type 2 diabetes.L-28 medical students-white & blue colors

Type 2 diabetes.L-28 medical students-white & blue colors

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Unformatted text preview: Type 2 Diabetes in Children Dr. Abdulmoein Al-Agha, MBBS,DCH,CABP, MRCP(UK Consultant, Pediatric Endocrinologist, King AbdulAziz University Hospital, Jeddah . Diabetes mellitus type 2 Is a metabolic disorder that is primarily characterized by insulin resistance, relative insulin deficiency & hyperglycemia It is rapidly increasing in the developed world Has characterized the increase as an epidemic Unlike type 1 diabetes, there is little tendency toward ketoacidosis in Type 2 diabetes, though it is not unknown Complex and multi-factorial metabolic changes lead to damage & function impairment of many organs, most importantly the cardiovascular system Criteria for the Diagnosis of Diabetes Symptoms of diabetes plus random plasma glucose concentration 200 mg/dl (11.1 mmol/l. The classic symptoms of diabetes include: polyuria, polydepsia, and unexplained weight loss. OR FPG 126 mg/dl (7.0 mmol/l. Fasting is defined as no caloric intake for at least 8 h. OR 2-h PG 200 mg/dl (11.1 mmol/l during OGTT The test should be performed as described by W HO using a glucose load containing equivalent of 75-g anhydrous glucose dissolved in water. Pathophysiology Insulin resistance means that body cells do not respond appropriately when insulin is present Other important contributing factors: increased hepatic glucose production (e.g., from glycogen degradation, especially at inappropriate times decreased insulin-mediated glucose transport in (primarily muscles & adipose tissues (receptor and post-receptor defects impaired beta-cell functionloss of early phase of insulin release in response to hyperglycemic stimuli Underlying causes of type 2 diabetes Obesity Insulin resistance -cell defect Impaired glucose tolerance Early diabetes Late diabetes Hyperinsulinaemia Decreased insulin secretion -cell failure Adapted from Saltiel AR. J Clin Invest 2000;106:163164 . Obesity & Type 2 Diabetes Too large meals ! Too high Calories ! Sedentary life style !! Normal The progressive nature of type 2 diabetes Impaired glucose tolerance Type 2 diabetes Fasting plasma glucose Insulin sensitivity Insulin secretion Insulin sensitive Normal insulin secretion Normoglycaemia Hyperglycaemia -cell...
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Type 2 diabetes.L-28 medical students-white & blue colors

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