The document discusses insulin resistance (IR) from various perspectives. It begins by explaining the importance of understanding IR as a measurable parameter that can provide insights into various conditions. It then covers topics such as assessing IR, the epidemiology of IR, the role of IR in type 1 diabetes, metabolic syndrome, obesity, hypertension, polycystic ovarian syndrome (PCOS), and other issues. The document emphasizes that IR underlies many common health problems and that measuring and managing IR can help address these conditions clinically.
1. Genetic syndromes of severe insulin resistance include rare monogenic defects that result in conditions like leprechaunism (Donohue syndrome) and Rabson-Mendenhall syndrome. These are caused by mutations in the insulin receptor gene that produce nonfunctional or impaired insulin receptors.
2. Leprechaunism is the most severe form, characterized by intrauterine growth retardation, fasting hypoglycemia, and death in the first 1-2 years of life. It results from autosomal recessive mutations that create inactive insulin receptors. Rabson-Mendenhall syndrome is also autosomal recessive but milder, causing growth abnormalities and androgen excess.
Insulin resistance is caused by decreased biological response to normal insulin levels and is often seen with conditions like diabetes, metabolic syndrome, obesity, and pregnancy. It can cause an inability to focus, increased hunger, weight gain, and high blood pressure. Insulin resistance is associated with increased insulin production by the pancreas and can lead to diabetes, cardiovascular disease, and other health issues. It involves defects in insulin signaling pathways involving proteins like PKB, IRS, and PI3 kinase. Treatment involves lifestyle changes and medications to lower blood sugar and insulin levels.
The document provides information about insulin resistance and related mechanisms. It discusses how insulin resistance is caused by factors like obesity, inflammation, oxidative stress, and microbial dysbiosis. It outlines key regulators of insulin sensitivity including PPARγ, mTOR, AMPK, sirtuins, and miRNAs. The document promotes QIAGEN products for analyzing gene expression and signaling pathways involved in insulin resistance and related conditions.
Insulin resistance occurs when cells become less responsive to insulin. It can be caused by genetic or diet-induced factors, with obesity being the most common cause. Insulin resistance is associated with inflammation, oxidative stress, and lipid accumulation in tissues like muscle and fat cells. Disrupted gut microbiota may also contribute by impacting energy harvest and metabolite production. Regulators of insulin sensitivity include PPARγ, AMPK, mTOR, and sirtuins, which control pathways involved in glucose and fatty acid metabolism. Gene expression analysis using PCR arrays can help study mechanisms of insulin resistance.
This document discusses insulin resistance (IR) and its relationship to various medical conditions. It begins by defining IR and describing methods to assess it, then discusses its epidemiology and links to type 1 diabetes, metabolic syndrome, obesity, hypertension, polycystic ovarian syndrome (PCOS), and other issues. Management of IR focuses on lifestyle changes, diet, exercise and medication when needed. Prevention of diabetes is also emphasized given IR's role in increasing risk.
Insulin Resistance A Challenge In Diabetes ManagementMrs Aissa Rim
This document discusses insulin resistance as a challenge in diabetes management. It provides statistics on the prevalence of diabetes worldwide, which is projected to double by 2030. Insulin resistance develops due to defects in insulin receptors and target tissues. It can result from genetic and lifestyle factors like obesity and physical inactivity. Insulin resistance leads to hyperglycemia and impaired glucose tolerance and can progress to type 2 diabetes if not managed properly through diet, exercise and medication.
The document discusses various methods for directly assessing insulin resistance, including the hyperinsulinemic euglycemic clamp, which is considered the gold standard. It involves infusing high levels of insulin while frequently measuring blood glucose to maintain normal levels, and the glucose infusion rate required is a measure of insulin sensitivity. Other direct methods discussed are the hyperglycemic clamp to measure insulin secretion, insulin tolerance test, and minimal model analysis of intravenous glucose tolerance tests.
1. Genetic syndromes of severe insulin resistance include rare monogenic defects that result in conditions like leprechaunism (Donohue syndrome) and Rabson-Mendenhall syndrome. These are caused by mutations in the insulin receptor gene that produce nonfunctional or impaired insulin receptors.
2. Leprechaunism is the most severe form, characterized by intrauterine growth retardation, fasting hypoglycemia, and death in the first 1-2 years of life. It results from autosomal recessive mutations that create inactive insulin receptors. Rabson-Mendenhall syndrome is also autosomal recessive but milder, causing growth abnormalities and androgen excess.
Insulin resistance is caused by decreased biological response to normal insulin levels and is often seen with conditions like diabetes, metabolic syndrome, obesity, and pregnancy. It can cause an inability to focus, increased hunger, weight gain, and high blood pressure. Insulin resistance is associated with increased insulin production by the pancreas and can lead to diabetes, cardiovascular disease, and other health issues. It involves defects in insulin signaling pathways involving proteins like PKB, IRS, and PI3 kinase. Treatment involves lifestyle changes and medications to lower blood sugar and insulin levels.
The document provides information about insulin resistance and related mechanisms. It discusses how insulin resistance is caused by factors like obesity, inflammation, oxidative stress, and microbial dysbiosis. It outlines key regulators of insulin sensitivity including PPARγ, mTOR, AMPK, sirtuins, and miRNAs. The document promotes QIAGEN products for analyzing gene expression and signaling pathways involved in insulin resistance and related conditions.
Insulin resistance occurs when cells become less responsive to insulin. It can be caused by genetic or diet-induced factors, with obesity being the most common cause. Insulin resistance is associated with inflammation, oxidative stress, and lipid accumulation in tissues like muscle and fat cells. Disrupted gut microbiota may also contribute by impacting energy harvest and metabolite production. Regulators of insulin sensitivity include PPARγ, AMPK, mTOR, and sirtuins, which control pathways involved in glucose and fatty acid metabolism. Gene expression analysis using PCR arrays can help study mechanisms of insulin resistance.
This document discusses insulin resistance (IR) and its relationship to various medical conditions. It begins by defining IR and describing methods to assess it, then discusses its epidemiology and links to type 1 diabetes, metabolic syndrome, obesity, hypertension, polycystic ovarian syndrome (PCOS), and other issues. Management of IR focuses on lifestyle changes, diet, exercise and medication when needed. Prevention of diabetes is also emphasized given IR's role in increasing risk.
Insulin Resistance A Challenge In Diabetes ManagementMrs Aissa Rim
This document discusses insulin resistance as a challenge in diabetes management. It provides statistics on the prevalence of diabetes worldwide, which is projected to double by 2030. Insulin resistance develops due to defects in insulin receptors and target tissues. It can result from genetic and lifestyle factors like obesity and physical inactivity. Insulin resistance leads to hyperglycemia and impaired glucose tolerance and can progress to type 2 diabetes if not managed properly through diet, exercise and medication.
The document discusses various methods for directly assessing insulin resistance, including the hyperinsulinemic euglycemic clamp, which is considered the gold standard. It involves infusing high levels of insulin while frequently measuring blood glucose to maintain normal levels, and the glucose infusion rate required is a measure of insulin sensitivity. Other direct methods discussed are the hyperglycemic clamp to measure insulin secretion, insulin tolerance test, and minimal model analysis of intravenous glucose tolerance tests.
OBESITY, INSULIN RESISTANCE AND POLYCYSTRIC OVARIAN SYNDROMEShakilur Rahman
Obesity, insulin resistance, and polycystic ovarian syndrome (PCOS) are interrelated. PCOS is characterized by hyperandrogenism and irregular periods and is the most common endocrinopathy in women of reproductive age. Both obesity and PCOS can cause each other - obesity can cause insulin resistance which leads to hyperinsulinemia and hyperandrogenism, all of which contribute to PCOS, while PCOS makes weight control difficult and contributes to obesity. Insulin resistance is a key factor linking obesity and PCOS.
Insulin resistance occurs when cells become insensitive to insulin and the body produces more insulin to help cells use glucose. A diet high in carbohydrates can cause this over time. Insulin resistance leads the body to store sugar as fat rather than use it for energy, slowing metabolism. It also causes excessive insulin and glucose in the bloodstream, accelerating aging and increasing risks of diseases like heart disease. Symptoms include inability to lose weight despite dieting, fatigue, and health issues related to high blood sugar, cholesterol, or blood pressure.
1) The document discusses cellular signaling in diabetes, specifically insulin receptor substrate 1 (IRS1). IRS1 plays a key role in insulin signaling transduction and glucose uptake.
2) Resistance to insulin in skeletal muscle, the primary site of glucose disposal, is a major factor in type 2 diabetes. This resistance is due to impaired insulin signal transduction and defects in IRS1 phosphorylation and activation of downstream targets.
3) Multiple molecular mechanisms can contribute to insulin resistance in type 2 diabetes, including elevated free fatty acids, chronic inflammation, mitochondrial dysfunction, and serine phosphorylation of IRS1 by kinases like JNK and PKC, which inhibit insulin signaling.
