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Update on Diabetes 2010
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Update on Diabetes 2010

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Presented by Wanda Andrews, PA-C at Men's Health 2010

Presented by Wanda Andrews, PA-C at Men's Health 2010

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  • From beta cell dysfunction
  • Glyburide, Glipizide, Glimepuride
  • Prandin, Starlix
  • Metformin
  • Actos, Avandia
  • Precose, Glyset
  • Januvia, Onglyza
  • Isolated from the saliva of the Gila monster lizard

Update on Diabetes 2010 Update on Diabetes 2010 Presentation Transcript

  • Update on diabetes 2010
    • Men’s Health
  • High blood sugar
  • Energy/Fuel
  • Magic Numbers
    • Fasting glucose over 100
    • Fasting glucose of 126 twice
    • AIC – glucose average 6.5 or greater
  •  
  • Where do we get sugar?
  •  
  •  
  • Symptoms - dilution
  • Why?
  •  
  •  
  • Damage to Cells
  • Genetics
  • Stressing the Pancreas
  • Inflammation
  •  
  • Complications
  • Other causes of Inflammation
  • Overall Risk
    • Blood sugar
    • Blood pressure
    • Cholesterol
    • Smoking
    • Aspirin
  • Belly Fat
  •  
  • Prevalence
    • Age 20 years or older: 23.5 million or 10.7% of all people in this age group have diabetes.
    • Age 60 years or older: 12.2 million or 23.1% of all people in this age group have diabetes.
    • Men : 12.0 million or 11.2% of all men aged 20 years or older have diabetes.
  • Future? 36 million in 2025?
  • Prevention
    • Stop stressing the pancreas!
    • Start Exercising
    • Weight loss
  • Medications
    • Increase insulin production
    • Reduce insulin resistance
    • Reduce spikes of glucose after meals
    • Reduce glucose released by the liver
    • Supplement the body’s production of insulin
  • Treatment
  •  
  • Insulin stimulation
  • Stimulate insulin right after eating
  • Reduce insulin resistance reduce glucose production by liver
  • Allow insulin to enter cells
  • Prevent the digestive system from absorbing insulin
  • Promote Incretins – keeps you blood sugar in a more normal range after eating
  • Injectable Medications
  • Insulin
    • Rapid-acting
    • Short-acting
    • Intermediate-acting
    • Long-acting
    • Pre-mixed
    • Vials or pens
  •  
  •  
  • Incretin Mimetics – GLP-1
    • Lower glucose by increasing insulin secretion when glucose levels are elevated (after eating)
    • Injected with meals?
    • Twice a day?
    • Once a day?
    • Once a week?
  •  
  •  
  • Amylin/Symlin
    • Another hormone deficient in diabetes
    • Works with insulin to reduce glucose levels
    • Used with insulin at meals
    • Reduce hypoglycemia
    • Reduce appetite
    • ? Weight loss
  •  
  • Insulin Pump
  •  
  •  
  • What else can we do?
  • For a transplant
    • Need 2 or more pancreases
    • Insulin independent for only 2 years
    • Side effects from procedure and drugs are significant
  • Not enough insulin producing cells
    • Lets make more?
    • 1960’s : first pancreas transplants
    • 1972: islet cells transplanted in rats
    • 1980: Large animal work with islets
    • 1989: First serious human transplants of islet cells – depressing results
    • 2009: Pancreas Transplantation
  • Islet Cells
  • Transplanted Islets
    • Not enough islet cells
    • Islets transplanted are “sick”
    • Loss of Islets with transplantation
    • Gradual loss of effective working of the islet cells over time
  • Other problems
    • 4000 pancreases available
    • Every year 35,ooo new cases of type 1 diabetes
    • 50% of the pancreases accepted for transplant produce useful islet cells
    • 4 pancreases needed for each recipient
  • Artificial Pancreas?
  • What else can we do?
    • Prevention
    • Adopt diabetes care guidelines in healthcare
    • Monitor outcomes in the treatment of diabetes
    • Education
    • Involve communities in diabetes control activities
  • Teach your children well… * A code you can live by * Teach them when you see the truth Crosby, Stills Nash and Young, 1970 * Don’t let them stress their pancreas * Keep them moving