PHA 3112 Lecture Notes - Lecture 7: Diabetes Mellitus Type 1, Diabetic Ketoacidosis, Diabetes Mellitus Type 2
12 Mar 2018
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Only treatment in early days: near starvation diet (return to case histories) Type 1 diabetes insulin-dependent diabetes mellitus, iddm) Need insulin replacement to live (no c-peptide) Incidence in canada: 20/100,000/yr (increasing 3-4%: hyperglycemia, tiredness, weight loss, polyuria, thirst, polydipsia, nausea and vomiting = impending ketoacidosis. Complications over time: (morality increase 4-7x: microvascular: nephropathy, neuropathy, retinopathy, macrovascular: coronary heart disease. Type 2 diabetes non-insulin-dependent diabetes mellitus (niddm) Can survive w/o (therapeutic) insulin, although may improve control (c-peptide present) Represents at least 90% of diabetic population (mostly older and obese although is increasing in children) Cause: impaired insulin secretion and tissue insensitivity to insulin; strong genetic predisposition. High risk of: atherosclerosis, hypertension, hyperlipidemia & obesity (metabolic syndrome x), myocardial infection. Microvascular complications less common (than in type 1) Mortality: increased 2-3x; life expectancy reduced by 5-10yrs. Elevated blood glucose: increased insulin from pancreatic b cells & peripheral glucose uptake, decreased glucose production, decreased blood glucose.
