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Unformatted text preview: Pharmacology-Diabetes and Hypertension: October 5th: [look up others note in email from other students] Diabetes Mellitus: OBJECTIVES: -Diff between type 1/2-The mechanism of action of classes of diabetes mellitus-Recommend management strategies for common ADR Insulin products based on onset/duration of action-Identify common complications/recognize appropriate adjunct treatment agents. Description: Metabolic disorder associated with abnormal carb/fat/and protein metabolism. It is characterized by hyperglycemia. It leads to chronic complications: Cardiovascular diseases, retinopathy, neuropathy?, etc TYPE 1 DIABETES MELLITUS: Autoimmune disorder leading to absolute insulin deficiency. Usually diagnosed in children/young adults. Formerly called Insulin Dependent Diabetes Mellitus. TYPE 2 DIABETES MELLITUS: Progressive insulin resistance. Usually diagnosed in adults, but prevalence is increasing in children/teens. [related to the rise of obesity]. Formerly known as Non-Insulin Dependent Diabetes Mellitus. GESTATIONAL DIABETES: Diagnosed in pregnant patients. Most patient return to normoglycemia following delivery. 30-50% will develop DM2 later in life. [It is considered a risk factor for developing dm2] EPIDEMIOLOGY: Nearly 21 million americans diagnosed [1/4 of total cases undiagnosed]. Estimated economic burden of $132 billion in 2002. It is the leading causes of blindness for ages 20-74, Leading case of end stage of renal disease, Est. 82,000 diabetic limb amputations yearly. [loose feeling in feet, nerves break down, step on something, develop sore, etc etc]-Type 1: 5-10% of cases, Less than 1% of susceptible population [genes] will develop-Type 2: up to 90% of cases. prevalence of 9.6% in age greater than 20. Prevalence increases with age, Variations between race [increase seen in native americans, african americans, hispanic americans, asian americans, and pacific islanders], increased prevalence in children. PATIOPHYSIOLOGY: -Glucose Metabolism: 75% of glucose metabolized by non-insulin dependent tissue (brain/liver/GI tissue) [don't need insulin to process it, they can just take glucose out of the bloodsteam], 25% of glucose is metabolized by muscle which requires insulin [needs insulin to get into the cells]-Fasting glucose production: 85% produced by the liver, 15% produced by the kidney, Glucagon produced by the he pancreas to oppose insulin and stimulate hepatic glucose production. [the anti insulin]-Dietary Glucose/Carb intake: Carb intake increases bld glucose and stimulates insulin release from the pancreas. Increased bld insulin suppresses hepatic glucose production [body says hey, i've got all this sugar i've already eaten, i don't need you to make any, ill just use this sugar], Uptake of glucose by peripheral tissues Glucose Metabolism: Pancreas makes insulin. That works with liver, that converts the glucose to glycogen (stored form of sugar, used by muscle and fat). When bld glucose starts to fall, insulin starts to fall. It is a sort of circuit.starts to fall....
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This note was uploaded on 02/14/2012 for the course PHR 338 taught by Professor Karboski during the Fall '09 term at University of Texas at Austin.
- Fall '09