Introduction

Diabetes Mellitus is a disease that occurs as a result of absolute or relative deficiency of
insulin that results in metabolic and vascular abnormalities.
The etiologies include Obesity (because chronic calorie intake and prolonged stimulation of β
cell causes a decrease in insulin receptor and also adipose tissue and muscle are less
sensitive),hereditary,damage of pancreatic tissue, diabetogenic hormones(like growth hormone,
thyroid, epinephrine), diabetogenic drugs like Thiazide diuretics, epinephrine, phenothiazines
,Other factors like Pregnancy.
The common Signs and symptoms include polydipsia, polyphagia, polyuria, dehydration due to
glucosuria.
Diabetes has dangerous complications: including ketoacidosis (in types I), hyperglycemic
osmolal non ketotic coma (in type II), cardiovascular (like atherosclerosis, myocardial infarction,
peripheralarterialinsufficiency, Anemia, Hypertension,stroke), nephropathy, retinopathy,
neuropathy.
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It can be classified as: Type I: IDDM (or Juvenile type) occurs predominantly in children and
young adults who have no insulin secretion and Type II: NIDDM (or maturity onset type) usually
occur after the age of 40years.
Diabetic ketoacidosis (DKA) is serious complication of diabetes. It is severe metabolic
disturbance due to insulin deficiency, which results in hyperglycemia, ketonimia and later
acidosis. It is characterized by headache, nausea, vomiting, rapid pulse, dry skin, deep
breathing, and change in mentation. Management includes Regular (soluble) insulin IV infusion,
treatment of dehydration and precipitating factor.
Hypoglycemic Coma is more serious complication which usually occurs due to excess dose of
insulin which produces severe lowering of blood glucose that may leads to coma.
The Sign /Symptom are mental confusion, in coordination, paresthesia, convulsion, coma and
Signs of sympathetic over activity. The aim of treatment is to restore blood glucose to normal by
giving glucose 50% 20 – 100 ml IV, or glucagon 1mg iv, im, sc