Diabetes Mellitus (‘Diabetes’)

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Definition –  persistently elevated blood glucose due to either insulin deficiency and/or insulin resistance

Epidemiology – major public health issue and disease burden resulting in vascular disease

Diagnostic criteria – fasting BSL > 7mmol/L (see other Diagnostic Criteria for Diabetes Mellitus)

Pathophysiology – Various causes due to either endocrine pancreatic insufficiency or peripheral tissue resistance to insulin resulting in hyperglycaemia and disorders of CHO/fat metabolism.  Commonest cause related to high CHO/fat diet and inadequate activity

Complications – Acutely related to combination of hyperglycaemia  (see Diabetic Ketoacidosis) and/or ketogenesis (see Hyperosmolar Non-ketotic Hyperglycaemia).  Chronically resulting in vascular disease (see Diabetic complications)

Clinical features (related to high serum glucose) – polyuria, polydipsia

Management – lifestyle/diet change, pharmacological (see Diabetes Mellitus – Therapeutics)

Prevention – random urine glucose screening or fasting glucose for patients at risk e.g. obesity, history of vascular disease

*CHO = carbohydrate



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