1. Insulin resistance and impaired insulin secretion lead to elevated hepatic glucose production and hyperglycemia in type 2 diabetes.
2. The decreased uptake of glucose by tissues like muscle results in high blood glucose levels.
3. Over time, the persistent hyperglycemia can damage organs and tissues, worsening insulin resistance and beta-cell function in a vicious cycle.
Metabolic syndrome is defined by a constellation of interconnected factors that increase the risk of cardiovascular disease and diabetes. It is caused by abdominal obesity and insulin resistance due to genetic and lifestyle factors like poor diet, sedentary behavior, and stress. The main pathophysiological mechanisms are chronic inflammation from excess abdominal fat, dyslipidemia, hypertension, and impaired glucose tolerance. Treatment involves lifestyle modifications like weight loss through calorie restriction and increased physical activity as well as medications targeting obesity, blood sugar, blood pressure, and cholesterol.
1. Obesity is defined as a BMI of 30 kg/m2 or higher and is a growing global problem affecting over 1.7 billion people worldwide.
2. Factors that contribute to obesity include increased caloric intake, decreased energy expenditure, genetics, and behavioral/cultural influences.
3. Medical complications of obesity include increased risk of heart disease, stroke, diabetes, cancers, and other serious diseases. Losing weight can significantly improve health outcomes.
The document proposes a research study investigating biomarkers for Type 2 Diabetes Mellitus. It reviews literature showing that adiponectin and leptin levels negatively correlate with diabetes risk while homocysteine and inflammatory markers like TNF-α and CRP positively correlate. The study aims to determine associations between these biomarkers and examine factors like obesity, ethnicity and age. Blood samples would be collected from diabetic and non-diabetic controls to measure biomarker levels and correlations.
Intermittent fasting and metabolic syndromefathi neana
Dr. Fathi Neana discusses metabolic syndrome and its impact on the musculoskeletal system. Metabolic syndrome is reaching epidemic proportions and is associated with obesity, diabetes, gout, and other conditions that can cause surgical difficulties and complications. Intermittent fasting is presented as a potential strategy for correcting metabolic abnormalities and managing conditions associated with metabolic syndrome like type 2 diabetes.
Obesity is rising globally despite increased knowledge about diet and exercise. Risks include heart disease, stroke, diabetes, and some cancers. Factors causing obesity include an evolutionary tendency to efficiently store calories combined with current low activity, high calorie diets. Appetite is regulated by hormones that signal fullness or hunger. Gut hormones like GLP-1 and leptin help regulate food intake while ghrelin stimulates appetite. Adipose tissue also secretes hormones that impact metabolism.
This document summarizes different aspects of diabetes mellitus (DM) and insulin. It defines DM as characterized by elevated blood sugar levels due to lack of insulin. It describes the two main types of DM, and discusses HbA1c levels, insulin secretion, the conversion of proinsulin to insulin, and the storage and metabolic effects of insulin. The document also outlines the mechanisms of insulin action in the liver, muscle, and adipose tissue, describes various insulin preparations and their durations of action, and discusses potential adverse effects and mechanisms to reduce blood sugar levels, including sulfonylureas, biguanides, thiazolidinediones, alpha-glucosidase inhibitors, GLP-1 analogs, and D
This document discusses ectopic fat deposition in non-adipose tissues and the concept of lipotoxicity. It begins by outlining the physiological roles of fat tissue and triglycerides in energy storage. It then discusses the negative effects of excess fat accumulation, describing how too much visceral fat is associated with metabolic complications. The document explores how lipid accumulation in the liver, muscles, pancreas and other tissues can impair organ function and insulin sensitivity through lipotoxicity. It examines the mechanisms of lipotoxicity and discusses lifestyle and pharmacological interventions that may help treat lipotoxicity and non-alcoholic fatty liver disease.
With a growing number of conditions being grouped under the ‘umbrella’ of autoimmune disease, supporting clients who are, increasingly, presenting with various, and often multiple, autoimmune conditions, can appear complex at first glance.
In this webinar, Dr Danielle Crida outlines a clinical protocol that can support most autoimmune conditions, and takes a deep dive into the role of the immune system and key inflammatory processes at play.
Diabetes mellitus is characterized by hyperglycemia due to insufficient insulin production or ineffective insulin. There are two main types - type 1 diabetes results from autoimmune destruction of insulin-producing pancreatic beta cells, while type 2 diabetes involves insulin resistance along with relative insulin deficiency. Insulin regulates carbohydrate, fat, and protein metabolism, maintaining blood glucose levels. Glucagon has opposing effects, promoting gluconeogenesis and glycolysis to increase glucose levels. Tight regulation of insulin and glucagon secretion is needed to keep glucose within its narrow physiological range.
The document discusses metabolic syndrome (MetS), also known as syndrome X. MetS is defined as a constellation of interconnected factors that increase the risk of cardiovascular disease, diabetes, and mortality. It commonly includes central obesity, elevated blood pressure, high blood glucose, excess body fat around the waist. The pathophysiology involves chronic low-grade inflammation and insulin resistance linked to obesity, genetic susceptibility, and lifestyle factors. Treatment focuses on lifestyle modifications like weight loss, dietary changes, and physical activity as well as medications.
1. Type 2 diabetes results from insulin resistance in the liver and peripheral tissues like muscle, as well as relative insulin deficiency. This leads to elevated hepatic glucose production and reduced glucose uptake in tissues.
2. Sustained hyperglycemia can cause glucotoxicity and further impair insulin secretion and action, exacerbating the disease. It also increases renal glucose reabsorption above normal levels, causing glucosuria.
3. Over time, this pathophysiology can damage target organs and increase the risk of diabetes complications if not properly treated. Treatment aims to reduce hyperglycemia through medications that increase insulin secretion and action or decrease hepatic glucose production.
By Juliana C N Chan, MBChB, MD, FRCP Professor of Medicine & Therapeutics, Director, Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China
The document discusses hypothalamic obesity caused by damage to the hypothalamus. It summarizes that the hypothalamus regulates energy balance and appetite. Damage to medial hypothalamic nuclei disrupts these circuits, leading to unopposed appetite activation and deficient responses to satiety signals. This causes hypothalamic obesity characterized by uncontrolled appetite, fatigue, and morbid obesity. Treatments aim to restrict appetite, increase energy expenditure, or bypass portions of the stomach and intestine.
This document discusses several studies related to omega-3 fatty acids and their effects on cardiovascular health markers. One study showed that a 1 g/day dose of Omacor (an omega-3 supplement) increased the omega-3 index in subjects' blood from 3.6% to 5.4% on average, but about 16% of subjects did not achieve an EPA+DHA level over 4.8%. The same study reduced the arachidonic acid to EPA ratio from 20 to 7.2. Another section discusses the role of transcription factors like NF-kB in inflammatory conditions and diseases.
This document discusses the underlying pathophysiology of type 2 diabetes, specifically insulin resistance and beta-cell dysfunction. It notes that insulin resistance, where tissues do not respond properly to insulin, is a major defect in type 2 diabetes and closely associated with obesity. Beta-cell dysfunction refers to the reduced ability of pancreatic beta cells to secrete insulin in response to high blood glucose levels. Over time, the combination of insulin resistance and beta-cell dysfunction leads to chronically high blood glucose levels and a diagnosis of type 2 diabetes. The document recommends that treatment of type 2 diabetes should target these underlying defects by addressing insulin resistance through medications like thiazolidinediones in addition to other antidiabetic agents.
This document discusses insulin resistance and related topics. It begins with a brief history of insulin resistance and defines it as a failure of target organs to respond normally to insulin. It then discusses various factors that can contribute to insulin resistance, including obesity, diet, genetics, and certain drugs. The document also discusses the metabolic syndrome, which includes insulin resistance along with other risk factors. It provides diagnostic criteria for metabolic syndrome and discusses treatments like weight loss, exercise, and dietary changes. The rest of the document discusses various proteins and cytokines secreted by adipose tissue, such as leptin, adiponectin, resistin, and TNF-alpha, and their roles in insulin resistance. It also discusses how lack of adipose tissue can
OBESITY, INSULIN RESISTANCE AND POLYCYSTRIC OVARIAN SYNDROMEShakilur Rahman
Obesity, insulin resistance, and polycystic ovarian syndrome (PCOS) are interrelated. PCOS is characterized by hyperandrogenism and irregular periods and is the most common endocrinopathy in women of reproductive age. Both obesity and PCOS can cause each other - obesity can cause insulin resistance which leads to hyperinsulinemia and hyperandrogenism, all of which contribute to PCOS, while PCOS makes weight control difficult and contributes to obesity. Insulin resistance is a key factor linking obesity and PCOS.
