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Unformatted text preview: 11/7/2010 1 N116A 2010 Pathophysiology & Consequences Acute effects of insulin deficiency (effects on C, P & F metabolism) Long term complications Clinical Trials in Diabetes & implications for Nutrition DCCT & EDIC DPP & DPPOS, ACCORD MNT Goals & Recommendations Type 1 Diabetes Autoimmune disease absence of insulin production Impaired Glucose Tolerance Pre-Diabetes Variable etiology Decreased ability to regulate blood glucose Type 2 Diabetes Relative lack of insulin, and decreased or lack of response to insulin at tissues Gestational Diabetes DM developing during pregnancy Fig 17.10 in Text Grouped according to macronutrient substrate metabolism (C, P, F) Insulin deficiency, whether absolute (as in Type 1 DM) or relative (as in Type 2 DM), results in signs and symptoms Polyuria, polyphagia, polydipsia, And also include others such as: ketosis, wt loss, etc. Understand the metabolic pathophysiology behind the clinical manifestations Limited/or No glucose uptake by cells intracellular glucose polyphagia Glucagon stimulates hepatic glucose output hyperglycemia glucosuria occurs when renal threshold for glucose is exceeded osmotic diuresis therefore polyuria occurs dehydration leads to polydipsia Cellular dehydration & shrinking (hyperglycemic, hyperosmolar syndrome) nervous system malfunction (irritability, fatigue, blurred vision) If polyuria is unable to be corrected low blood volume circulatory failure to periphery, kidneys, brain, etc death possible TG synthesis, lipolysis due to counterregulatory hormones FA as energy source...
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This note was uploaded on 11/21/2010 for the course NUT 116A 72876 taught by Professor Steinberg/stern during the Fall '10 term at UC Davis.
- Fall '10