[Music]
in these lectures we're going to talk
about diabetes mellitus diabetes
mellitus can be defined as a chronic
metabolic disease characterized by
elevated plasma glucose this is usually
due to insulin deficiency in the case of
type one diabetes type one diabetes can
be immune mediated due to beta cell
destruction or idiopathic which is non
immune mediated this particular type is
very rare acquired diabetes is diffuse
damage of the beta cells with subsequent
insulin deficiency and this can occur
from infections or drugs that affect the
pancreas impaired action of insulin
secondary to insulin resistance is the
hallmark of tannic 2 diabetes probably
the most common form of diabetes that we
encounter in medical practice one can
also get the combination of these two
abnormalities pre-diabetes is defined as
elevated kazmo glucose levels below the
diagnostic criteria for diabetes but
above the normal range gestational
diabetes or pregnant but pregnancy
induced diabetes is any degree of
glucose intolerance with onset or first
recognition during pregnancy the
definition applies where the insulin or
only diet modification is used for
treatment and whether or not the
condition persists after pregnancy
elevated plasma glucose can be defined
as a plasma glucose level that occurs
between the range of 100 and 125
milligrams per deciliter also on a
glucose tolerance test a range of plasma
glucose between 140 and 199 milligrams
per deciliter this is usually two hours
after a 75 gram oral glucose load and
then finally a glycosylated hemoglobin
level or hemoglobin a1c of 5.7 26.4%
criteria for diagnosing diabetes are
numerous
and this but this particular series of
slides will take you through
differentiating the normal range
pre-diabetes and over diabetes mellitus
a random plasma glucose in the setting
of classic hypoglycemic symptoms such as
polyuria polydipsia polyphagia plus a
plasma glucose level that exceeds or is
equal to 200 milligrams per deciliter
will give you the diagnosis of diabetes
fasting plasma glucose after an eight
hour fast within the normal range should
be less than 100 milligram per deciliter
pre-diabetes is defined as a fasting
plasma glucose between 100 and 125
milligrams per deciliter and avert
diabetes occurs when the fasting plasma
glucose is greater than or equal to 126
milligrams per deciliter plasma glucose
during a 2 hour 75 gram oral glucose
tolerance test under normal
circumstances should be less than 140
milligrams per deciliter in pre-diabetes
this will range between 140 and 199 and
in overt diabetes greater than 200
milligrams per deciliter hemoglobin a1c
of less than 5.7 is normal between 5
point 7 and 6 point 4 indicates
pre-diabetes and overt diabetes is
diagnosed when the hemoglobin a1c
exceeds 6.5 percent I referred earlier
in the slide to classic hypoglycemic
symptoms there is a generally accepted
triad although they don't necessarily
always occur in patients with diabetes
but more often than not excessive
urination or polyuria excessive hunger
polyphagia and excessive thirst or
polydipsia are hallmarks of elevated
serum glucose in the absence of
hypoglycemic symptoms and abnormal
fasting plasma glucose an abnormal oral
glucose tolerance test test or
hemoglobin a1c should be confirmed by
repeated testing let's say a few words
about the metabolic syndrome this is a
group of risk factors that increase the
probability of developing tight
diabetes mellitus and cardiovascular
disease this in turn can result in
impaired glucose metabolism central body
obesity hypertension and hyperlipidemia
there's also an increased relative risk
of developing cardiovascular disease and
an increased risk of developing diabetes
in fact the risk for cardiovascular
disease is two times normal and the risk
for developing of the diabetes is five
times normal
[Music]