Insulin resistance occurs when cells become insensitive to insulin and the body produces more insulin to help cells use glucose. A diet high in carbohydrates can cause this over time. Insulin resistance leads the body to store sugar as fat rather than use it for energy, slowing metabolism. It also causes excessive insulin and glucose in the bloodstream, accelerating aging and increasing risks of diseases like heart disease. Symptoms include inability to lose weight despite dieting, fatigue, and health issues related to high blood sugar, cholesterol, or blood pressure.
1) The document discusses cellular signaling in diabetes, specifically insulin receptor substrate 1 (IRS1). IRS1 plays a key role in insulin signaling transduction and glucose uptake.
2) Resistance to insulin in skeletal muscle, the primary site of glucose disposal, is a major factor in type 2 diabetes. This resistance is due to impaired insulin signal transduction and defects in IRS1 phosphorylation and activation of downstream targets.
3) Multiple molecular mechanisms can contribute to insulin resistance in type 2 diabetes, including elevated free fatty acids, chronic inflammation, mitochondrial dysfunction, and serine phosphorylation of IRS1 by kinases like JNK and PKC, which inhibit insulin signaling.
1. Insulin resistance and impaired insulin secretion lead to elevated hepatic glucose production and hyperglycemia in type 2 diabetes.
2. The decreased uptake of glucose by tissues like muscle results in high blood glucose levels.
3. Over time, the persistent hyperglycemia can damage organs and tissues, worsening insulin resistance and beta-cell function in a vicious cycle.
Metabolic syndrome is defined by a constellation of interconnected factors that increase the risk of cardiovascular disease and diabetes. It is caused by abdominal obesity and insulin resistance due to genetic and lifestyle factors like poor diet, sedentary behavior, and stress. The main pathophysiological mechanisms are chronic inflammation from excess abdominal fat, dyslipidemia, hypertension, and impaired glucose tolerance. Treatment involves lifestyle modifications like weight loss through calorie restriction and increased physical activity as well as medications targeting obesity, blood sugar, blood pressure, and cholesterol.
1. Obesity is defined as a BMI of 30 kg/m2 or higher and is a growing global problem affecting over 1.7 billion people worldwide.
2. Factors that contribute to obesity include increased caloric intake, decreased energy expenditure, genetics, and behavioral/cultural influences.
3. Medical complications of obesity include increased risk of heart disease, stroke, diabetes, cancers, and other serious diseases. Losing weight can significantly improve health outcomes.
The document proposes a research study investigating biomarkers for Type 2 Diabetes Mellitus. It reviews literature showing that adiponectin and leptin levels negatively correlate with diabetes risk while homocysteine and inflammatory markers like TNF-α and CRP positively correlate. The study aims to determine associations between these biomarkers and examine factors like obesity, ethnicity and age. Blood samples would be collected from diabetic and non-diabetic controls to measure biomarker levels and correlations.
Intermittent fasting and metabolic syndromefathi neana
Dr. Fathi Neana discusses metabolic syndrome and its impact on the musculoskeletal system. Metabolic syndrome is reaching epidemic proportions and is associated with obesity, diabetes, gout, and other conditions that can cause surgical difficulties and complications. Intermittent fasting is presented as a potential strategy for correcting metabolic abnormalities and managing conditions associated with metabolic syndrome like type 2 diabetes.
Obesity is rising globally despite increased knowledge about diet and exercise. Risks include heart disease, stroke, diabetes, and some cancers. Factors causing obesity include an evolutionary tendency to efficiently store calories combined with current low activity, high calorie diets. Appetite is regulated by hormones that signal fullness or hunger. Gut hormones like GLP-1 and leptin help regulate food intake while ghrelin stimulates appetite. Adipose tissue also secretes hormones that impact metabolism.
This document summarizes different aspects of diabetes mellitus (DM) and insulin. It defines DM as characterized by elevated blood sugar levels due to lack of insulin. It describes the two main types of DM, and discusses HbA1c levels, insulin secretion, the conversion of proinsulin to insulin, and the storage and metabolic effects of insulin. The document also outlines the mechanisms of insulin action in the liver, muscle, and adipose tissue, describes various insulin preparations and their durations of action, and discusses potential adverse effects and mechanisms to reduce blood sugar levels, including sulfonylureas, biguanides, thiazolidinediones, alpha-glucosidase inhibitors, GLP-1 analogs, and D
This document discusses ectopic fat deposition in non-adipose tissues and the concept of lipotoxicity. It begins by outlining the physiological roles of fat tissue and triglycerides in energy storage. It then discusses the negative effects of excess fat accumulation, describing how too much visceral fat is associated with metabolic complications. The document explores how lipid accumulation in the liver, muscles, pancreas and other tissues can impair organ function and insulin sensitivity through lipotoxicity. It examines the mechanisms of lipotoxicity and discusses lifestyle and pharmacological interventions that may help treat lipotoxicity and non-alcoholic fatty liver disease.
With a growing number of conditions being grouped under the ‘umbrella’ of autoimmune disease, supporting clients who are, increasingly, presenting with various, and often multiple, autoimmune conditions, can appear complex at first glance.
In this webinar, Dr Danielle Crida outlines a clinical protocol that can support most autoimmune conditions, and takes a deep dive into the role of the immune system and key inflammatory processes at play.
Diabetes mellitus is characterized by hyperglycemia due to insufficient insulin production or ineffective insulin. There are two main types - type 1 diabetes results from autoimmune destruction of insulin-producing pancreatic beta cells, while type 2 diabetes involves insulin resistance along with relative insulin deficiency. Insulin regulates carbohydrate, fat, and protein metabolism, maintaining blood glucose levels. Glucagon has opposing effects, promoting gluconeogenesis and glycolysis to increase glucose levels. Tight regulation of insulin and glucagon secretion is needed to keep glucose within its narrow physiological range.
The document discusses metabolic syndrome (MetS), also known as syndrome X. MetS is defined as a constellation of interconnected factors that increase the risk of cardiovascular disease, diabetes, and mortality. It commonly includes central obesity, elevated blood pressure, high blood glucose, excess body fat around the waist. The pathophysiology involves chronic low-grade inflammation and insulin resistance linked to obesity, genetic susceptibility, and lifestyle factors. Treatment focuses on lifestyle modifications like weight loss, dietary changes, and physical activity as well as medications.
1. Type 2 diabetes results from insulin resistance in the liver and peripheral tissues like muscle, as well as relative insulin deficiency. This leads to elevated hepatic glucose production and reduced glucose uptake in tissues.
2. Sustained hyperglycemia can cause glucotoxicity and further impair insulin secretion and action, exacerbating the disease. It also increases renal glucose reabsorption above normal levels, causing glucosuria.
3. Over time, this pathophysiology can damage target organs and increase the risk of diabetes complications if not properly treated. Treatment aims to reduce hyperglycemia through medications that increase insulin secretion and action or decrease hepatic glucose production.
By Juliana C N Chan, MBChB, MD, FRCP Professor of Medicine & Therapeutics, Director, Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China
The document discusses hypothalamic obesity caused by damage to the hypothalamus. It summarizes that the hypothalamus regulates energy balance and appetite. Damage to medial hypothalamic nuclei disrupts these circuits, leading to unopposed appetite activation and deficient responses to satiety signals. This causes hypothalamic obesity characterized by uncontrolled appetite, fatigue, and morbid obesity. Treatments aim to restrict appetite, increase energy expenditure, or bypass portions of the stomach and intestine.
This document discusses several studies related to omega-3 fatty acids and their effects on cardiovascular health markers. One study showed that a 1 g/day dose of Omacor (an omega-3 supplement) increased the omega-3 index in subjects' blood from 3.6% to 5.4% on average, but about 16% of subjects did not achieve an EPA+DHA level over 4.8%. The same study reduced the arachidonic acid to EPA ratio from 20 to 7.2. Another section discusses the role of transcription factors like NF-kB in inflammatory conditions and diseases.
This document discusses the underlying pathophysiology of type 2 diabetes, specifically insulin resistance and beta-cell dysfunction. It notes that insulin resistance, where tissues do not respond properly to insulin, is a major defect in type 2 diabetes and closely associated with obesity. Beta-cell dysfunction refers to the reduced ability of pancreatic beta cells to secrete insulin in response to high blood glucose levels. Over time, the combination of insulin resistance and beta-cell dysfunction leads to chronically high blood glucose levels and a diagnosis of type 2 diabetes. The document recommends that treatment of type 2 diabetes should target these underlying defects by addressing insulin resistance through medications like thiazolidinediones in addition to other antidiabetic agents.
