L 25 T2DM Background Flashcards
What is Diabetes Mellitus?
Metabolic disorder result high level or Blood glucose
When diabetes occurs?
- Body doesn’t make ANY insulin
2. Body doesn’t make enough/effective insulin
What may cause diabetes to patients?
Increase urination Thirsty Weight loss Tired Poor circulation
Difference between Type 1 vs Type ii
Type 1 isInsulin dependent. Type ii is not
T1DM onset and cause
Early age of people show its onset, is a chronic autoimmune disease caused by immune destruction of Beta islet cells
What % of diabetics are T1DM?
5-10%
T2DM onset and cause
Adult onset, insulin deficiency due to B islet cell dysfunction and insulin resistance
Latent autoimmune diabetes (LADA) of the Adult has features of…
T1 and T2 diabetes show same features to patient
LADA is another type diabetes we can say patients are usually adult obese and less active.
What nations have the highest prevalence of diabetes?
Pacific nations
Is T2DM environment or genetic?
Both, genetic factors exert their effects after exposure to obesogenic environment
What is metabolic syndrome
A cluster of conditions like excess nutrition, insufficient exercise, and a genetic predisposition, that increase the risk of heart disease, stroke, and diabetes, usually due to obesity.
Diagnosis of metabolic syndrome is determined by
Elevated:
- Waist circumference
- TGs
- Blood pressure
- Fasting glucose
What are the Outcomes of Metabolic syndrome?
30% increase in mortality
2x risk of stroke and heart disease
5x risk of diabetes
Vein thrombosis
What is HbA1c and what is it used for?
Hb with glucose bound (glycosylated Hb).
It is a measure of chronic exposure to glucose in the blood,over the previous 8-12 weeks.
Policies recommended for obesity in NZ
- Sugar tax
- Education!!
- Reduction in fizzy drink serving sizes
- Healthy eating policies in schools and ECEs
- Junk food marketing restrictions
T2DM in NZ who is at higher risk?
Pacific & disabled 13 and 15% accordingly
Nutrition advice for T2DM
More whole grains, fruits, nuts, legumes.
Less processed grains, meats, sweetened beverages.
Is diabetes polygenic or monogenic?
Polygenic
Pathogenesis of T2DM and insulin resistance
B cell function decline caused decreased insulin production.
Also can get insulin resistance when the insulin receptors are no longer sensitive to insulin secretions due to previously sustained high blood glucose.
Macrovascular complications of T2DM
CVD, Brain diseases, Peripheral vascular disease (extremities)
Microvascular complications of T2DM
Kidney, retina and nervous system (neuropathy)
Co-morbidities common with T2DM
Depression, non alcoholic fatty liver, obstructive sleep apnoea
What is the prevention of T2DM
Prevent reduced B cell function and loss
Diet and exercise
Current key molecular targets for T2DM
GLP-1 and SGLT-2
Biggest prevention for T2DM:
Weight loss and healthy diet
Obesity in NZ?
12.4 of children are obese.
And 31.9% is overweight.
T2DM has how many proportion concordance with identical twins?
70%
T2DM has how many proportion concordance with both parents T2DM?
70%