BCHS-4361-09-DIABETE_38364

BCHS-4361-09-DIABETE_38364 - Classification of Diabetes...

Info iconThis preview shows pages 1–10. Sign up to view the full content.

View Full Document Right Arrow Icon
Classification of Diabetes Mellitus by Etiology Type 1 β -cell destruction—complete lack of insulin Type 2 β -cell dysfunction and insulin resistance Gestational β -cell dysfunction and insulin resistance during pregnancy Other specific types Genetic defects of β -cell function Exocrine pancreatic diseases Endocrinopathies Drug- or chemical-induced Other rare forms 11
Background image of page 1

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
I. DIABETES MELLITUS Diabetes mellitus (DM) can be regarded as a disease of glucose homeostasis. It is a chronic disorder characterized by fasting hyperglycemia (>11 mM; >200 mg/dL) at any time of day, or plasma glucose levels above normal during an oral glucose tolerance test (OGTT). An OGTT measures the ability of an individual to handle a high dietary carbohydrate (CHO) level. In the test, subjects fast for ca. 12 h and then ingest a 50-100 g glucose load. Plasma glucose is sampled before ingestion and then two hours later.
Background image of page 2
II. DIABETES MELLITUS: OGTT Interpretation of OGTT: – 2 h postload: glucose: < 7.8 mM; < 140 mg/dL interpreted as normal glucose tolerance. – 2 h postload: glucose 7.8-11.0 mM; 140-199 mg/dL interpreted as impaired glucose tolerance – 2 h postload: glucose >11 mM; >200 mg/dL interpreted as provisional diagnosis of diabetes. The shape of an abnormal glucose tolerance curve will depend on other factors, such as obesity.
Background image of page 3

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Diabetes Mellitus: Type II a Group of Diseases Figure 22-16: Normal and abnormal glucose tolerance tests
Background image of page 4
III. DIABETES MELLITUS: GLYCATION Another diagnostic test is the measurement of glycated hemoglobin. HbA and many other proteins are continuously undergoing a nonenzymatic reaction between glucose and primary (N-terminal or lysyl side chain) amino groups in proteins. Protein-NH 2 + R-CHO forms R-CH=N-protein (Schiff base) which rearranges to R-CH 2 -NH-protein (Amadori product; HbA 1c ) . This a stable glycated product, which can further react and rearrange to form advanced glycation end products (AGE).
Background image of page 5

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
GLYCATION OF HEMOGLOBIN AND OTHER PROTEINS
Background image of page 6
SYMPTOMS OF DIABETES MELLITUS 1. Excessive thirst (=> polydipsia ) 2. Frequent urination ( polyuria ) 3. Excretion of large amounts of glucose in the urine ( glucosuria ) 4. Excessive but incomplete oxidation of fatty acids in the liver Overproduction of ketonebodies ( ketosis ) Acetone, β -hydroxybutyrate Increase of ketone bodies in the blood ( ketoanemia ) Increase of ketone bodies in the urine ( ketouria ) 5. Lowering of blood pH ( ketoacidosis )
Background image of page 7

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
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
Background image of page 8
Undiagnosed diabetes 5.9 million Prevalence of Glycemic Abnormalities in the United States Additional 24.6 million with IGT Diagnosed type 2 diabetes 10 million Diagnosed
Background image of page 9

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Image of page 10
This is the end of the preview. Sign up to access the rest of the document.

Page1 / 36

BCHS-4361-09-DIABETE_38364 - Classification of Diabetes...

This preview shows document pages 1 - 10. Sign up to view the full document.

View Full Document Right Arrow Icon
Ask a homework question - tutors are online