This document discusses insulin resistance and related topics. It begins with a brief history of insulin resistance and defines it as a failure of target organs to respond normally to insulin. It then discusses various factors that can contribute to insulin resistance, including obesity, diet, genetics, and certain drugs. The document also discusses the metabolic syndrome, which includes insulin resistance along with other risk factors. It provides diagnostic criteria for metabolic syndrome and discusses treatments like weight loss, exercise, and dietary changes. The rest of the document discusses various proteins and cytokines secreted by adipose tissue, such as leptin, adiponectin, resistin, and TNF-alpha, and their roles in insulin resistance. It also discusses how lack of adipose tissue can
The document provides instructions for a student art project on creating symmetrical smudges. It outlines the objectives of understanding composition and completing a finished project. Materials needed are listed as tempera paint and black felt pens. Students are tasked with using symmetrical techniques to create an aesthetic form, keeping their work surfaces clean. Their work will be evaluated based on criteria of completing the activity creatively and turning in a neat and tidy symmetrical composition.
This document summarizes and analyzes elements from the author's horror movie trailer and compares them to techniques used in other successful horror trailers. Key elements discussed include using title cards to convey information without giving too much away, establishing shots of wooded settings, shots of intimidating antagonists in the woods seen through trees, shots of attackers overpowering victims, and an unconventional direct address from the antagonist to the audience. The analysis shows how the author's trailer employs similar visual conventions to other horror films but also takes an original approach in one scene.
Hola Amigos en esta ocasión veremos unas diapositivas de la fabulosa compañía de Apple Computer Company, una de las mejores compañías a nivel tecnológico de todo el mundo reconocida en cada rincón del mundo es la dueña de los Iphones teléfonos de gama alta caracterizados por su innovador diseño.
Grafico diario del dax perfomance index para el 11 06-2013Experiencia Trading
Este documento presenta un análisis técnico del índice Dax Performance usando medias simples representadas en 1, 2, 5, 13, 34, 89, 233 y 610 períodos. Explica que las tendencias se definen por los cruces de estas medias, que actúan como niveles de soporte y resistencia. También incluye consideraciones sobre los diferentes plazos temporales (corto, medio y largo plazo) y posibles escenarios futuros para el índice dependiendo de si mantiene o pierde ciertos niveles clave.
The document defines a sadist as someone who receives gratification from causing pain or cruelty to others without remorse. It provides examples of sadistic characters from various cultures including Hades from Greek mythology who traps Persephone in the Underworld, Nero the Roman emperor who enjoyed watching people suffer, Jack from Lord of the Flies who murders boys to gain power, and Sweeney Todd who kills men without reason. The document examines how these characters exemplify sadism through their violent, destructive, and psychologically brutal acts without care or sympathy for their victims.
The document discusses several examples of the chief archetype found in prominent stories and epics from around the world. The chief is typically portrayed as a heroic leader who overcomes challenges on a quest and inspires others, such as Gilgamesh, Odysseus, Rama, Beowulf, Theseus, Aeneas, and Julius Caesar.
The daily market report provides an overview and outlook of market indices. The Nifty 50 index opened subdued but saw selling pressure, declining to a low of 5135 before rebounding to close at 5178, down 15 points. Key support levels for the index are at 5150 and stronger support at 5080-5000. Bounce backs from 5150-5170 could see the index test resistance at 5220, 5300, and 5385. Two stocks, Hero MotoCorp and Asian Paints, are highlighted as top trades to watch, with analysis of chart patterns and recommendations to buy.
This document provides tips for creating effective PowerPoint slides, including:
1. Use outline slides at the beginning to summarize the presentation structure and main points.
2. Limit each content slide to 1-2 minutes of speaking time with 4-5 bullet points maximum in clear, concise language.
3. Use large, easy-to-read fonts in dark colors that contrast the background, and consistent formatting throughout.
4. Include high-quality, relevant images and graphs instead of walls of text, and proofread for errors.
Hannah Smith_Throwing Sh*t against the wallDistilled
Hannah Smith discusses challenges and strategies for content marketing. She notes that content must entertain or educate people in order to be widely shared, rather than just advertise. Marketers should understand their audience's interests through research. While goals can include driving sales, content should also focus on the audience. Creating engaging content requires testing new ideas, accepting that most will fail, and learning from mistakes. As online consumption changes, the most important thing is for people to love a company's marketing. Success requires persistence through failures.
Community Career Center: Use Google Chrome Like A ProKeitaro Matsuoka
Google's Chrome web browser is a popular browser, for good reason: clean and polished user interface, speedy JavaScript performance and its library of extensions that make it even better. But don't let the minimalist look fool you. There is plenty of hidden functionality embedded just below the surface that you probably don't know about but should be using. In this presentation, I will talk about tips and tricks hidden inside Chrome that you will want to know.
Topics include:
Omnibox (what is that?)
Tab management
Chrome as file viewer
Drag to search
Bookmarking made easy
Opening tabs like a pro
Zooming in and out
Chrome on smartphone
Hidden settings
And more!
This document discusses neural networks and their mechanisms. It describes the initial random connection of neurons with initial weights of 1. It also explains how the weight between two neurons increases if one fires to the other and the other fires back. The document raises questions about the randomness, quantifying the model, and building upon the initial project through formalization and multi-threading performance improvements.
Friedrich Hundertwasser fue un artista multitalentoso austriaco conocido por su rechazo a las líneas rectas y su defensa de la armonía entre la naturaleza y la creación humana. Criticó la arquitectura moderna por ser fría y uniforme, y promovió el diseño orgánico y la vegetación espontánea en los edificios. A lo largo de su vida, diseñó varias construcciones siguiendo sus principios de integrar la naturaleza y la individualidad.
Employment prospects for teens and young adults in the nation’s 100 largest metropolitan areas plummeted between 2000 and 2011. On a number of measures—employment rates, labor force underutilization, unemployment, and year-round joblessness—teens and young adults fared poorly, and sometimes disastrously. While labor market problems affected all young people, some groups had better outcomes than others: Non-Hispanic whites, those from higher income households, those with work experience, and those with higher levels of education were more successful in the labor market. In particular, education and previous work experience were most strongly associated with employment.
Policy and program efforts to reduce youth joblessness and labor force underutilization should focus on the following priorities: incorporating more work-based learning (such as apprenticeships, co-ops, and internships) into education and training; creating tighter linkages between secondary and post-secondary education; ensuring that training meets regional labor market needs; expanding the Earned Income Tax Credit; and facilitating the transition of young people into the labor market through enhanced career counseling, mentoring, occupational and work-readiness skills development, and the creation of short-term subsidized jobs.
This document discusses insulin resistance (IR) and its relationship to various medical conditions. It begins by defining IR and explaining common methods to assess IR, such as HOMA-IR and QUICKI. It then discusses the epidemiology of IR and its role in conditions like type 1 diabetes, metabolic syndrome, non-alcoholic fatty liver disease, obesity, hypertension, polycystic ovarian syndrome, and others. Management strategies for IR are also reviewed. The document provides an overview of the importance of recognizing and addressing IR in clinical practice.
Fasting and Caloric Restriction Show Promise for Reducing Type 2 Diabetes Bio...Premier Publishers
The global epidemic of type 2 diabetes (T2D) and its co-morbidities threatens to overwhelm public health services and urgent patient intervention is necessary. A review of mainly randomised controlled trials investigating the reduction of biochemical T2D risk markers through fasting or caloric restriction (CR) found that in T2D or where baseline fasting glucose or HbA1c were elevated, there were significant improvements in fasting glucose and HbA1c, while fasting insulin and insulin resistance may show improvement regardless of condition or baseline levels. There may, however, be ethnic differences, with a clear positive correlation found only in Caucasians. Intermittent CR (i.e. non-continuous periods of fasting) is at least as effective as isocaloric continuous CR, while CR of 400-800 kcal/day is possibly more effective than higher levels for reducing fasting glucose and HbA1c. Time restricted feeding also shows promise but there are few human studies. The findings suggest that the optimum regimen to reduce biochemical risk markers for T2D is an intermittent fasting programme employing a very low-calorie diet with the longest possible number of consecutive days of fasting. The addition of liquid meal replacements, low carbohydrate CR and supplementation of vitamin D, ω-3 PUFAs and L-carnitine may also be of benefit.
The document discusses the metabolic syndrome, including its definition, major features, epidemiology, pathophysiology, approach to diagnosis, and management. Regarding management, lifestyle modifications like weight loss through calorie restriction and increased physical activity are emphasized. Pharmacological treatments and metabolic/bariatric surgery may also be considered in some cases to treat individual components of the metabolic syndrome.
The document discusses the role of peroxisome proliferator activated receptor gamma (PPARγ) agonists in treating type 2 diabetes and reducing cardiovascular risk. PPARγ agonists like thiazolidinediones improve insulin sensitivity and have beneficial effects on lipids, inflammation, and vascular cell proliferation. They may reduce cardiovascular events in type 2 diabetes through these metabolic and anti-inflammatory mechanisms. However, PPARγ agonists can also cause side effects like fluid retention, weight gain, and congestive heart failure, so their risks and benefits must be carefully weighed.
