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2LA2 UNIT 2 module- diabetes.docx

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Peter Helli

AlterationsinHormonalRegulationsDIABETESOBJECTIVESReadingsFunctions of glucose fats and proteins in meeting energy needs of the bodyActions of insulin w reference to glucose fats and protein metabolismMeaning of counterregulatory hormones and describe actions of glucagon epinephrine growth hormone and glucocorticoid hormones in regulation of blood glucose lvls ModuleCurrent Can trends in prevalence of diabetes mellitusEtiology of diabetes comparing type 1 and 2 diabetes mellitus and gestational diabetes Describe glucose fat and protein metabolismIdentify glucoseregulating hormones and their functionPathophysiology of type 1 and 2 diabetes mellitusPathogenesis of diabetes mellitus to clinical manifestations and evaluation of this disease Scientific rational for interventions and for patient teaching Short termsT1DMType 1 diabetes mellitusT1ADType 1 A diabetes mellitusT1BDType 1B diabetes mellitusT2DMtype 2 diabetes mellitusGDMGestational diabetes mellitusotherDiabetes will be used interchangeably w diabetes mellitusDiabetesexcessive excretion of urineDiabetes mellitusDisorder of carbohydrate fat and protein metabolism w absolute or relative insulin deficiency Diabetes insipiduswill not be covered in the module PREVALENCE OF DIABETES20062007 prevalence of diagnosed diabetes increased by 4 from previous year and 21 from 20022003 to 20062007Type 2 DM accounts for approx 90 of diabetes cases Type 1 DM accounts for 102 million 1 in 16 Can dx w diabetes 20062007According to Can Diabetes Association 9 mill Can live w diabetes or prediabetes Overall prevalence 62 59 F62 MPrevalence of dx diabetes in children 03 is lower than adults 64 1Among adults the prevalence increases w age from 2 30 yrs peeking at 23 or 1 in 5 adults 7579 yrs Consequences premature death and complications ie increase risk of heart disease stroke kidney disease blindness amputation and erectile dysfunction80 w diabetes will die as a result of heart disease or stroke Type 1 diabetics life expectancy may be shorten by 15 yrs Type 2 diabetes life expectancy may be shortened by 510 yrs Financial burdenPersonal annual medical cost 100015 000Diabetes est to cost 169 billionyr by 2020 ETIOLOGY TYPE 1 DMCharacterized into 2 types1Autoimmune Type 1A Accounts for 9095 T1D cases Autoimmune mediated specific loss of beta cells in pancreatic islets LangerhansAs a whole T1D includes cases of diabetes that result of beta cell destruction leading to insulin deficiency and is prone to ketoacidosisResult of a geneticenv Interaction GenesoMHC genes on chromosome 6 encode leukocyte antigens HLADQ and HLADR Specifically HLA DR3HLA DR4 is associated w increase risk of T1ADM thats 2040x higher than that of the general population Some leukocyte antigens are thought to decrease the risk of T1D ie HLA DR2oThere is also insulin gene which regulates beta cell replication and function on chromosome 11There will most likely be a polygenic inheritance of T1D meaning susceptible individuals have more than 1 genetic polymorphismBtwn 1013 ppl w newly diagnosed T1D have a firstdegree relative w T1D Identifying genes w predisposed individuals to diabetes has advantages and disadvantages Pros and cons to genetic testing is worth thinking about as it become relevant in most clinical practice areas oAutoantibodies specific to beat cell destruction includeInsulin autoantibodiesIslet cell autoantibodiesAntibodies directed at other islet auto antigens ie glutamic acid decarboxylaseGADtyrosine phosphatase IA2 oEnv factorsDrugschemicalsNutritional intakeViruses2
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