Your SlideShare is downloading. ×
0
Type 2 Diabetes –
Type 2 Diabetes –
Type 2 Diabetes –
Type 2 Diabetes –
Type 2 Diabetes –
Type 2 Diabetes –
Type 2 Diabetes –
Type 2 Diabetes –
Type 2 Diabetes –
Type 2 Diabetes –
Type 2 Diabetes –
Type 2 Diabetes –
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Type 2 Diabetes –

286

Published on

Basic overview and description of Type II Diabetes

Basic overview and description of Type II Diabetes

Published in: Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
286
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
15
Comments
0
Likes
1
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. TYPE 2 DIABETES – THE #1 PREVENTABLE CHRONIC DISEASE! Dorothy D. Zeviar 17 April 2009
  • 2. WHAT IS TYPE 2 DIABETES?
    • The inability of insulin to act to get glucose into the cells
      • Sometimes called “insulin resistance”
      • Causes hyperglycemia – too much glucose in the bloodstream and not enough in the cell
    • “ Lock and key mechanism”
  • 3. WHAT HAPPENS IN TYPE 2 DIABETES?
    • Cells require glucose (sugar) and oxygen to survive
      • Cellular respiration
      • C 6 H 12 O 6 + 6O 2  6CO 2 + 6H 2 O + 38 ATP
    • Cells receive both from the bloodstream
    • When insufficient glucose is available to the cells, the liver tries to compensate by releasing glucagon (a counter-regulatory hormone).
    • When this is insufficient, the body compensates thru lipolysis and proteolysis (attempting to get its energy requirements thru breakdown of fats and proteins).
  • 4. WHAT HAPPENS, con’t.
    • Hyperglycemia in the bloodstream  fluid and electrolytes imbalances  osmotic diuresis 
      • Polyuria  dehydration and loss of electrolytes 
      • Polydipsia  cell starvation 
      • Polyphagia  starvation mode 
      • Lipolysis  fatty acids  Kussmaul breathing/fruity breath 
      • Metabolic acidosis
      • Hyperviscosity of blood 
      • HTN 
      • Hypoperfusion 
      • Kidney and cardiac insufficiencies, etc
      • Neuropathies
      • Necrosis  amputations
      • Erectile dysfunction
  • 5. WHAT HAPPENS, con’t
  • 6. WHAT HAPPENS IN VASCULATURE?
    • Microvasculature
      • Sugar “scars” the epithelium, making it more porous 
      • Large pores and structural changes in basement membrane
      • Chronic ischemia due to lack of oxygen exchange 
      • Tissue hypoxia  skin ulcers
      • Tissue hypoxia  necrosis  amputations
      • Retinopathy  blindness
      • Neuropathy  permanent loss of fx
    • Macrovasculature
      • Tissue hypoxia  coronary heart disease, CVA, PVD
      • Tissue “scarring”  platelet agglutination  clots/occlusion 
      • AS, MI  left ventricular dysfx, heart failure
      • Hyperglycemia  albuminuria  nephron occlusion  Kidney failure
  • 7. RISK FACTOR CORRELATES OF DIABETES
    • Highly correlated with HTN, obesity, sedentary lifestyles, poor nutrition/poor glucose control
    • HTN > 140/90 mm Hg
    • BMI > 25
    • LDL > 130 mg/dl
    • HDL < 40 mm/dl
    • Triglycerides > 250 mg/dl
    • History of frequent yeast infections
    • History of poor/slow wound healing
    • Increased risk for infection
    • Poor oral hygiene
  • 8. EPIDEMIOLOGY OF TYPE 2 DIABETES
    • Seventh leading cause of death in US
    • 17 million people or 6+% of population
    • 6 million people are undiagnosed with diabetes
    • Prevalence same for men and women
    • Incidence higher among African-Americans, Native Americans and Hispanic-Americans
    • 20% of healthcare dollars is spent on people w/ diabetes
    • 88 million disability days
    • 176,000 cases of permanent disability -- $7.5 billion!
  • 9. LABS AND DIABETES
    • Blood glucose values dx Diabetes
    • Fasting blood glucose -- two separate test results > 126 mg/dL
    • Oral glucose tolerance test -- blood glucose > 200 mg/dL after 120 mins
    • Glycoselated hemoglobin assay -- HbA1c -- “sugar-coated” RBCs long-term glycemic control > 8%
    • Ketoneuria  ketoacidosis
    • Proteinuria  kidney failure
  • 10. MEDICATIONS AND DIABETES
    • Oral therapy
      • Sulfonylurea agents stimulate remaining beta cells  insulin  risk of hypoglycemia
      • Caution w/ warfarin, beta-blockers, Ca+ channel blockers, H 2 antagonists, MAO inhibitors, NSAIDS, tetracycline, anti-fungals, steroids, thiazide diuretics, Lasix, estrogen, thyroxine
      • Biguanides (metformin) decrease cellular resistance, so no risk of hypoglycemia
    • Insulin
      • Short-acting (Humulin R), intermediate-acting (NPH, Humulin N), Lente (Humulin L), Long-acting (Humulin U, glargine)
      • Basal insulin levels = 40-50U daily; maintained by pancreas secretions
  • 11. KEY TEACHING POINTS FOR DIABETES
    • Controlling glycemic levels
    • Hypoglycemia
    • Diet
    • Exercise
    • Foot care
  • 12. THE END IS THE BEGINNING! 

×