DIABETES MILITUS

MEMBER OF GROUP 1

NI PUTU LILIS RASNITA DEWI

(12700050)
NI LUH PUTU WARDANI
(12700052)
NI LUH PUTU MIRANTI WARDANI
(12700056)
I PUTU BAYU SUKMANTARA
(12700084)
I GEDE PUTU BOBY SETYABUDI
(12700092)
IDA BAGUS GEDE PUTERA BRAHMANSA (12700122)
NI KADEK TRISNA PUJIANTI
(12700142)
PUTU GEDE TARA DARMA PUTRA
(12700144)
NI WAYAN EKA ARIMAS
(12700212)
IDA BAGUS DARMAWIGUNA
(12700222)

DEFINITION OF DIABETES
All cells in the human body needs sugar to
work normally. Sugar can enter the body's
cells with the help of the hormone insulin. If
the amount of insulin in the body is not
enough, or when the body's cells do not
respond to insulin (insulin resistance), there
will be a buildup of sugar in the blood. This
is what happens in patients with diabetes
mellitus.

TYPES OF DIABETES

Diabetes mellitus type 1, diabetes mellitus

that is caused by insufficient production of
insulin by the pancreas.
Diabetes mellitus type 2, which is caused by
insulin resistance, so the use of insulin by the
body becomes ineffective.
Gestational diabetes, hyperglycemia was
first discovered during pregnancy.

CAUSES OF DIABETES MELLITUS

Type 1 diabetes is believed to be an autoimmune disease in

which the body's own immune system specifically attack and
destroy insulin-producing cells found in the pancreas.
Type 2 diabetes is thought to be caused by a combination of
genetic and environmental factors. Many patients with type 2
diabetes have a family member who also suffers from type 2
diabetes or other health problems associated with diabetes,
such as high blood cholesterol, high blood pressure
(hypertension) or obesity.
Gestational diabetes is caused by the hormonal changes that
occur during pregnancy. Elevated levels of several hormones
produced by the placenta makes the body's cells become less
responsive to insulin (insulin resistance). Because the placenta
continues to grow during pregnancy, hormone production is
also increasing and aggravate insulin resistance has occurred.

SYMPTOMS OF DIABETES MELLITUS

At first, patients often do not realize that he was
suffering from diabetes mellitus, even many years later.
However, it should be suspected if a person has a
complaint DM DM classical form:

polyuria (many of urination)

polydipsia (thirst so so much to drink)
polyphagia (eat a lot because feeling hungry constantly)
weight loss can not be explained why

If the above complaint experienced by someone, may be

examined to confirm the diagnosis of DM in the form of
additional complaints:

weakness, tiredness, tingling, itching

blurred vision
poor wound healing
erectile dysfunction in male patients
itching in genital female patients

COMPLICATIONS OF DIABETES MELLITUS

Acute Complications
Circumstances include the acute complications of DM is diabetic ketoacidosis
(KAD) and hyperosmolar hyperglycemic status (SHH). In this two-state blood
glucose levels are very high (the KAD 300-600 mg / dL, the SHH 600-1200
mg / dL), and patients are usually unconscious. Due to a high death rate, the
patient should be immediately taken to the hospital for proper treatment.
The state of hypoglycemia are also included in the acute complications of
diabetes, in which blood glucose levels decreased to <60 mg / dL. DM
patients are unconscious to think having a state of hypoglycemia. Things that
can cause hypoglycemia as patients taking too much (most often
sulfonylureas) or inject too much insulin, or the patient does not eat after
taking the drug or injecting insulin.
Symptoms of hypoglycemia include profuse sweating, palpitations, trembling,
hunger, dizziness, anxiety, and if severe, may lose consciousness to coma. If
the patient is conscious, can soon be given a sweet drink containing glucose.If
the patient's condition does not improve or unconscious patient should be
immediately taken to hospital for treatment and subsequent monitoring.

Chronic complications
Diabetes mellitus uncontrolled for long periods will cause
damage to blood vessels and nerves. The blood vessels can be
damaged divided into two types, namely large and small blood
vessels.
Included in the large blood vessels, among others:
The blood vessels of the heart, which if broken will lead to
coronary heart disease and sudden cardiac arrest
Peripheral blood vessels, especially in the legs, which if
damaged will cause ischemic injury to the leg
Cerebral blood vessels, which if damaged could cause a stroke
Damage to small blood vessels (microangiopathic) such as the
retinal blood vessels and can lead to blindness. Also, it can cause
damage to kidney blood vessels which will lead to diabetic
nephropathy. For more details, read the article to kidney failure.

