written by Sivaram

Jagadeesan

DIABETES BY SIVA
" " ,
,

 Diabetes by Siva

................................................................................................................................................. 2
................. 4
1 .......................................................................................................... 7
2 ......................................................................................................... 11
- 1....................................................... 15
- 2....................................................... 18
............................................................................... 20
........................................ 24

- ............................................................................................................ 26

- ................................................................................................. 29
...................................................................................................................... 33

- - ................................................... 36
- 2 ................................................................................ 40
- 1 - ....................................................... 48

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

 Diabetes by Siva

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written by Sivaram Jagadeesan (Sivaramj@gmail.com)

 Diabetes by Siva
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written by Sivaram Jagadeesan (Sivaramj@gmail.com)

 Diabetes by Siva

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written by Sivaram Jagadeesan (Sivaramj@gmail.com)

 Diabetes by Siva
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written by Sivaram Jagadeesan (Sivaramj@gmail.com)

 Diabetes by Siva
.

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.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

 Diabetes by Siva

1
.
.

1. Insulin Dependent Diabetes Melitus - -1

2. The Insulin-Resistant Diabetic - -2.

. - Latent
Autoimmune Diabetes LADA. 35

-1 -2

. HBA1C 5.5


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written by Sivaram Jagadeesan (Sivaramj@gmail.com)

 Diabetes by Siva
1921

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1922 ( ) 14

.
.

1978
. 1978 -
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written by Sivaram Jagadeesan (Sivaramj@gmail.com)

 Diabetes by Siva
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written by Sivaram Jagadeesan (Sivaramj@gmail.com)

 Diabetes by Siva
.
,
.

-2
( ) .
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

10

 Diabetes by Siva

2
90-95

The Insulin-Resistant Diabetic - -2. -2 .

40 20

. 80

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written by Sivaram Jagadeesan (Sivaramj@gmail.com)

11

 Diabetes by Siva
. .
(hyperinsulinemia - ).

.
. .
.

. ,
.

-2 .

-2 .

-1 . -2
.
, . 35

45
.

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-2 .

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.

: ,

. HBA1C 6

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()

.
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

12

 Diabetes by Siva

.
.

( )

.
.
.

. .
.

.
- ,
-

-
-

-
-

-
- ,

- (PCOS) - . (PCOS
)

HBA1C

HBA1C .

""

. . "" ""
.

" "
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

13

 Diabetes by Siva
. 100
1.30 (1 1.5 2
.
) 130 .
:
-1 , .

-2

.
.

.
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

14

 Diabetes by Siva

- 1

() .

. ()
.

.

-2
.

70 95 .

.
140 .

.
, .
, ,

.
.

.
.
.

. .
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

15

 Diabetes by Siva

.
.

.
. 40

.
.

.
.
,

.
.
.

. ,

. (,
.

).

.
. 40
, 20

. -
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

16

 Diabetes by Siva
.

.
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

17

 Diabetes by Siva

- 2
- 5 .

.
, ,
.

.
. ,

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.
.

-1
.

, -
.
, , (.)

. , 1
5.5 .

(35 ) 80% ,
.

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.
,

.
, .

, () .

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

18

 Diabetes by Siva
,
. .

,
.

,
.
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, .

()

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.

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,
.

,
,
.

.
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

19

 Diabetes by Siva

,
.
, Hba1C:
.

().
80-100, 100-120
. .
.

HBA1C
. ,

.
.
.

24
HBA1C .
200

HBA1C . , , HBA1C
.

(
).

.
.

Serum C-Peptide (-):

- .
-

. ,
. ,

,
.
Complete Blood Count:

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

20

 Diabetes by Siva
.

, ,
.

Serum Ferritin :
,

(-2)
.

Lipid profile :
HDL, LDL, Triglycerides

CRP (C-reactive protein) .

:

.
.

& :

.

24

( )
.

,
.

Insulin-like Growth Factor 1 (IGF-1):

( 300-400 )

,
.
R-R Interval study:

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

21

 Diabetes by Siva
( )

, ,
.

, ,

,
.

180 , 200
,

.

.

,
.

.
:
,
.
:

. ,
,
.

. ,
HBA1C.

.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

22

 Diabetes by Siva

. ,

.
HBA1C , , ,

, ,
, . 50

.
.
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

23

 Diabetes by Siva

,
.

, ,

. ,
,
.

.
.

- ,
, .

- ,
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

24

 Diabetes by Siva
*
*

*
*

* ()
* ,

*
.

Glucograf III
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

25

 Diabetes by Siva

-

.

,
.
1.
2.

3.

,
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20 .

.
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.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

26

 Diabetes by Siva
, , ,

, , ,
.

, , ,

.
.

,
, 36% .
.

. ,
.

0.8
. , /

1.8 2
.
, , ,

, .

.
(, ) .
, ,

.

.

glomerular filtration rate

(GFR).
GFR .

