Disease: WEEK 1 diabetes

Question 1

What is the prevalence of diabetes? How many people are undiagnosed?
Prevalence in NL?

Answer 1

• 463 million people. Undertreat diabetes, (50% globally undiagnosed, don’t know they have high glucose levels)
• Future: 700 million (no of people, life expectancy)
• Netherlands: 1 mil patients, 350.000 not diagnosed (screening)

Question 2

Incidence of diabetes (US)?

Answer 2

• 1.5 mil new patients per year in US. 40% of people will develop type 2 diabetes (lifetime incidence)

Question 3

What types of diabetes are there and how are they developed?

Answer 3

• Type 1: auto-immune disease. No production of insulin (uptake glucose). Usually develops in childhood and patients require lifelong insulin injections.
• Type 2 diabetes: metabolic disorder characterized by hyperglycaemia (high blood sugar) and altered lipid metabolism. Usually develops in adulthood and is associated with a unhealthy
  lifestyle; it is the major form of diabetes.
• Gestational diabetes: state of hyperglycaemia developing during pregnancy

Question 4

Where in the body may problems arise when having diabetes?

Answer 4

• eyes (damage to blood vessels: blindness),
• kidney (damage blood vessels: excess blood glucose overworks: dialyses)
• numbness ( nerve damage: feet),
• Brain (stroke, cerebrovascular disease (impairment bloodflow), cognitive impairment),
• Heart (coronary heart disease)
• Slow healing of wounds.

Question 5

How is screening & diagnosis performed?

Answer 5

• Sweet urine
• Measure glucose levels
• Oral glucose tolerance test (glycemic response)
• Gba1c (glycoselated hemoglobin): indication of past 6 weeks glycemic control

Question 6

Stages in development of type 2 diabetes?

Answer 6

Genetic predisposition + obesity lifestyle factors
= insulin resistance -> normoglycemia (compensatory beta cell) -> impaired glucose tolerance (beta cell failure: early) -> diabetes (beta cell failure: late)

Question 7

How is diabetes treated?

Answer 7

• Lifestyle intervention:
  Weight loss
  Dietary modifications
  Physical activity and exercise
• Drug therapy (tablets)
  Insulin injections

Question 8

What are risk factors for T2DM?

Answer 8

Non-modifiable:
- age
- genetics

Modifiable:
- Overweight
- Physical activity
- diet
- smoking
- alcohol

Other:
- high/low birth weight
- social environment

Question 9

Obesity: higher risk in men or women?

Answer 9

Female gender is associated with twice the risk of being overweight or having obesity.