HLTC07 - Lec 6 - Diabetes (near-verbatim)

9 Pages
Unlock Document

Trinity College Courses
Caroline Barakat

C07 6: Patterns of Chronic Diseases - Diabetes Date: Oct 24, 2012 Slide 2: Lecture Outline  Diabetes Mellitus o Types of Diabetes o Worldwide prevalence of Type 2 Diabetes  In developing world and developed world o Causes/risk factors o Strategies for prevention  Major Project Work Slide 3: Types of Diabetes  Chronic progressive disorder characterized by abnormalities in carbs, fat, and protein metabolism and hyperglycemia (=excess of glucose in the bloodstream; when glucose can’t be broken down and concentrates in blood – signifies diabetes)  Chronic hyperglycemia is associated with damage to many areas  Most complications begin about 10-15 yrs after disease onset and include the following:  Common complications: o Heart disease o High blood pressure o Stroke o Kidney failure o Amputations o Blindness  4 clinical classes of diabetes: o Type 1 diabetes o Type 2 diabetes o Gestational diabetes o Other  Pre-diabetes – recognized clinical state that’s associated with elevated risk of diabetes – this person is now at high risk for developing diabetes and it is recognized by glucose levels Slide 4: Type 1 Diabetes  Results from autoimmune beta cell destruction  Leads to absolute insulin deficiency where there’s: o Abrupt onset of hyperglycemia (glucose accumulating in blood stream) o Ketoacidosis (chemical imbalance when the body becomes far too acidic b/c there’s an accumulation of ketone bodies in blood)  5-10% of all diabetes cases  Associated w/ genetic factors although there’s no known single gene factor that’s known to be the cause of Type 1 diabetes Slide 5: Type 2 Diabetes – diff b/c has multi-hormonal pathophysiology 1 C07 6: Patterns of Chronic Diseases - Diabetes Date: Oct 24, 2012  Usually occurs at a later time:  Insufficient amounts of insulin are produced or the cells are resistant to the biological effects of insulin o Hyperglycemia (=excess glucose in the blood)  Typically progresses from initially being insulin resistant (means it’s not producing as much as it needs to break down all the glucose) then it moves onto post-prandial hyperglycemia eventually to clinical diabetes – it is a slow progression which will require pharmacological intervention  Type 2 diabetes is as serious Type 1 if not properly controlled;  Insulin resistance – postprandial hyperglycemia – clinical diabetes  85% of diabetes cases – more common type worldwide  There’s no ‘mild’ type of diabetes  Type 2 is just as serious as Type 1 if not properly controlled Slide 6: Gestational Diabetes (GDM)  Diagnosed during pregnancy  Pregnancy hormones block the action of maternal insulin causing insulin resistance and hyperglycemia (due to increased glucose in blood)  Women with history of GDM – increased risk of developing Type 2 diabetes o Most of the time, when hormone levels go down/pregnancy over, the diabetes may go away but what is noticed is that there’s a link between ppl who developed GDM and those that develop type 2 diabetes in later age  Women who have GDM tend to have overweight babies Slide 7: Other Types of Diabetes (uncommon)  5% of cases have other causes: o Mutation of a single gene that also causes situation where glucose is no longer broken down o Chromosomal abnormality o Chemically induced diabetes  Enviro chemicals that interfere with normal metabolism of proteins, carbs, glucose  Prediabetes or IGT (impaired glucose tolerance) – raises the risk of developing type 2 diabetes, heart disease and stroke o This happens when blood glucose levels are between normal and diabetic range o At some instances, you’ll be beyond normal range but the person isn’t classified as diabetic o Anything in between the upper limit of the normal range and diabetic range – person classified as impaired glucose tolerance – clinically recognized state IGT/prediabetes o Obesity and physical inactivity are modifiable factors that may reduce risk of progression into Type 2 diabetes for those that are IGT  Physical activity and weight loss by 7% may bring them back to normal levels 2 C07 6: Patterns of Chronic Diseases - Diabetes Date: Oct 24, 2012 Slide 8: World Prevalence – Developing Countries  In developing countries o Cultural changes (going from rural areas to cities): these are common to developing nations; will find that there are diff regional factors but in general there is a cultural change throughout the world and in developing countries, it tends to be more magnified because of globalization and because ppl are going from rural to city – means they are closer to work, closer to each other = less