# Diabetes Mellitus: Epidemiology, Pathophysiology & Management
> Explore a comprehensive guide on Diabetes Mellitus covering global prevalence, T1D and T2D classifications, diagnosis criteria, and clinical management.

Tags: diabetes-mellitus, endocrinology, public-health, medical-education, type-2-diabetes, pathophysiology, clinical-guidelines
## Diabetes Mellitus Overview
* Comprehensive look at epidemiology, etiology, pathophysiology, and management.

## Global Epidemiology
* 2021: 537 million adults affected.
* 2030 projection: 643 million.
* 2045 projection: 783 million.
* ~80% of cases are in low- and middle-income countries.

## Introduction & Classifications
* **Definition:** Chronic metabolic disorder defined by hyperglycemia.
* **Type 1:** Autoimmune beta-cell destruction.
* **Type 2:** Insulin resistance and relative deficiency (96% of cases).

## Etiology & Risk Factors
* Genetics/Family history.
* High BMI/Obesity (leading driver of T2D disability).
* Sedentary lifestyle and diet high in processed foods.

## Pathophysiology
* **Insulin Resistance:** Failure of muscle, fat, and liver to respond to insulin.
* **Beta-Cell Dysfunction:** Pancreatic failure to overcome resistance.
* **Metabolic Syndrome:** Damage leading to heart disease and nephropathy.

## Clinical Manifestations
* **Symptoms:** Polyuria, polydipsia, polyphagia, fatigue, and blurred vision.
* **Acute Complications:** Ketoacidosis (T1D) and Hyperosmolar Hyperglycemic State (T2D).
* **Chronic Issues:** Retinopathy, neuropathy, stroke, and heart disease.

## Diagnosis Criteria
* **Fasting Plasma Glucose:** ≥126 mg/dL.
* **Oral Glucose Tolerance Test (2-hour):** ≥200 mg/dL.
* **Hemoglobin A1C:** ≥6.5%.
* **Random Glucose:** ≥200 mg/dL with symptoms.

## Non-Pharmacological Management
* Medical Nutrition Therapy (MNT).
* Physical Activity: 150+ minutes/week.
* Weight Management: 5-10% weight loss target.
* Continuous glucose monitors (CGM) for adherence.

## Pharmacological Management
* **First-Line:** Metformin.
* **GLP-1 Receptor Agonists:** e.g., semaglutide (weight loss & cardioprotection).
* **SGLT2 Inhibitors:** e.g., empagliflozin (heart & kidney protection).
* **Insulin:** Essential for Type 1 and advanced Type 2.

## Public Health Observation
* Nearly 45% of diabetes cases remain undiagnosed worldwide, highlighting a need for early screening.
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