Pioglitazone is a newer thiazolidinedione insulin sensitizer that reduces insulin resistance. It works by activating PPARγ receptors in fat and muscle cells. Studies show pioglitazone improves glycemic control similarly to metformin but is more effective at increasing insulin sensitivity. Pioglitazone also improves lipid profiles and has potential cardiovascular benefits through effects on multiple risk factors, though longer term outcome studies are still needed.
This document summarizes a study that assessed liver function in 200 Sudanese patients with long-standing type 2 diabetes compared to 100 healthy controls. The levels of various liver enzymes and proteins were measured and compared between the two groups. The study found significantly higher levels of ALT, AST, ALP, and bilirubin and lower levels of total protein and albumin in the diabetic patients compared to controls. It also found positive correlations between the levels of ALT, AST, ALP and bilirubin and the duration of diabetes, and negative correlations between the levels of total protein and albumin and diabetes duration. The study concludes that type 2 diabetes is associated with abnormal liver function tests and that liver dysfunction increases with longer diabetes duration
This document summarizes a review article on type 2 diabetes mellitus. It discusses the pathophysiology, epidemiology, screening, diagnosis, and management of type 2 diabetes. Some key points include:
- Type 2 diabetes is characterized by insulin resistance and impaired insulin secretion, accounting for 90% of diabetes cases worldwide.
- Rates of type 2 diabetes have increased dramatically in recent decades due to obesity and decreased exercise.
- Screening for type 2 diabetes involves measuring fasting plasma glucose levels, and an oral glucose tolerance test may also be used for diagnosis.
- Management of type 2 diabetes focuses on lifestyle changes as well as medications to lower blood sugar and prevent complications.
Abstract— Non Alcoholic Fatty Liver Disease is also becoming public health impotance nowadays. So this study was aimed to determine the association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. This study includes a total of 222 subjects were enrolled as per the inclusion/exclusion criteria, out of which 110 cases who had NAFLD with hepatic steatosis on ultrasonography and 112 subjects who did not have NAFLD were considered control. These cases and controls were interrogated and investigated further. Observations were recorded and association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. Statistical methods used were unpaired student’s t-test for continuous variables, Fischer’s and chi-sq test for categorical variables using bivariate analysis by Graph Pad Instat Version 3.10. Risk was assessed in terms of Odd's Ratio. The patients with MS and NAFLD had a higher proportion of CVD compared with those who did not have NAFLD (29.1 vs 18.1 %). This study concludes that NAFLD is significantly associated with MS; most significant with WC, followed by TG and FBS and thus can be considered as hepatic component of MS. This needs more research with large multi-centric prospective studies to evaluate NAFLD as an independent risk factor for CVD.
Diabetes and chronic liver disease (CLD) commonly coexist and interact with each other. CLD can cause abnormalities in glucose metabolism, while diabetes accelerates progression of CLD. For compensated CLD, anti-diabetic treatment is similar to those without liver disease. In decompensated CLD, tight glycemic control is not the goal and insulin therapy requires careful monitoring to avoid hypoglycemia due to altered liver function and insulin metabolism.
1) Prediabetes is a condition where blood sugar levels are higher than normal but not high enough for a diagnosis of diabetes. It affects an estimated 14% of people in India and 9.9-25% of people in other countries.
2) Lifestyle changes like diet modification, increased physical activity, weight loss and smoking cessation can help prevent or delay progression from prediabetes to diabetes. Medications like metformin have also shown effectiveness.
3) People with prediabetes have an increased risk of cardiovascular diseases like heart attack and stroke, even at blood sugar levels below the prediabetes threshold. Intensive lifestyle interventions or metformin treatment can significantly reduce risk of developing diabetes.
The document provides an overview of diabetes mellitus, including the different types (Type 1, Type 2, gestational), signs and symptoms, causes, and statistical data on prevalence worldwide and in the Philippines. It then discusses a case study of a 71-year old Filipino man diagnosed with diabetes. It outlines his medical history, including a family history of diabetes, and analyzes factors affecting his nutrition and eating patterns such as his beliefs about food, personal preferences for oily and sweet foods, sedentary lifestyle, and lack of religious dietary restrictions.
This document provides an overview of diabetes mellitus including definitions, classification, epidemiology, pathophysiology of type 1 and type 2 diabetes, and goals of treatment. Key points include:
- Type 1 diabetes results from autoimmune destruction of pancreatic beta cells in genetically predisposed individuals and requires lifelong insulin treatment.
- Type 2 diabetes involves both insulin resistance and impaired insulin secretion and is strongly associated with obesity and physical inactivity. It can often be managed through lifestyle modifications and oral medications.
- Medical nutrition therapy, physical activity, weight loss (if indicated), glucose monitoring, and pharmacologic therapy including insulin are important components of diabetes management and prevention of complications.
Diabetes mellitus is a metabolic disorder characterized by high blood glucose levels due to either lack of insulin production or resistance to insulin. It ranges from asymptomatic to causing severe health issues like cardiovascular disease if uncontrolled. Risk factors include genetics, obesity, physical inactivity, and diet. Prevention strategies involve education, screening high risk groups, early treatment, and ongoing management of the condition and related health factors.
Study of Serum Omentin-1 in Relation to Insulin Resistance in Type II Diabete...iosrjce
This study examined the relationship between serum Omentin-1 levels and insulin resistance in type 2 diabetes mellitus patients. It found that type 2 diabetes patients had significantly lower serum Omentin-1 levels compared to healthy controls. Serum Omentin-1 levels were negatively correlated with fasting blood sugar, fasting insulin levels, and insulin resistance (as measured by HOMA-IR) in diabetes patients. This suggests that higher insulin resistance is associated with lower serum Omentin-1 levels. The study concludes that Omentin-1 may play a role in insulin resistance and have potential as a future therapeutic target for diabetes.
This document discusses nonalcoholic fatty liver disease (NAFLD). It begins by explaining that NAFLD ranges from simple steatosis to nonalcoholic steatohepatitis (NASH), which can progress to cirrhosis. Insulin resistance plays a key role in the metabolic abnormalities seen in NAFLD. The pathogenesis of NASH is not fully understood. Currently, there are no approved therapies, so treatment focuses on lifestyle modifications like weight loss and exercise to improve comorbidities. The prevalence of NAFLD is increasing due to the rising obesity epidemic.
This document summarizes a journal club discussion on the role of peroxisome proliferator-activated receptor gamma (PPARγ) agonists in treating diabetes and cardiovascular disease. PPARγ agonists like thiazolidinediones improve insulin resistance and reduce inflammation. They may protect blood vessels by inhibiting smooth muscle cell proliferation and migration involved in atherosclerosis and restenosis. While clinical trials show PPARγ agonists reduce cardiovascular risk factors, their side effects like fluid retention require monitoring, and further outcomes research is still needed to establish their long-term cardiovascular benefits and safety.
Prevalence and Associated Risk Factors of Dyslipidemia among Type Two Diabeti...ijtsrd
Dyslipidemia is one of the major modifiable risk factors for cardiovascular disease in type 2 diabetic patients. Dyslipidemia in type 2 diabetic patients is attributed to increased free fatty acids flux secondary to insulin resistance. Despite its high prevalence and related complications of in type 2 diabetic patients, there is a paucity of data on the prevalence of dyslipidemia in type 2 diabetic patients in Tiko. The objective of this study was to determine the prevalence of dyslipidemia amongst type 2 diabetic patients attending Tiko Cottage Hospital. A cross sectional based study was conducted from February to April 2023. A convenient sampling technique was used to recruit 179 type 2 diabetic patients into the study. Data on socio demographic characteristics, behavioral and clinical factors were collected using a structured questionnaire through face to face interviews. Five milliliters of venous blood sample were collected for serum glucose and lipid analysis. Blood pressure, weight and height were measured. Data were analyzed using SPSS version 21, whereby univarriate analysis using frequency and proportions described the variables, bivarriate analysis with the support of Chi Test of independence measured the association between two variable while multivariate analysis was employed to highlight critical risk factors with the support Logistic Regression. The overall prevalence of dyslipidemia among study participants was 54.7 . Isolated lipid profile abnormality of hypercholesterolemia was found in 14.0 , hypertriglyceridemia was absent, high level of High density lipoprotein HDL C was found in 53.1 , and high level of low density lipoprotein LDL C was found in 0.6 of study participants. Being obese was significantly associated with dyslipidemia and female were significantly more exposed. The study concluded that high prevalence of dyslipidemia was found among type 2 diabetic patients in the study area and that obesity was a critical risk factor. The findings of this study should be taken into account to conduct appropriate intervention measures on the identified risk factors and implement routine screening, treatment and prevention of dyslipidemia. Fodji Praise Afuh | Moses N. Ngemenya | Lepasia Arnold Fonge | Nana Célestin "Prevalence and Associated Risk Factors of Dyslipidemia among Type Two Diabetic Patients Attending Tiko Cottage Hospital" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd61307.pdf Paper Url: https://www.ijtsrd.com/medicine/nursing/61307/prevalence-and-associated-risk-factors-of-dyslipidemia-among-type-two-diabetic-patients-attending-tiko-cottage-hospital/fodji-praise-afuh
Diabetes mellitus (DM) is a disease of inadequate control of blood levels of glucose. It has many subclassifications, including type 1, type 2, maturity-onset diabetes of the young (MODY), gestational diabetes, neonatal diabetes, and steroid-induced diabetes. Type 1 and 2 DM are the main subtypes, each with different pathophysiology, presentation, and management, but both have a potential for hyperglycemia. This activity outlines the pathophysiology, evaluation, and management of DM and highlights the role of the interprofessional team in managing patients with this condition.
