DM epedimiology,aetiology and patio physiology W1 Flashcards
What is type one diabetes?
Insulin dependent
What is type two diabetes?
Non-insulin independent
What is secondary diabetes?
One to 2% of new new cases are secondary diabetes
There is a known underlying cause and treating the course can remove the diabetes
Examples can include liver disease, pancreatic disease, endocrine disease and drug induced disease
What is gestational diabetes?
Diabetes during pregnancy, usually in the second or third trimester
Affects 3 to 4% of pregnancies
Caused by insulin resistance
Usually managed by diet, but may need insulin
Risk of large birth weight baby
Usually return to normal following delivery
epidemiology of diabetes
Worldwide in 2017 there was 425 million cases and this will rise to 629 million cases by 2045
There is still up to 1,000,000 people diagnosed in the UK alone
One person is diagnosed every two minutes
Epidemiology of type one diabetes
Accounts for 8% of all patients with diabetes
It is highest in Caucasians
It is lowest in Japan and Pacific areas
It can present any age but prominently a disease of childhood peeking at puberty
Epidemiology of type two diabetes
It is more common than type one accounting for 90% of all patients with diabetes
It increases with age and obesity
African/Caribbean or 3 to 4 times more at risk
Aetiology of type one diabetes
Is a Human leukocyte antigen associated immune mediated disease (HLA) - caused by immune system
HLA is a marker for immune disease
> 90 of T1 diabetes is carry HLA-DR3 marker
Autoantibodies are created by body and destroy its own pancreatic cells
Not genetically predetermined but there is an increased susceptibility to disease may be inherited
Your lifetime risk is increased if a family member has diabetes
Diabetes family risk percentages type one
A child of a type one diabetic is 3 to 6% likely to have diabetes
Having a sibling with type one diabetes gives you a 3% chance of developing diabetes
Your twin having type one diabetes gives you 30 to 50% chance of getting diabetes
Aetiology of type two diabetes
Stronger genetic relationship than type one
Obesity occurs in 80% of people
There is increased insulin resistance and decreased number of cells
Low birth weight and weight at 12 months but it’s not proven and can develop glucose intolerance later in life
Diabetes family risk percentages type two
If your twin has type two then it is 100% for the other twin
If you are a child of type two diabetic, you are 5 to 10% at risk of getting diabetes
What is metabolic syndrome?
A combination of medical disorders and when occurring together, they increase the risk of CVD and type two diabetes
- Increased blood pressure
- Increased blood glucose
- Increased central abdominal obesity
- Increased cholesterol
Pathophysiology of diabetes
There is a decreased mass of B cells equals decreased insulin produced
- In type one there is less than 5 to 10% remaining of original B sell mass
- In type two there is 50% remaining of original B cell mass which is a target in drug therapy
There is unregulated hepatic glycogen analysis and gluconeogenesis in both type one and type two
