Part 3 Diabetes 2018 posted.ppt - HNSC 3310 Macronutrients...

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HNSC 3310 Macronutrients and Human Health Part 3 Diabetes Fall 2018
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Diabetes Chapter 30 (13 th edition Chapter 31) Medical Nutrition Therapy for Diabetes Mellitus and Hypoglycemia of Non-diabetic Origin See tabs and sub-topics About Diabetes (**Diabetes Dictionary) Diabetes and You Short videos at Diabetes=“to flow through” and mellitus=“honey- like” (sweet-tasting) urine
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A Timeline 1552 BC: earliest known mention of diabetes, on papyrus, Egypt 1869: German medical student Paul Langerhans identifies 2 systems of pancreatic cells, one later named Islets of Langerhans 1911: Benedict Solution developed to measure sugar levels in urine 1921: Canadians Banting, Best, Collip & McLeod discover insulin (pancreatic extract) 1922: injected children (comatose, dying from diabetic ketoacidosis) at Toronto General Hospital
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A Timeline 1923: Nobel prize in Medicine in 1923 1959: Diabetes recognized as having 2 forms, type 1 and type 2 1966: First pancreas transplant performed at University of Manitoba 1983: First biosynthetic human insulin is introduced 1999: Edmonton Protocol transplants insulin- producing islets from donor’s pancreas into diabetic recipient’s liver, resulting in production of insulin
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DM-1 DM-2 Not used: insulin- dependent (IDDM) or Type I ~5% of DM Usually juvenile onset (can be adulthood) Genetic component: twin studies More common in Caucasians Not used: non-insulin dependent (NIDDM) or Type II ~90% of DM Usually maturity onset >30 yrs but now in youth (adolescents) Genetic predisposition & environmental factors (diet & lifestyle) All groups; High incidence in Aboriginal, Hispanic, African American, Polynesian
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DM-1 DM-2 Destruction of -cells; autoimmune disease; Insulin deficiency: Hypoinsulinemia Usually ‘lean’ but increasing incidence of overweight & obesity Balance insulin injections, diet & activity Ketosis-prone Enlarged -cells & eventually -cell exhaustion Insulin resistance: Hyperinsulinemia Insulin resistance associated with obesity (but lean DM-2 possible) Diet, weight loss; oral agents; insulin (later stages) Ketosis-resistant (except Youth with DM-2 may present with DKA =diabetic ketoacidosis )
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The Disease Continuum 9 million Canadians (or 1 in 4) are living with diabetes (3 million) or pre-diabetes (6 million) Diabetes is expected to cost $12.2 Billion in 2010 (twice the costs in 2000)
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Practice Guidelines Be aware that these documents exist – Information you need to know is on the slides and handouts. 2013 Clinical Practice Guidelines for the Management of Diabetes in Canada (and 2015 and 2016 updates), specific chapters listed: Nutrition Therapy Chapter: PDF for this chapter will be available on UMLearn
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Diagnosis of Diabetes Based on blood glucose concentration casual plasma glucose > 11.1 mmol/L and classic symptoms of diabetes = polyuria, polydipsia,
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