Objectives:
Describe the pathophysiology of diabetes mellitus.
Outline the epidemiology and risk factors of diabetes mellitus.
Review the treatment considerations and common complications of diabetes mellitus.
Identify the importance of improving collaboration and care coordination amongst the interprofessional team to enhance the delivery of care for patients affected by diabetes mellitus.
Access free multiple choice questions on this topic.
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Introduction
Diabetes mellitus is taken from the Greek word diabetes, meaning siphon - to pass through and the Latin word mellitus meaning sweet. A review of the history shows that the term "diabetes" was first used by Apollonius of Memphis around 250 to 300 BC. Ancient Greek, Indian, and Egyptian civilizations discovered the sweet nature of urine in this condition, and hence the propagation of the word Diabetes Mellitus came into being. Mering and Minkowski, in 1889, discovered the role of the pancreas in the pathogenesis of diabetes. In 1922 Banting, Best, and Collip purified the hormone insulin from the pancreas of cows at the University of Toronto, leading to the availability of an effective treatment for diabetes in 1922. Over the years, exceptional work has taken place, and multiple discoveries, as well as management strategies, have been created to tackle this growing problem. Unfortunately, even today, diabetes is one of the most common chronic diseases in the country and worldwide. In the US, it remains as the seventh leading cause of death.
Diabetes mellitus (DM) is a metabolic disease, involving inappropriately elevated blood glucose levels. DM has several categories, including type 1, type 2, maturity-onset diabetes of the young (MODY), gestational diabetes, neonatal diabetes, and secondary causes due to endocrinopathies, steroid use, etc. The main subtypes of DM are Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM), which classically result from defective insulin secretion (T1DM) and/or action (T2DM). T1DM presents in children or adolescents, while T2DM is thought to affect middle-aged and older adults who have prolonged hyperglycemia due to poor lifestyle and dietary choices. The pathogenesis for T1DM and T2DM is drastically different, and therefore each type has various etiologies, presentations, and treatments.
Diabetes mellitus is a group of metabolic diseases characterized by high blood glucose level caused by either absolute or relative deficiency of insulin. Classifications,sings and symptoms,complications,and prevalence of the disease particularly in Egypt are presented. Management of diabetic patients undergoing oral surgical procedures is discussed.
This document discusses diabetes and new antidiabetic drugs. It notes that diabetes cases are rising significantly worldwide and that diabetes increases the risk of serious health complications. It describes the different types of diabetes and their presentations. It recommends screening guidelines for prediabetes and notes the importance of lifestyle changes to prevent progression to diabetes. It discusses treatment targets and factors like hypoglycemia. It also provides an overview of various drug classes used to treat diabetes, including their mechanisms and effects.
Similar to ueda2012 insulin resistance idf-d.emad (20)
Ueda2016 workshop - hypoglycemia1 -lobna el toonyueda2015
This document discusses hypoglycemia in diabetes. It defines hypoglycemia and describes its prevalence, causes, and risk factors. It notes that hypoglycemia is more common in type 1 diabetes and with intensive diabetes control. The document outlines the symptoms of mild, moderate, and severe hypoglycemia and explains how the body normally protects against low blood sugar. However, in diabetes these protective mechanisms become impaired over time, increasing the risk of severe hypoglycemia. The document discusses hypoglycemia in the context of type 1 and type 2 diabetes and provides tips for prevention and management, including recognizing risk factors, treating the underlying cause, and adjusting medications and food intake. It focuses on strategies to prevent nocturnal hypoglycemia specifically
Ueda2016 new horizon in the management of dyslipidemia - diaa ewaisueda2015
1) PCSK9 inhibitors are a new class of drugs that lower LDL cholesterol by blocking the PCSK9 protein and preventing degradation of LDL receptors.
2) Clinical trials of the PCSK9 inhibitors evolocumab and alirocumab showed reductions of LDL cholesterol up to 60-70% and reduced cardiovascular events.
3) PCSK9 inhibitors are effective in lowering cholesterol in patients who cannot tolerate high intensity statins and in those with familial hypercholesterolemia. They are intended for use in addition to, not instead of, statin therapy.
Ueda2016 workshop - diabetes in the elderly - mesbah kamelueda2015
This document discusses diabetes management challenges in elderly patients. It notes that the prevalence of diabetes increases with age and peaks between 60-74 years of age. Screening and diagnosing diabetes in elderly patients can be difficult due to non-specific symptoms. Management goals aim to avoid hypoglycemia and other adverse drug reactions while controlling hyperglycemia and risk factors. The risk of hypoglycemia, functional decline, depression and other geriatric issues increases with age, requiring special consideration in diabetes management for frail elderly patients.
Ueda2016 woman’s health & diabetes - lobna el toonyueda2015
This document discusses how diabetes differs and is managed for women at various life stages including puberty, pregnancy, and menopause. It notes that diabetes has more severe health impacts and higher mortality for women compared to men. During puberty, diabetes can delay menarche and cause menstrual disturbances. Gestational diabetes requires screening and treatment during pregnancy to prevent complications for mother and baby. Women with a history of gestational diabetes have a high risk of developing type 2 diabetes later in life. The document provides guidance on managing diabetes throughout these various stages.
This document discusses insulin therapy for diabetes. It begins with a brief history of insulin's discovery in 1921 by Banting and Best in Toronto. It then covers normal insulin secretion patterns and the types of insulin available, including rapid-acting, short-acting, intermediate-acting, premixed, basal, and extended long-acting analog insulins. The document discusses initiating and titrating insulin using the ADA treatment algorithm, beginning with basal insulin and adding bolus insulin as needed based on blood glucose levels and HbA1c targets. It also covers starting and adjusting premixed insulin doses.
This document discusses insulin pens and proper injection techniques. It begins by introducing insulin pens and their importance for precise insulin dosing. It then discusses barriers to initiating insulin therapy, including concerns about hypoglycemia, weight gain, and complexity of treatment. The document provides tips for proper insulin pen use, such as priming the pen before injections, holding the needle in place for 10 seconds after injecting, and disposing of needles properly. It addresses issues like insulin dripping or leaking after injection and provides solutions. The key message is on the importance of proper injection technique for optimal insulin dosing and outcomes.
Ueda2016 type 1 diabetes guidelines - hesham el hefnawyueda2015
This document provides information about Prof. M. Hesham El Hefnawy, the head of the National Institute of Diabetes & Endocrinology in Egypt. It gives details about his credentials and experience in diabetes research and management. It then discusses guidelines for managing type 1 diabetes, including using insulin therapy, nutritional education, exercise, and treating complications. It provides guidance on initial insulin dosing, separating doses into basal and bolus components. It also offers tips on titrating insulin doses based on glucose monitoring and factors affecting insulin needs. The document aims to help optimize type 1 diabetes management through individualized care plans.
This document discusses tobacco and noncommunicable diseases (NCDs) in Egypt. It notes that over 170,000 Egyptians die each year from tobacco-related illnesses. Tobacco use also results in significant economic costs for healthcare and lost productivity. The four main NCDs - cardiovascular disease, diabetes, cancer and chronic respiratory disease - all share four main modifiable risk factors, one of which is tobacco use. The document outlines Egypt's ratification of the WHO Framework Convention on Tobacco Control and implementation of Law 157/2007 to increase tobacco taxes, expand health warnings on packaging, ban indoor smoking and restrict youth access.
Ueda2016 thyroid nodule in practice - khaled el hadidyueda2015
The document discusses thyroid nodules and guidelines for their evaluation and management. It provides definitions of thyroid nodules and discusses their prevalence in the population. Risk factors for malignancy are outlined. The American Thyroid Association guidelines from 2009 and 2015 are summarized, including recommendations on ultrasound characteristics warranting biopsy and nodule size thresholds for biopsy consideration. Systems for stratifying nodules based on ultrasound features, such as the TI-RADS system, are also covered briefly.
