1. DIABETES MELLITUS TYPE II NON INSULIN DEPENDENT DIABETES (NIDDM)

2. PREVALANCE The most prevalent form of DM ≈ 95% cases of DM ≈ 20% of Saudi Adults 50% Polynesians 6-7% in western countries

3. PATHOGENESIS ß Cell dysfunction Insulin resistance Insulinopenia Increased Hepatic glucose production

4. CLINICAL PRESENTATIONS - WIDE VARIATION Found by chance on routine screening Symptoms Polyurea Polydipsia Fatigue Manifest after the development of complications Obesity ≈ 80% of patients Most patients diagnosed after the age of 40

5. DIAGNOSIS Random > 200mg/dl ≥11.1 M.MOL /L Fasting > 126mg/dl ≥7.8 M.MOL /L

6. DIAGNOSIS Continue Transient:- Stress (physical/emotional) Infection Trauma Medication Hormonal Other diseases

7. CLINICAL FEATURES Acute symptoms of (non control) Polyurea – Polydipsea – weight loss- fatigue-mascular cramps-infections-D.KA Late complications Microangiopathy Retinopathy Nephropathy Neuropathy Macroangiopathy Myocardial/Infarction (I.H.D) Cerebro – vascular accident Atherosclerosis

8. OUTLINE OF MANAGEMENT Life style changes (prevention) Obesity Exercise Food Education Diet Total calorie intake Soluble sugars Diet plans Exercise Drugs Insulin PLAN

9. OUTLINE OF MANAGEMENT continues Compliance Monitoring Associated Disease Complication Early detection & treatment Support Psychological Social Financial Medical

10. THANK YOU