Lecture 6 - 2/18/10 Diabetes
Mellitus 
 •  • ...

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Unformatted text preview: 2/18/10 Diabetes
Mellitus 
 •  •  •  •  Epidemiology
 Diagnosis
 Symptoms
 Treatment
 U.S.
Diabetes
Prevalence 
 •  Diabetes kills 1 American every 3 minutes New case diagnosed every 40 seconds More deaths than AIDS and breast cancer combined Average life expectancy: 15 years less than non-diabetes population Afflicts over 177 million people worldwide 300 million afflicted by 2025 18 Million •  •  •  •  •  World
View 
 •  177
million
worldwide
 •  Leading
cause
of
death
by
disease
 •  India
33
million
people
with
diabetes
 •  China
23
million
people
with
diabetes
 •  PopulaBon
of
diabetes
will
double
to
triple
by
 2025

 •  One
out
of
every
three
Americans
born
today
 will
develop
diabetes
 Time magazine December 2003; CDC Age-adjusted percentage of adults aged ≥20 years with diagnosed diabetes, 2007 Age-adjusted percentage of adults aged ≥20 years who are obese, 2007 MMWR 58:1259-1263, 2009 Age‐adjusted
Percentage
of
U.S.
Adults
Who
 Were
Obese
or
Who
Had
Diagnosed
Diabetes

 Obesity (BMI ≥30 kg/m2) 1994 2000 2008 •  Diagnosis
 •  2
separate
occasions
of
high
 blood
glucose
 •  urine
tesBng
(should
glucose
 be
present?)
 No Data <14.0% 14.0-17.9% 18.0-21.9% 22.0-25.9% >26.0% Diabetes 1994 2000 2008 •  Symptoms:
The
3
Poly’s
 •  Polyuria‐
excess
urine
 •  Polydipsia‐
excess
thirst
 •  Polyphagia‐
excessive
eaBng
 http://www.diabetesandrelatedhealthissues.com/ No Data <4.5% 4.5-5.9% 6.0-7.4% 7.5-8.9% >9.0% CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics 1 2/18/10 Effects/Treatments 
 •  •  •  •  •  Type 2 diabetes affects many organs Type 2 diabetes changes over time Diabetes treatment changes over time Medications to work where the problem is Combinations of medications, because they work at different sites •  Pancreas Transplants •  Dialysis •  Kidney Transplants Hemodialysis 
 Dialysis
between
blood
and
another
fluid
 –  Used
to
compensate
for
impaired
kidney
funcBon
 –  Can
be
done
for
extended
periods,
such
as
when
the
kidneys
have
 failed
and
no
matching
donor
kidney
is
available
 Blood
is
withdrawn
from
an
artery
and
passed
across
a
dialysis
 membrane
 –  toxins
in
the
blood
diffuse
into
the
prepared
soluBon,
while
 necessary
blood
plasma
components
are
either
 •  prevented
from
diffusing
by
puUng
the
same
concentraBon
of
 these
components
in
the
dialysis
fluid
as
in
the
blood
 •  added
to
the
blood
by
increasing
their
levels
in
the
dialysis
 fluid
 –  the
dialyzed
blood
is
then
sent
back
to
the
body
 Kidney
Transplants 
 In
some
cases,
a
kidney
is
so
diseased
that
it
needs
to
be
 replaced
 Kidney
transplants
are
relaBvely
common
 Kidney
transplants
are
highly
successful
transplant
operaBons,
 with
almost
80
percent
paBent
and
organ
survival
rate
aYer
 one
year
 2 ...
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