Ueda2016 the role of gut microbiota in the pathogenesis of obesity & tdm2...ueda2015
The document discusses the role of gut microbiota in the pathogenesis of obesity and type 2 diabetes mellitus (TDM2). It provides an introduction to gut microbiota, symbiotic relationships, evidence connecting gut microbiota to obesity and TDM2, and potential mechanisms of causality. Key points include that gut microbiota composition differs between obese and lean individuals, transplantation studies show gut microbiota can influence weight gain, and mechanisms may involve energy harvest from food, production of short chain fatty acids, effects on hormones like GLP-1, and low-grade inflammation from bacterial translocation.
Ueda2016 the agenda for ncd prevention and control - samer jabbourueda2015
This document discusses non-communicable diseases (NCDs) in the Eastern Mediterranean region. It finds that NCDs account for over half of all deaths in the region. The top four NCDs - cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes - cause over 2.2 million deaths annually. The document then outlines the WHO's agenda and framework for NCD prevention and control. This includes strategic interventions related to governance, prevention, surveillance, and healthcare. It emphasizes that both population-level prevention efforts and improved healthcare services will be needed to achieve global NCD reduction targets.
Ueda2016 recommendations for management of diabetes during ramadan - update 2...ueda2015
This document provides recommendations for managing diabetes during Ramadan, including:
1. Individuals with diabetes who wish to fast should undergo a medical assessment prior to Ramadan to adjust medications and ensure safety.
2. Education on self-monitoring, nutrition, exercise and medication adjustments can help diabetics fast safely. Hypoglycemia and hyperglycemia risks are increased and must be managed.
3. For type 2 diabetics, metformin, DPP-4 inhibitors, glitazones and short-acting insulin secretagogues are preferred treatment options during Ramadan due to lower hypoglycemia risks compared to sulfonylureas. Basal-bolus regimens are recommended
Ueda2016 prevention of diabetes,the role of patients’ associations -mominaat ...ueda2015
- Prevention of diabetes is a priority in Azerbaijan due to rising rates of diabetes from 40,000 cases in 1995 to 240,000 cases in 2015. Contributing factors include high rates of overweight and obesity in women.
- The Azerbaijan Diabetes Society (ADS) works to promote diabetes prevention through public awareness campaigns, education in schools, and establishing diabetes care centers.
- ADS initiatives include testing students for diabetes risk, running a "Healthy Lifestyle - Healthy Generation" campaign to promote healthy eating and exercise in schools, and making policy recommendations to the government.
This document discusses some pitfalls in the treatment of diabetic foot ulcers. It begins by stating that no lesion should be underestimated. It then covers diabetic foot infection, describing the differences between contamination, colonization, and infection. Grading of foot wound infection from mild to severe is explained using the IDSA IWGDF classification system. The importance of debriding wounds with necrotic tissue is highlighted. Different dressings are discussed, noting that keeping wounds dry is no longer the preferred treatment and that some older antiseptics like Mercurochrome are no longer recommended. The concept of wound bed preparation focusing on issues of non-viable tissue, infection, moisture balance, and non-advancing edges is introduced
Ueda2016 non pharmacological diabetes management - emad hamedueda2015
The document compares diabetes management in a standard clinic versus an integrated diabetes center. It discusses several non-pharmacological approaches to diabetes care including self-management education, physical activity, medical nutrition therapy, stress management, foot care education, smoking cessation, and immunization. It emphasizes that these modalities are effective, safe, and can be affordable ways to manage diabetes when offered to patients.
This document discusses non-communicable diseases (NCDs) and NCD alliances. It notes that 57% of deaths in the Eastern Mediterranean region are due to NCDs like heart disease, diabetes, and cancer. Risk factors for NCDs like tobacco use, unhealthy diets, and physical inactivity are on the rise globally. In 2011, the UN held its first high-level meeting on NCDs which resulted in a political declaration and commitments to address the growing NCD burden. The document then discusses the role of the NCD Alliance, a civil society network, in supporting a global response to NCDs at national and regional levels including the formation of country-level alliances.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
3. Why Insulin Resistance ?
Although it is a well known and documented condition for
years; I think it is still a vague issue in the minds of many
Practicing Physicians.
We want to point out the role of IR in T1DM, hypertension,
PCOS and other conditions.
It is important to clarify that IR is a measurable parameter and
it's measurement is easy, practical and very useful in
understanding the underlying pathogenesis of different
conditions and consequently their management.
4. Presentation Topics
Background
Assessment of Insulin Resistance
Epidemiology
Type 1 Diabetes
Insulin Resistance & Metabolic Syndrome
Metabolic Syndrome (MS)
MS in Persons with IFG & IGT
5. Presentation Topics
IR & the Liver
OBESITY
IR & Hypertension
IR & Vit. D
IR & PCOS
IR & Other Issues ( Spleen – Psoriasis )
Management of IR
Prevention of Diabetes
6. Background
The syndromes of insulin resistance actually make up a
broad clinical spectrum, which includes obesity, glucose
intolerance, diabetes, and the metabolic syndrome, as
well as an extreme insulin-resistant state.
Many of these disorders are associated with various
endocrine, metabolic, and genetic conditions.
7. Assessment of Insulin Resistance
In theory, insulin sensitivity can be assessed through the
following methods:
Fasting insulin level Measurement of response to direct
intravenous infusion of insulin.
Euglycemic insulin clamp technique.
“These 2 tests are accurate, but they are research tools
and are not routinely used in clinical practice”.
8. Homeostatic model assessment for insulin resistance
(HOMA-IR)
• = fasting glucose (mg/dL) X fasting insulin (uU/mL) / 405
• = fasting glucose (mmol/L) X fasting insulin (uU/L) / 22.5.
• A value greater than 2 indicates insulin resistance.
Quantitative Insulin Sensitivity Check Index (QUICKI).
They both correlate reasonably well with the euglycemic
clamp technique.
Assessment of Insulin Resistance
9. Epidemiology
The mean HOMA-IR score of the subjects from urban
community were statistically greater than that of the
subjects from rural community.
The prevalence of insulin resistance in urban community
and rural community were 64% and 2% respectively.
( P-1393, Nigeria )
10. Epidemiology
A study was done to examine Insulin Resistance among 5-
15 years old children from an urban area of Sri Lanka.
Although many children were able to control glucose
within normal limits, they had very high levels of insulin
secretion denoting that insulin resistance is developing
form a very young age. Those who were of low birth
weight but obese as children had the highest risk of
developing insulin resistance.
( O-0434, Sri-Lanka )
11. Epidemiology
A study was done to assess IR in diabetic people as well in
healthy controls and to find out it's association with the
components of MS in Nepal.
C-peptide levels and insulin resistance are closely associated
with the components of MS in healthy individuals as well as in
diabetic people.
( P-1392, Nepal )
12. Type 1 DM
MS is a frequent finding in Type1 DM and it's presence
is associated with poor metabolic control and more
micro and macro vascular complications.
MS was associated with increased IR estimated by
eGDR.
( D-1108, Spain)
Obese Type1 patients may as well show insulin
resistance. The amount of insulin can be significantly
reduced through additional treatment with Metformin
and DPP4 inhibitors.
( P- 1402, Germany )
13. IR & Metabolic Syndrome
Insulin resistance plays a major pathogenic role in the
development of the metabolic syndrome, which may include any
or all of the following:
Hyperinsulinemia
Type 2 diabetes or glucose intolerance
Central obesity
Hypertension
Dyslipidemia that includes high triglyceride levels
Low HDL-C level and small, dense low-density lipoprotein
(LDL) particles
Hypercoagulability characterized by an increased plasminogen
activator inhibitor–1 (PAI-1) level.
14. Metabolic Syndrome
Metabolic syndrome (MS) is defined by cluster of
cardiovascular risk factors which to a greater extent is
influenced by ethnicity. Many definitions have been
suggested since the inception of this syndrome which has
created uncertainty among physicians.
To determine the frequency of metabolic syndrome in type
2 D.M according to three commonly used operational
definitions (WHO, NCEP ATP III and IDF) and to evaluate
the agreement between these classifications in Pakistani
cohort.
15. Metabolic Syndrome
A study was done to examine the relationship between
reduction in insulin resistance and various metabolic
parameters in patients with metabolic syndrome.
Data obtained show that insulin sensitizing therapy
significantly changes SUA levels and other metabolic
parameters; all this strongly depends on the degree of
the reduction in insulin resistance.
( P-1408, Georgia )
16. Metabolic Syndrome
This study results suggest that NCEP (ATPIII) and IDF are
the most reliable criteria for diagnosing metabolic
syndrome in type 2 diabetic patients, with NECP capturing
more patients in comparison to IDF definition.
The alarmingly high frequency of metabolic syndrome in
type 2 diabetes found in this study suggests that primary
prevention strategies should be initiated early in this ethnic
group and our health care system should be geared up to
cope with this deadly condition.
( P-1400, Pakistan )
17. Metabolic Syndrome
A study was done to examine the difference in prevalence
of Metabolic Syndrome in populations of Albania in
confront of the Italians and Peruvians.