PREVENTION OF DIABETES MELLITUS

Prevention of type 2 diabetes mellitus is mainly aimed at people who are
at risk of developing type 2 diabetes. The goal is to slow the onset of type
2 diabetes, maintain the function of insulin-producing cells in the
pancreas, and prevent or delay the emergence of disorders of the heart and
blood vessels. Risk factors for type 2 diabetes can be divided into factors
that can be modified and the factors that can not be modified. Prevention
efforts by reducing modifiable risk

Risk factorsthat can not be modified for example, race and ethnicity,
history of family members suffering from diabetes mellitus

Modifiable risk factors for example being overweight, physical

inactivity, hypertension (> 140/90 mmHg), impaired blood lipid profile
(HDL <35 mg / dL or triglycerides> 250 mg / dL, and an unhealthy diet
high in sugar and low in fiber

Prevention of type 2 diabetes in people at risk in principle is to make

lifestyle changes that include exercise, weight loss, and dietary
adjustments.

MANAGEMENT OF DIABETES
Destination management of patients with diabetes mellitus type 2 is
a lower blood glucose levels to normal or near normal, so as to
prevent the occurrence of complications in these patients. In patients
with type 2 diabetes, management begins with lifestyle change which is
doing a healthy diet and increasing physical activity in order to reach
your ideal weight.
Diabetes mellitus is not curable, but can still be controlled.

In diabetic patients, diet is an important aspect to control the

elevated levels of blood glucose.
Weight loss and exercise is very important because it will increase
the body's sensitivity to insulin, thus helping to control blood glucose
levels increase. Aerobic exercise such as walking, cycling, jogging, and
swimming are encouraged performed regularly for 30 minutes, 3-4 times
a week.

HYPOGLYCEMIA DURING EXERCISE

Sports, no doubt, bring positive effects to the health of patients with
diabetes mellitus. Exercise is one of the recommended ways to control
blood sugar levels and prevent long-term diabetes complications such as
nerve damage and heart disease. However, you should still be mindful
of the risk of blood sugar drop too low, or often referred to as
hypoglycemia
Symptoms of hypoglycemia include:

weakness and fatigue

confused
hungry
tremble

cold sweats
headache
fainting

or seizures (in severe cases)

SPORTS TIPS FOR DIABETES PATIENTS

Activities can be divided into several sessions, each session
of 10-15 minutes. Recommended activities are activities that
increase breathing and heart rate and cause little sweat, such
as walking, gardening, swimming, or cleaning the house. Perform
an increase in the intensity and duration of exercise gradually.

WARNING
Do not do physical activity is too heavy or too long. If you do, your
body will produce hormones adrenaline and other hormones that will
fight insulin function. That way, your blood sugar will increase.

TIPS EXERCISES FOR DIABETES PATIENTS :

Before starting the exercise, patients with diabetes should consult with
their doctor to ensure that the activities are chosen fairly safe practice and
in accordance with the physical circumstances,

Practice with someone who knows that you are a diabetic and knows
what he should do if you are suddenly experiencing hypoglycemic.

Bring snacks during exercise, such as a box of raisins or candy, to be

used if you are experiencing hypoglycemic.

If not accompanied, use bracelets or attribute that indicates that you are
diabetic.

Use shoes and comfortable cotton socks

After the exercise, perform the checks on your feet to look for any
redness, blisters, sores or blisters.

Drink plenty of water before, during and after exercise to prevent

dehydration.

Do not ignore your pain. Immediately stop exercising if you suddenly

feel the pain.

Choose activities that you enjoy doing so that you can live happily
activity regularly.

SPORT FOR PEOPLE WITH DIABETES

Sport is an important activity that should be done every one to stay
healthy. For patients with diabetes mellitus, well controlled or not
controlled, the benefits of exercise even more. The types of exercise is
good for diabetic patients include:

Aerobic

Aerobic exercise makes the heart and bones strong, reduce

stress and improve blood flow. Examples of aerobic exercise that can be
done iswalking briskly, dancing or aerobics class. If you have a
problem with the nerve foot or knee, you should reduce the load on the
foot by choosing swimming, cycling or rowing.

Lifting weights (weight lifting)

Weight training can help improve bone strength and muscle while
burning fat and maintaining bone density.

Stretching (stretching)
Stretching or stretching to prevent muscle cramps, stiffness and
muscle injuries. Several types of flexibility exercises such as yoga
and tai chi involves meditation and breathing techniques to reduce
stress

Other activities?

Choosing up the stairs of the escalator or elevator ride

Parking the car in a place away from the mall entrance

Brisk walking or cycling when there is an opportunity

Playing with the kids

Pet dog a walk

DIABETES FOOT CARE

One complication that often occurs in patients with diabetes
mellitus is a matter of feet. Problems in the feet of people with DM
is caused by two things, namely:

Poor blood flow. This happens because the blood vessel damage
caused by high blood sugar levels for a long time. Impaired blood
flow causes the foot is not getting enough nutrition, so skin
becomes weak legs, easy cuts and difficult to recover in the event
of injury.

Nerve damage. It also occurs due to high blood sugar levels for a
long time. Nerve damage causing a patient's sensitivity to pain DM
is reduced, so that the patient is unconscious when her feet hurt

THANKYOU FOR
YOUR ATTENTION
IS THERE ANY
QUESTION?