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Contents :
Definition and Types

Risk factors and Etiology
Epidemiology
Pathophysiology
Clinical presentation
Diagnosis
Treatment
Prevention and control
Definition & Types
Eman AbdElmoneim
Definition :
Diabetes is a chronic disease that occurs either
when the pancreas does not produce enough
insulin or when the body cannot effectively use the
insulin it produces
Type 1 diabetes
Type 1 diabetes (previously known as insulin-

dependent(IDDM), juvenile or childhood-onset)
is characterized by deficient insulin production and requires
daily administration of insulin . The cause of type 1 diabetes is
not known and it is not preventable with current knowledge.
Type 2 diabetes
Type 2 diabetes (formerly called non-insulin-dependent(NIDDM or adult-

onset)
results from the body’s ineffective use of insulin . Type 2 diabetes comprises
the majority of people with diabetes around the world , and is largely the result
of excess body weight and physical inactivity.
Gestational Diabetes(GD)
Is hyperglycaemia with blood glucose values above normal but below

those diagnostic of diabetes, occurring during pregnancy .
Women with gestational diabetes are at an increased risk of
complications during pregnancy and at delivery. They and their
children are also at increased risk of type 2 diabetes in the future.
Risk factors & etiology
Sara Mustafa
risk factors for type 1 diabetes
1.family history
2.enviromental factors
3.the presence of damaging immune system cells
4.dietary factors
risk factors for type 2 diabetes
non modifiable
1.family history
2.history of gestational diabetes
3.Age over 45 years
modifiable
4.physical inactivity
5.high body weight
6.high blood pressure
7.high cholesterol and TG
Epidemiology
Salwa Muawia
- In 2012 it resulted in 1.5million deaths worldwide making it
the 8th leading causes of death.
- As at 2013, 382million people have diabetes
- Gllobally , an estimated 422 million adults are living with

DM ,according to latest 2016 data from the WHO
- And the number is projected to almost double by 2030 to be

the DM is the 7th leading cause of death
- 90% of people with diabetes have type 2 diabetes
and its frequency is increasing in low and middle-
income countries. In the African Region, the rate of
diabetes is growing and this represents a big
challenge to governments, health services,
communities and individuals.
- International Diabetes Federation (IDF) data indicate
that by the year 2040, the number of people affected will
reach642 million –90% of these people will have Type 2
diabetes.
- The incidace rate of diabetes in Sudan are incease to
16.6% that due to unhelthy diatery food .
- The mortality rate are 2% from total mortality rate in

the Sudan .
Pathophysiology
Shima Bakry
Insulin define as: a hormone that secret from beta
cell of pancreas in response to increase blood
glucose level to enhance glucose entry into the
cells to produce energy.
Diabetes mellitus type 1:
Autoimmune destruction of beta cells of

pancreas decrease insulin production
(hypoinsulinemia) increase blood glucose
(hyperglycemia).
Diabetes mellitus type 2:
• beta cells is intact and insulin is produce but:

• Body become resistant to insulin glucose cannot enter cells and
there is no energy produce liver start to release
glucose(gluconeogenesis) in response to low energy high blood
glucose level.
Clinical presentation
Mishkat AbdElgadir
ciinical features
• Type 1 DM • Type 2 DM
- Patients can be asymptomatic

- Polyuria - Polyuria
- Polydipsia - Polydipsia
- Polyphagia - Polyphagia
- Fatigue
- Weight loss - Most patients are discovered
- Weakness while performing urine
glucose screening
- Ketoacidosis
diagnosis
Treatment
Sara Nasir
If patients diagnosed with DM the therapeutic focus is -
on preventing complications caused by hyperglycemia
- Glycemic control
Two primary techniques are available to assess a
patients glycemic control :self monitoring of blood
glucose ( SMBG) and interval measurement of
hemoglobin A1c (HbA1c)
- Self monitoring of blood glucose
- Use (SMBG) is an effective method to evaluate short term glycemic
control it help patients and physicians assess the effects of food
medications stress and activity on blood glucose level
- Hemoglobin A1c
- HbA1c measures nonreversible glycosylation of the hemoglobin
molecule which directly related to blood glucose concentrations it
reflect mean blood glucose values over a 2-to 3-month period and can
be used as a predictor of a patients risk of microvascular complications
Insulin therapy
Type of insulin Onset Peak Duration
Rapid- acting 10-15 min 60-90 min 4-5 h
Short acting Within 15 min 2-4 h 5-8 h
Intermediate- acting 1-3 h 5-8 h Up to 18 h
Extended long- 90 min Non 24 h

acting
Oral Hypoglycaemic Medications
Drug name Mechanism of action
Metformin Inhibit glucose production by the liver
Glimepiride Increase insulin secretion by pancreatic beta cells

Glipizide
Glyburide
Repaglinied Increase insulin secretion by pancreatic beta cells
Nateglinied
Pioglitazone Increase glucose uptake by skeletal muscle

Rosiglitazone
Acarbose Inhibit carbohydrate absorption by small intestine

Miglitol
Prevention & Control
Sara Elabas
Screening: The preventive significance of early detection are two
folds:
1. Discovery of the disease in its pre-symptomatic state if followed by
adequate treatment minimize the danger of complications such as
coma and infection.
2. Early therapy reduces the progress of disease and may reverse the
pathologic changes.
All risk groups should be screened periodically.

Treat complications and rehabilitate patient to lead a life
as normal as possible.
periodic checkups for visual acuity (retinopathy), renal

functions (nephropathy), and testing peripheral nerves
sensation (neuropathy
Health Education
Sittana Mohammed
References
World health organization-Diabetes country profiles,2016

http://who.int/mediacentre/factsheets/fs312/en
International diabetes federation(IDF)

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Group (25)

Definition and Types

Type 1 diabetes (previously known as insulin-

Type 2 diabetes (formerly called non-insulin-dependent(NIDDM or adult-

Is hyperglycaemia with blood glucose values above normal but below

- As at 2013, 382million people have diabetes

- Gllobally , an estimated 422 million adults are living with

- And the number is projected to almost double by 2030 to be

- The mortality rate are 2% from total mortality rate in

Autoimmune destruction of beta cells of

• beta cells is intact and insulin is produce but:

- Patients can be asymptomatic

Type of insulin Onset Peak Duration

Rapid- acting 10-15 min 60-90 min 4-5 h

Short acting Within 15 min 2-4 h 5-8 h

Intermediate- acting 1-3 h 5-8 h Up to 18 h

Extended long- 90 min Non 24 h

Drug name Mechanism of action

Metformin Inhibit glucose production by the liver

Glimepiride Increase insulin secretion by pancreatic beta cells

Pioglitazone Increase glucose uptake by skeletal muscle

Acarbose Inhibit carbohydrate absorption by small intestine

All risk groups should be screened periodically.

periodic checkups for visual acuity (retinopathy), renal

World health organization-Diabetes country profiles,2016

International diabetes federation(IDF)

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