11:15 - Metabolic Syndrome and Diabetes

11:15 - Metabolic Syndrome and Diabetes - Diabetes and...

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Unformatted text preview: Diabetes and Metabolic Syndrome Reading: Gropper 4 th ed, Ch 4, p. 107; Ch 8, pp. 253255 Gropper 5 th ed, Ch 3, p. 105; Ch 7, pp. 276277 Overview of Metabolic Syndrome (Slides With Audio) (18:40) http://www.medscape.com/viewarticle/577141 2 Objectives for today: Diabetes Types 1 and 2 Metabolic consequences Metabolic syndrome: Link between obesity and chronic diseases 3 ALL CAUSES 2,425,901 Diseases of the heart 629,191 (710,760 in 2002) Malignant neoplasms (cancer) 560,102 (553,091 in 2002) Cerebrovascular disease (stroke) 137,265 (167,661 in 2002) Chronic lower respiratory disease 124,614 Unintentional injuries (accidents) 117,748 Alzheimers disease 72,914 Diabetes mellitus 72,507 (69,301 in 2002) Pneumonia and influenza 56,247 Nephritis, nephrotic syndrome, and nephrosis 44,791 Septicemia 34,031 Leading Causes of Death, All Races and Both Genders, U.S. (NCHS, CDC, U.S. Department of Health and Human Services, 2006) Rank Order and Number of Deaths 4 Diabetes mellitus Characterized by hyperglycemia and glucosuria (passing large amounts of sweet urine) Type 1 Insulin-dependent (IDDM) Type 2 Non-insulin-dependent (NIDDM) Formerly, Juvenile DM and Maturity-onset DM Compare with diabetes insipidus (passing large amounts of tasteless urine) Caused by deficiency in pituitary antidiuretic hormone (ADH/vasopressin) or kidney insensitivity to ADH 5 Type 1 Diabetes Autoimmune disease Destruction of pancreatic -cells, loss of insulin production Usually appears in childhood and adolescence Symptoms Polyuria Polydypsia Polyphagia Develops rapidly (weeks or months) 6 p. 253a Type 1 Diabetes 7 Diagnostic tests Fasting blood glucose (12 hrs/overnight) Normal = 70105 mg/dl Oral glucose tolerance test (OGTT) 8 Oral Glucose Tolerance Test Measurement of the ability of cells to secrete insulin Ability of insulin to lower blood glucose Normal persons rise in blood [glucose] after drinking solution is reversed to normal in 2 hrs Insert fig. 19.8 9 Table 8-1, p. 241 10 10 Type 1 Diabetes Consequences of lack of insulin resemble starvation (Designed to maintain blood glucose for needs of central nervous system and red blood cells) Decreased glucose uptake by tissues Decreased lipogenesis in depots Increased hepatic glucose output Excessive hepatic ketogenesis Increased protein catabolism causes muscle wasting 11 11 Type 1 Diabetes But glucose levels are already high Hyperglycemia exacerbated by physiologic response Dehydration Osmotic diuresis (loss of water and electrolytes) Kidneys cannot reabsorb excessive glucose (glucosuria) Worsened by ketosuria Hyperpnea Abnormally rapid breathing due to metabolic acidosis Increases insensible transpiration (loss of water vapor) 12 12 Fig. 8-9, p. 238 Fasting state 13 13 Fig. 6-27, p. 154 14...
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This note was uploaded on 11/25/2011 for the course NTR 342 taught by Professor Tillman during the Spring '09 term at University of Texas at Austin.

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11:15 - Metabolic Syndrome and Diabetes - Diabetes and...

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