MODULE 4 DIABETES MELLITUS - Module 4 DIABETES MELLITUS KEY TERMS Counter regulatory hormones Dawn phenomenon Diabetes Fasting blood glucose Glucagon

MODULE 4 DIABETES MELLITUS - Module 4 DIABETES MELLITUS KEY...

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Module 4: DIABETES MELLITUS KEY TERMS: Counter regulatory hormones Dawn phenomenon Disabesity Diabetes Fasting blood glucose Gestational diabetes Glucagon Gluconeogenesis Glycated hemoglobin (HbA1C) Glycogenolysis Hypoglycemia Insulin Insulin resistance Metabolic syndrome Nephropathy Neuropathy Oral glucose tolerance test Polydipsia Polyphagia Polyuria Random blood glucose Somatostatin Somogyi effect Type 1 diabetes Type 2 diabetes LEARNING OUTCOMES Upon conclusion of this unit the student will: 1.Describe current Canadian trends in the prevalence of diabetes mellitus.2.Compare the etiology of type 1 and type 2 diabetes.3.Consider the etiology of gestational diabetes.4.Describe carbohydrate,fat and protein metabolism.5.Identify and discuss the roles of glucose-regulating hormones.6.Compare and contrast the pathophysiological events that occur in type 1 and type 2 diabetes.7.Make links between the pathogenesis of diabetes mellitus and the clinical manifestations common to this disease.8.Describe the diagnostic criteria for diabetes mellitus (DM) and pre-diabetes according to the 2013 Canadian Clinical Guidelines by the Canadian Diabetes Association.9.Discuss the scientific rationale for selection of interventions in the management of diabetes. Page 1071-110 DIABETES MELLITUS PART 1 Diabetes actually means excessive excretion of urine . Diabetes mellitus refers to the disorder of carbohydrate, fat and protein metabolism with absolute or relative insulin deficiency. PREVALANCE OF DIABETES In 2008/09 the estimated prevalence of diagnosed diabetes amongst Canadian was 6.8% (2.4 million) o Approximately half of new cases diagnosed in individuals age 45-64 o Estimated to rise to 3.7 million Canadian by 2019 Type 2 DM accounts for app 90% of diabetes cases >10 million Canadian live with diabetes or prediabetes o Prevalence of diabetes lower in children than adults (2008/2009) o Prevalence higher in males (7.2%) than females (6.2%) (2008/2009) Personal costs of premature death and complications Financial burden o Personal annual medical cost $1000 - $15 000 o Diabetes estimated to cost $16.9 billion/year by 2020 ETIOLOGY TYPE 1 DM
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Autoimmune Type 1A Autoimmune mediated specific loss of beta cells in the pancreatic islets Langerhans (leads to absolute insulin deficiency and is prone to ketoacidosis.) Genetic-environment interaction Genes o MHC genes on chromosome 6 encode leukocyte antigens HLA-DQ and HLA-DR ( HLA-DR3 and HLA-DR4 is associated with an increased risk of type 1A diabetes that is 20 to 40 times higher than that of the general population.) HLA-DR2 are thought to decrease type 1 diabetes o Chromosome 11 – insulin gene regulating beta cell replication and function Autoantibodies : insulin autoantibodies, islet cells autoantibodies, antibodies directed at other islet autoantigens (glutamic acid decarboxylase-GAD & tyrosin phosphatase IA-2) Environmental factors : drugs & chemicals; nutritional intake; viruses o Alloxan, Streptozotocin and Vacor as well as certain drugs such as Pentamidine have been associated with type 1 diabetes o
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