, ,

.

.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

27

 Diabetes by Siva
.
.

, , , , , (100
62 )

.
.
.

.
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

28

 Diabetes by Siva

-

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,
.

,
,

.
30

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,

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.
,

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,

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

29

 Diabetes by Siva
.
.

. .
.

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() .

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.

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,

, .

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.

80%
.
.
.
, ,

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-3 .

: : 20% : 65% : 15%

.
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

30

 Diabetes by Siva

.

. , ,
,
. 2
.

,
,

.
.

.
,

.
.

( )

, , , ,

,
.

,
.

-2

. (atherosclerosis).
(CRP Test reading) ,

. ,

.
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

31

 Diabetes by Siva
.
.

. .
, ;

, .
. .

: 200 .
HDL: , 40
LDL: , 130 .

. ,
. 100
,

.
.
CRP . 2
.

Triglyceride: .
150 .
.

.
(Ketone Bodies) .
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

32

 Diabetes by Siva

.
(ketone bodies) .

,
40 , -2

.
, .

.

()
.

. ,
, , ,

.
.

? .

, .
.

.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

33

 Diabetes by Siva

. ,
.
.

.
.

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.
.
.
.

.
48

.
.

.
, .

,
.

, .
()
.

* -2
.
*

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

34

 Diabetes by Siva
* ,
.

*
*

*
.

* .

* () .

.
*

* (acne)
.

*
*
.
.

.
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

35

 Diabetes by Siva

-
.
,
() .

. .

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, , . , ,

.
.
.

1984
.
, -,
. -

.
.
44 . ,

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, .

, .

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

36

 Diabetes by Siva
.
1. ()
2.

3. ()
:
, , ,

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,

.
.
:
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:
.
.

25 30
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.

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.

.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

37

 Diabetes by Siva
,

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, .

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.

.
.

.
,

? .

. ,

.
40 ,

, 100 , ,

40 .

-2
.
.

*
. ; .

* 40 .

* .
.

*
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

38

 Diabetes by Siva
.
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

39

 Diabetes by Siva

- 2
, ,


.

( ,

, .

.

.

(Oral Hypoglycemic Agents - OHAs) .

* (Insulin sensitizers) -
.

* (Insulin mimetics) - .
* .

() -2

.

.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

40

 Diabetes by Siva

.

.

.

300 ,

, , ,
.

(tyrosine kinase) . ,

.
.
.
. .

,
. ,

,
.
.

, .

.
,

. .

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

41

 Diabetes by Siva
.
.

. .

.
.

,

.

()
.

-2

.
.

, ,

.
, , .

.
Biguanides ():

.
, ,
-2
.

. .

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

42

 Diabetes by Siva

.

( )
, .

(Lactoasidosis)
.

.
,
.

.
.
(
) .

,
.

,
.

- .
-
.

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.
.

,
.

,
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

43

 Diabetes by Siva
. ,

.
(200 )
.

, .

.

() .

,
.

.
.
(

.
.
)

.

.

1940

. , , ,
. 1952
, .

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

44

 Diabetes by Siva
1954 1956
.

,
.

.
. -1 .

. ,
.

.
.

tolbutamide
acetohexamide
tolazamide
chlorpropamide

glipizide
glyburide or glibenclamide
glimepiride
gliclazide
glycopyramide
gliquidone

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

45

 Diabetes by Siva


.
Canagliflozin
Dapagliflozin

,
. ,
,

.
.

Miglitol
Acarbose
Voglibose

(
- 7 )

300 .

, ,
.

, .

. , ,
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

46

 Diabetes by Siva

. , 7
, .
, ,

. 11
,

.
,

, .
.

, ,
.

.
.

( , ,
).

.
, ,

.
.

.

.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

47

 Diabetes by Siva

- 1 -
-1
.

, ,

, 1
. 1
2

1 .

.
.

1
. .

1 2 ?

30 2
1 . 300

.
1 .

.
/
.

. .
.
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

48

 Diabetes by Siva
1

.
.

1. Islet Cell Cytoplasmic Autoantibodies (ICA): ,

(Islet)
. 70-80

2. Glutamic Acid Decarboxylase Autoantibodies (GADA) :

.

3. Insulinoma-Associated-2 Autoantibodies (IA-2A) : #2

.

4. Insulin Autoantibodies (IAA) :

.
.

.
.
.

.
,
.

.
. (

) . , ,
, .
.

40 100

. 100

.
. .
, ( )

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

49

 Diabetes by Siva
.

.
,

, . ,
.
56 80
. .

(Generic names)

.
, , ,
,
.

.
.
. .
.

(Lispro) : 15-30 30-90

3-5
.

(Aspart) : 10-20 40-50

3-5
.

(Glulisine) : 20-30 4-12

18-24
.

written by Sivaram Jagadeesan (Sivaramj@gmail.com)

50