walking)  Less physical activity  Higher rates of obesity  Changes in food availability  Impact of globalization! o Changes in food chains and lifestyle are impacting those in developing countries o Lifestyle and dietary changes are brought about by globalization and diabetes pandemic/epidemic is due to globalization and changes in lifestyle – gives rise to obesity pandemic and sedentary, technology oriented lifestyles Slide 9: Worldwide prevalence – Developed countries – is a bit diff  DM is the 4 or 5 leading cause of death in developed world o There are many reasons behind this o It affects the aging pop’n more, older than 65  Inequities in disease prevalence – poverty limits access to fresh fruit and vegetables, exercise and healthcare o In developed world, see a bit diff trend – see that poverty appears to be related to diabetes – due to limits of accessing good nutritious food, not enough time for exercise and lack of adequate healthcare  Alterations in food production, prep and consumption (ex: invention of microwave ovens, therefore available frozen foods with excessive fats/sugars/sodium – may be related to chronic diseases)  So, in developed country, diabetes linked to low SES because of lifestyle.  Link of age and diabetes in developed world, link of technology and diabetes in developed world and inequities in developed world. Slide 10:  Fig 1. Prevalence of diabetes in diff world regions – prevalence in millions  Based on year 2000 and projected for year 2030 o Prevalence of diabetes in percent = color-coded; darkest orange = more than 8% - mostly Middle East and Egypt – highest rates in the world – due to changes in lifestyle o N.America – 6-8% o Some places don’t have high prevalence – sub-saharan Africa o Projection in N.American from 33 million to 66 million = doubling 3 C07 6: Patterns of Chronic Diseases - Diabetes Date: Oct 24, 2012 o In Africa – more than 2 fold – from 7 to 18 million o In Europe – 33 and 48 million in 2030 o Potentially due to changes in demography o Middle East – tripled – going from 15 to 42 million o In Australia/Asia – from 82 million to 190 million - doubled o Huge increases projected for year 2030; demography Slide 11:  Fig 1. o Scale based on bubble size o Taken from 2 diff maps – try to magnify so that it can be proportionate o Prevalence worldwide based on bubble size o China = 90 million; Russia = 12.6 million o Gives idea of burden of this disease throughout the world o These are the prevalences, not prevalence rates/percentages which can give you a diff picture o Colors indicate whether high income, middle or low income  This isn’t really a problem related to low income countries  It is a problem related to high income countries  Low income countries are getting there but it’s not quite there yet  It is an epidemic – 146 million cases of diabetes worldwide – we must control it Slide 12: Prevalence of Diabetes worldwide  Fig 3. Prevalence of diabetes among adults based on the income of the country  Prevalence percentages based on where they fall in terms of income – it is definitely a middle/high income problem  Problem related to low income – also on the rise  Projected numbers – 2030 – in every single category – projected to increase  Mortality rates related to diabetes tend to be very high o More ppl die in lower income countries because not enough money spent for healthcare for ppl with diabetes Slide 13: Risk Factors – 1) Inactivity – ppl aren’t burning off what they eat as they should  Work-related physical activity reduced o Technology makes life easier but there’s less physical activity  Leisure-time physical activity also low  Time spent outdoors very low  Walking – most of the roads are paved, for cars – travelling in cars; urban planning, some places don’t even have sidewalks, safety, things are at a distance 4 C07 6: Patterns of Chronic Diseases - Diabetes Date: Oct 24, 2012 Slide 14:  2) Technology o Typical child watches 40,000 commercials on TV; many of them are food ads – exposes kids and adults to nutritionally poor foods o TV  Sit in front of TV; eating popcorn; tend to eat the same food that they see on TV  Sedentary lifestyle o Cars o Video games o Internet shopping  Has to do with time availability o Email o Personal digital assistants o Availability of tech means that ppl aren’t doing as much things on the go – sedentary lifestyle Slide 15:  3) Changes in diet o Westernization of diet is related to economic development – diabetes in developing countries – moving throughout the world
More Less

Related notes for TRN125Y1

Log In


Don't have an account?

Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.