Epidemiology & Pathophysiology of T2DM Flashcards
what is the prevalence of diabetes in adults(20-79) across the world
1 in 11 adults have diabetes, 463 million people
what fraction of people with diabetes are undiagnosed
1 in 2
what % of people with diabetes live in low/middle income countries
79%
how has the prevalence of diabetes in Scotland changed from 2001-2019
tripled, prevalence was 5.7% in 2019
what % of people with diabetes in Scotland have type 2 diabetes
87.9%
what is the risk of the offspring of someone with T2DM developing the disease
lifetime risk of 40%, not inevitable driven by lifestyle
what is the risk of twins developing T2DM if other one has, even if separated from birth
76%
what type of genetic disease is T2DM
polygenic ‘common complex disease’
ie 1000s of genetic variants that all contribute a little diabetes risk
what is the polygenic risk score of T2DM
summing up of all genetic variants
what % of people with T2DM are obese or overweight
overweight = 31.6%
obese = ~55%
~86% total
(important to remember not all with T2DM are overweight, but majority are)
are all obese people insulin resistant
no some obese people are not insulin resistant and many do not develop T2DM
describe what the fat storage threshold is in relation to T2DM
insulin resistance occurs when people can no longer safely store fat in s/c adipose tissue, so causes spill over of FFA to viscera
some ‘healthy’ obese people are able to store lots of fat in s/c
what is the direct effect of obesity and lack of activity
adiposity exceeding fat storage threshold, increased FFA and adipokines
at what point in T2DM can obesity result in insulin resistance(liver, pancreas + muscles)
after adiposity exceeds fat storage threshold(lipotoxicity)
what is the physiological response in people with normal beta-cells to insulin resistance
compensation with increase in insulin production, can maintain euglycaemia
