian :

  • Breakfast- Toast 2 oz or Atta-60 gm. ; Egg-1 ; Cream cracker biscuits-2 ; Tea with sorbitol- 1 cup. Lunch – Rice or Atta-70 gm. ; Green vegetables – 250 gm. ; Dal -1 cup ; Fish/meat-100 gm. ; Sour curd- 1 cup.
  • Afternoon tiffin-Cream cracker biscuits-2 ; Chhana-100 gm.; Cucumber-1 ; Tea with Sorbitol-1 cup. Dinner – Atta 70 gm. ; Fish or meat-100 gm. ; Green vegetables-250 gm.
  • NOTE : - Must avoid of sugar & its products, sweet, vegetables, and most of the underground vegetables. Use fructose or sorbitol instead of sugar.

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    Comments

    0 # Vaibhav 2018-12-14
    Hi, plz let me know What is the incubation period of Syphilis, also give me the list of good female's specialist in Chittaurgarh ?
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    0 # Dr. Naresh 2018-12-15
    Hii, The incubation period can be 10 to 90 days, plz find list of Gynecologist in Chittaurgarh
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    0 # Aayush 2018-12-07
    Hii, I am from , Please tell that can moisture be responsible for infections ?
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    0 # Dr. Pooja 2018-12-08
    Hello, good to see that you are from , yes,that is why u must keep your genital organs clean and dry because moisture can favour infections.
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    0 # Aarav 2018-11-23
    Hii can you plz tell me, Which fluids can cause or spread syphilis infection, alos give me the list of good gynec in Mayurbhanj?
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    0 # Dr. Pooja 2018-11-24
    Infection from semen, blood or lactation milk can occur and cause syphilis, Infection from blood syringes is very common, Infected mothers can transmit it through their milk also, consult with good Gynecologist in Mayurbhanj .
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    0 # Lakshay 2018-11-16
    Hii, I am from Munger, can you plz tell me What is the mode of infection in syphilis ?
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    0 # Dr. Naresh 2018-11-17
    90 percent cases in syphilis are transmitted through unsafe sexual contacts, Mothers can also pass infection through breast milk, you can also consult with good Gynecologist in Munger .
    Reply | Reply with quote | Quote
    0 # Vaibhav 2018-10-19
    Hello, plz let me know Can gonorrhoea be transmitted to small children, should I consult with good maternity doctor in Sindhanur
    Reply | Reply with quote | Quote
    0 # Dr. Naresh 2018-10-20
    yes,this can be transmitted by infected mothers to children, In this case it is called as ophthalmia neonatorum, find list of good doctor-.Obstetrician in Sindhanur
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    0 # Himmat 2018-10-12
    Hii, I am from Hazaribag, Please tell that can moisture be responsible for infections ?
    Reply | Reply with quote | Quote
    0 # Dr. Pooja 2018-10-13
    Hello, good to see that you are from Hazaribag, yes,that is why u must keep your genital organs clean and dry because moisture can favour infections.
    Reply | Reply with quote | Quote
    0 # Lakshay 2018-10-05
    Hii, I am from Mahasamund, Please tell that can moisture be responsible for infections ?
    Reply | Reply with quote | Quote
    0 # Dr. Naresh 2018-10-06
    Hello, good to see that you are from Mahasamund, yes,that is why u must keep your genital organs clean and dry because moisture can favour infections.
    Reply | Reply with quote | Quote
    0 # Himmat 2018-10-05
    Hi, plz let me know What is the incubation period of Syphilis, also give me the list of good female's specialist in East Nimar ?
    Reply | Reply with quote | Quote
    0 # Dr. Naresh 2018-10-06
    Hii, The incubation period can be 10 to 90 days, plz find list of Gynecologist in East Nimar
    Reply | Reply with quote | Quote
    0 # Vivaan 2018-09-28
    Hii, I am from Seoni, plz let me know What is gonorrhoea ?
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    0 # Dr. Pooja 2018-09-29
    Hello, Gonorrhoea is a sexually transmitted disease caused by the Neisseria gonorrhoea,This disease is caused in the genitourinary tracts, for more details plz visit good gynec in Seoni, find list of Gynecologist in Seoni
    Reply | Reply with quote | Quote