5281 - Diabetes and Cardiovascular Disease Epidemiology...

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TM © 1999 Professional Postgraduate Services ® Diabetes and Cardiovascular Disease Epidemiology Clinical Trials Management Nathan Wong
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TM © 1999 Professional Postgraduate Services ® Diabetes: Scope of Problem At least 10.3 million Americans have been diagnosed with diabetes mellitus, and another 5.4 million are estimated to have undiagnosed diabetes. Onset often precedes diagnosis by several years. About 90% of diabetic patients have Type II diabetes Hispanics, blacks, Native Americans, and Asians (especially South Asians) are especially susceptible to diabetes. Diabetes in women essentially cancels out any hormonal protection.
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TM © 1999 Professional Postgraduate Services ® Diabetes: Type II Diabetes and Insulin Resistance Type II diabetes is most common form, occurring later in life, and involving combination of impaired insulin-mediated glucose disposal (insulin resistance) and defective secretion of insulin by pancreatic beta cells Insulin resistance develops from obesity and physical inactivity and insulin secretion declines with advancing age (and accelerated by genetic factors)
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TM © 1999 Professional Postgraduate Services ® Accelerated atherosclerosis Clinical diabetes Hyperinsulinemia Impaired glucose tolerance Hypertriglyceridemia Decreased HDL-C Essential hypertension Insulin resistance Insulin Resistance and Atherosclerosis: Posited Relationships
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TM © 1999 Professional Postgraduate Services ® Diabetes and the Dysmetabolic Syndrome Insulin resistance often precedes type II diabetes and is often accompanied by other risk factors-- dyslipidemia, hypertension, and prothrombotic factors, the “dysmetabolic syndrome” Impaired fasting glucose (110-125 mg/dl) often accompanies the dysmetabolic syndrome. The threshold for fasting plasma glucose for diagnosis of diabetes has been lowered from 140 mg/dl to 126 mg/dl.
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TM © 1999 Professional Postgraduate Services ® Diabetes: Complications Cardiovascular diseases (CVD) account for about 65% of all deaths in diabetics; those with CVD have a worse prognosis than CVD patients without diabetes. Complications include CHD, stroke, peripheral arterial disease, nephropathy, retinopathy, and possibly neuropathy and cardiomyopathy.
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This note was uploaded on 03/08/2012 for the course PHARM 300 taught by Professor Staff during the Fall '11 term at Rutgers.

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5281 - Diabetes and Cardiovascular Disease Epidemiology...

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