Update on diabetes 2010 <ul><li>Men’s Health </li></ul>
High blood sugar
Energy/Fuel
Magic Numbers <ul><li>Fasting glucose over  100 </li></ul><ul><li>Fasting glucose of  126  twice </li></ul><ul><li>AIC – g...
 
Where do we get sugar?
 
 
Symptoms - dilution
Why?
 
 
Damage to Cells
Genetics
Stressing the Pancreas
Inflammation
 
Complications
Other causes of Inflammation
Overall Risk <ul><li>Blood sugar </li></ul><ul><li>Blood pressure </li></ul><ul><li>Cholesterol </li></ul><ul><li>Smoking ...
Belly Fat
 
Prevalence <ul><li>Age  20  years or older:  23.5  million or  10.7%  of all people in this age group have diabetes.  </li...
Future? 36 million in 2025?
Prevention <ul><li>Stop stressing the pancreas! </li></ul><ul><li>Start Exercising </li></ul><ul><li>Weight loss </li></ul>
Medications <ul><li>Increase insulin production </li></ul><ul><li>Reduce insulin resistance </li></ul><ul><li>Reduce spike...
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 <ul><li>Rapid-acting </li></ul><ul><li>Short-acting </li></ul><ul><li>Intermediate-acting </li></ul><ul><li>Long-a...
 
 
Incretin Mimetics – GLP-1 <ul><li>Lower glucose by increasing insulin secretion when glucose levels are elevated (after ea...
 
 
Amylin/Symlin <ul><li>Another hormone deficient in diabetes </li></ul><ul><li>Works with insulin to reduce glucose levels ...
 
Insulin Pump
 
 
What else can we do?
For a transplant <ul><li>Need 2 or more pancreases  </li></ul><ul><li>Insulin independent for only 2 years </li></ul><ul><...
Not enough insulin producing cells <ul><li>Lets make more? </li></ul><ul><li>1960’s : first pancreas transplants </li></ul...
Islet Cells
Transplanted Islets <ul><li>Not enough islet cells </li></ul><ul><li>Islets transplanted are “sick” </li></ul><ul><li>Loss...
Other problems <ul><li>4000 pancreases available </li></ul><ul><li>Every year 35,ooo new cases of type 1 diabetes </li></u...
Artificial Pancreas?
What else can we do? <ul><li>Prevention </li></ul><ul><li>Adopt diabetes care guidelines in healthcare </li></ul><ul><li>M...
Teach your children well… * A code you can live by * Teach them when you see  the truth Crosby, Stills Nash and Young, 197...
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Update on Diabetes 2010

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

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  • Update on Diabetes 2010

    1. 1. Update on diabetes 2010 <ul><li>Men’s Health </li></ul>
    2. 2. High blood sugar
    3. 3. Energy/Fuel
    4. 4. Magic Numbers <ul><li>Fasting glucose over 100 </li></ul><ul><li>Fasting glucose of 126 twice </li></ul><ul><li>AIC – glucose average 6.5 or greater </li></ul>
    5. 6. Where do we get sugar?
    6. 9. Symptoms - dilution
    7. 10. Why?
    8. 13. Damage to Cells
    9. 14. Genetics
    10. 15. Stressing the Pancreas
    11. 16. Inflammation
    12. 18. Complications
    13. 19. Other causes of Inflammation
    14. 20. Overall Risk <ul><li>Blood sugar </li></ul><ul><li>Blood pressure </li></ul><ul><li>Cholesterol </li></ul><ul><li>Smoking </li></ul><ul><li>Aspirin </li></ul>
    15. 21. Belly Fat
    16. 23. Prevalence <ul><li>Age 20 years or older: 23.5 million or 10.7% of all people in this age group have diabetes. </li></ul><ul><li>Age 60 years or older: 12.2 million or 23.1% of all people in this age group have diabetes. </li></ul><ul><li>Men : 12.0 million or 11.2% of all men aged 20 years or older have diabetes. </li></ul>
    17. 24. Future? 36 million in 2025?
    18. 25. Prevention <ul><li>Stop stressing the pancreas! </li></ul><ul><li>Start Exercising </li></ul><ul><li>Weight loss </li></ul>
    19. 26. Medications <ul><li>Increase insulin production </li></ul><ul><li>Reduce insulin resistance </li></ul><ul><li>Reduce spikes of glucose after meals </li></ul><ul><li>Reduce glucose released by the liver </li></ul><ul><li>Supplement the body’s production of insulin </li></ul>
    20. 27. Treatment
    21. 29. Insulin stimulation
    22. 30. Stimulate insulin right after eating
    23. 31. Reduce insulin resistance reduce glucose production by liver
    24. 32. Allow insulin to enter cells
    25. 33. Prevent the digestive system from absorbing insulin
    26. 34. Promote Incretins – keeps you blood sugar in a more normal range after eating
    27. 35. Injectable Medications
    28. 36. Insulin <ul><li>Rapid-acting </li></ul><ul><li>Short-acting </li></ul><ul><li>Intermediate-acting </li></ul><ul><li>Long-acting </li></ul><ul><li>Pre-mixed </li></ul><ul><li>Vials or pens </li></ul>
    29. 39. Incretin Mimetics – GLP-1 <ul><li>Lower glucose by increasing insulin secretion when glucose levels are elevated (after eating) </li></ul><ul><li>Injected with meals? </li></ul><ul><li>Twice a day? </li></ul><ul><li>Once a day? </li></ul><ul><li>Once a week? </li></ul>
    30. 42. Amylin/Symlin <ul><li>Another hormone deficient in diabetes </li></ul><ul><li>Works with insulin to reduce glucose levels </li></ul><ul><li>Used with insulin at meals </li></ul><ul><li>Reduce hypoglycemia </li></ul><ul><li>Reduce appetite </li></ul><ul><li>? Weight loss </li></ul>
    31. 44. Insulin Pump
    32. 47. What else can we do?
    33. 48. For a transplant <ul><li>Need 2 or more pancreases </li></ul><ul><li>Insulin independent for only 2 years </li></ul><ul><li>Side effects from procedure and drugs are significant </li></ul>
    34. 49. Not enough insulin producing cells <ul><li>Lets make more? </li></ul><ul><li>1960’s : first pancreas transplants </li></ul><ul><li>1972: islet cells transplanted in rats </li></ul><ul><li>1980: Large animal work with islets </li></ul><ul><li>1989: First serious human transplants of islet cells – depressing results </li></ul><ul><li>2009: Pancreas Transplantation </li></ul>
    35. 50. Islet Cells
    36. 51. Transplanted Islets <ul><li>Not enough islet cells </li></ul><ul><li>Islets transplanted are “sick” </li></ul><ul><li>Loss of Islets with transplantation </li></ul><ul><li>Gradual loss of effective working of the islet cells over time </li></ul>
    37. 52. Other problems <ul><li>4000 pancreases available </li></ul><ul><li>Every year 35,ooo new cases of type 1 diabetes </li></ul><ul><li>50% of the pancreases accepted for transplant produce useful islet cells </li></ul><ul><li>4 pancreases needed for each recipient </li></ul>
    38. 53. Artificial Pancreas?
    39. 54. What else can we do? <ul><li>Prevention </li></ul><ul><li>Adopt diabetes care guidelines in healthcare </li></ul><ul><li>Monitor outcomes in the treatment of diabetes </li></ul><ul><li>Education </li></ul><ul><li>Involve communities in diabetes control activities </li></ul>
    40. 55. 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

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