They conclude that in all three population the prevalence
of metabolic syndrome among young healthy people is
important and the risk factors are almost the same with a
difference for low HDL level that is found very often
amongst Albanian.
( P-1412, Albania )
18. Metabolic Syndrome
Metabolic Syndrome in obese women was frequent
especially after menopause, thus multiple cardiovascular
risk factors are added so a particular attention is needed to
avoid serious complications.
( P-1404, Tunisia )
19. Metabolic Syndrome
The aim of this paper was to examine the relationship
between time spent in sedentary behavior and metabolic
syndrome using meta-analysis.
Current results, emphasize the importance of reducing
sedentary behaviors, such as TV viewing and time on the
computer, for the prevention of metabolic syndrome.
( D-0817, UK )
20. Metabolic Syndrome
Waist circumference (WC) is a convenient measure of
abdominal adipose tissue and it is a risk factor for
cardiovascular diseases (CVD) and diabetes.
The cutoff points for WC are higher in women than the
currently recommended 80cm for Sub-Saharan
populations, whilst in men it is lower. Of importance is
that the cutoff points are reversed in this population for
the genders.
These results emphasize the importance of establishing
ethnic based values to correctly identify subjects with the
metabolic syndrome.
( D-1110, South Africa )
21. MS in Persons with IFG & IGT
The prevalence of MS in persons with either IFG or IGT
was twofold that encountered in the general population,
while in individuals with both IFG and IGT it is similar
to that found in patients with type 2 diabetes mellitus.
Therefore IFG and IGT should not be approached as
isolated conditions because often are associated with
other features of the MS that, individually and
interdependently, are responsible for a substantial
increase in cardiovascular morbidity and mortality.
( P-1399, Romania )
22. IR & the Liver
The liver has a central role in the regulation of
circulating glucose concentrations. During fasting,
glucose is produced mainly by the liver as a result of
increased glycogenolysis and gluconeogenesis (GNG).
During postprandial state the impaired suppression of
hepatic glucose production (HGP), due to the presence
of hepatic insulin resistance, determines high glucose
concentrations.
23. IR & the Liver
Insulin acts at the level of the liver through a direct
and/or indirect effect (i.e. on glucose transport and/or
intracellular enzymes). Insulin resistant (IR) subjects
have increased fasting GNG, but fasting glucose
concentration remains within normal ranges, as well as
HGP, because of a compensatory decrease in
glycogenolysis.
24. IR & the Liver
When T2DM develops, the hepatic autoregulation is
lost, increased GNG and glycogenolysis determine the
increase in HGP that explains fasting hyperglycemia.
In conclusion, the liver plays a determinant role in the
pathogenesis of T2DM.
( S-103, Italy )
25. IR & the Liver
Ectopic fat deposition in the liver is associated with
metabolic abnormalities, including insulin resistance,
dyslipidemia and diabetes.
Non-alcoholic fatty liver disease (NAFLD) is defined as
increased liver fat in individuals who do not drink
excessive alcohol and who do not have other causes for
liver disease.
26. IR & the Liver
A subset of patients with NAFLD have non-alcoholic
steatohepatitis (NASH) characterized by lobular
inflammation and evidence of cellular damage with or
without fibrosis.
While simple steatosis is considered relatively benign,
NASH can progress over time to cirrhosis.
( S-114, USA )
27. IR & the Liver
A study was done to assess the effect of Orlistat
(Gastrointestinal lipase inhibitors) + Metformin vs Metformin
alone in Nondiabetic Patients with Insulin Resistance and
Nonalcoholic Steatohepatitis (NASH)
Orlistat (Gastrointestinal lipase inhibitors) therapy and dietary
counseling were associated with significant decreases in
NASH.
( O-0439, Venezuela )
28. IR & the Liver
Nonalcoholic fatty liver disease (NAFLD) does not seem
to be associated with MS in Bangladeshi population as
defined through the 3 major criteria provided by IDF,
ATP III and WHO.
Various components of MS are associated with NAFLD
among which central obesity, dysglycemia and
dyslipidemia are the most significant ones. However,
they do not seem to cluster in the manner as predicted by
IDF, ATP III and WHO
( P-1384, Bangladesh )
29. IR & the Liver
Several prospective studies have shown that fat
accumulation in the liver due to non-alcoholic causes
(NAFLD) precedes and predicts type 2 diabetes,
cardiovascular disease and NASH independent of obesity
and fat distribution.
The study suggested that avoidance of excess simple
sugar intake may be an important factor in the prevention
of progressive deterioration in glycemic control in type 2
diabetes due to worsening hepatic insulin resistance and
of NASH.
( M 108, Finland)
30. OBESITY
Hypertrophic
• Fat storage lead to
inappropriate cellular
enlargement
• Metabolically ..
• Genetically determined
• 4 times more in FDR of
diabetics
• Related to the development
of DM
Hyperplastic
• Fat storage lead to
recruitment of new
adipose cells
• Metabolically Normal
(Abstract: 81, Sweden)
31. OBESITY
Visceral fat-derived protein " Visfatin" plasma levels
correlates strongly with the amount of visceral adipose
tissue in humans.
It has high significant correlation with HOMA IR and
other parameters linking Visceral fat to IR, DM and
obesity.
( D- 1112, Egypt )
32. IR & Hypertension
Hypertensive diabetics have significant insulin
resistance and higher fasting insulin levels when
compared to normotensive counterparts.
Though complications were higher in the same group
they were not statistically significant.
Diabetic patients with hypertension should be treated
more aggressively and evaluated for complications.
( D-1111, India )
33. Elevated values of heart rate and insulin resistance reflect
enhanced sympathetic nervous system activity and may
be connected with development of coronary artery
disease and diabetes.
24-h double product calculated as systolic blood pressure
and heart rate and body mass index may be
complementary parameters in prediction of insulin
resistance in hypertensive nondiabetics with coronary
artery disease.
( P-1386, Poland )
IR & Hypertension
34. Insulin Resistance & Hypertension
Nigerian hypertensives have greater HOMA-estimated
insulin resistance than their normotensive counterparts.
This finding implies that hypertensive patients should
have regular screening for diabetes mellitus and other
categories of glucose intolerance as the increased insulin
resistance seen in them will increase their risk of
developing type 2 diabetes mellitus.
( P-1387, Nigeria )
35. Vitamin D supplementation improved insulin resistance
after a single large dose of Vitamin D in South Asians.
Vitamin D deficiency may explain the higher prevalence
of diabetes and metabolic syndrome in South Asian
population.
( D-0820, UK )
Circulating osteocalcin level is associated with improved
glucose tolerance, insulin secretion and sensitivity
independent of the plasma adiponectin level in human.
( D-1109, Korea )
IR & Vit. D
36. IR & PCOS
Routine measurement of WC in patients with PCOS and normal body
mass can be a marker of IR, type 2 diabetes mellitus, arterial
hypertension and cardiovascular diseases.
(P-1397, Uzbekistan)
Recent studies indicate the possible role of vitamin D in the
pathogenesis of IR and glucose metabolism.
Women with PCOS have mostly insufficient 25-OH-D levels, and
25-OH-D replacement therapy may have a beneficial effect on IR in
obese women with PCOS.
(P-1383, India)
Hyperandrogenemia and insulin resistance in PCOS may have an
inherited basis and these are likely to be associated with the disorder
as independent traits.
(P-1410, Bangladesh)
37. IR & Other Conditions
A study was done to examine the spleen as a major
source of inflammation-induced insulin resistance in
obesity.
Spleen has a potential role on metabolism, as its surgical
removal causes protection against obesity-induced
inflammation and insulin resistance, enhanced by
reduction on macrophage migration to metabolic tissues.
(D-0819, Brazil)
38. IR & Other Conditions
Psoriasis (Ps) is a chronic autoimmune disease which affects
the skin and joints. Adipocytokines may play an important
role in the physiopathology of psoriasis lesions and
pathogenesis of impaired fasting glucose (IFG)
The secretory dysfunction of proinflammatory and anti-
inflammatory adipocytokines represent the main link
between IFG and Ps.
Weight loss and exercise have been reported to significantly
increase adiponectin and decrease leptin levels.
Body weight loss and exercise could potentially become part
of the general management of Ps in patients with IFG.
(P-1395, Romania)
39. Management of IR
Metformin in T2D & Prediabetes
Metformin is a biguanide; it reduces hepatic glucose
output and increases the uptake in the peripheral tissues
(muscle and adipocytes).
Metformin is a major drug in the treatment of patients
who are obese and have type 2 diabetes. The drug
enhances weight reduction and improves lipid profile
and vascular integrity.
40. Management of IR
Metformin in T2D & Prediabetes
Metformin in patients with T2D and prediabetes reduces
insulin resistance, especially at patients with IFG and
IGT, improves glycemic and lipid control, decreases
cytokines connected with insulin sensitivity.
(D-0821, Russia)
41. A study to evaluate the effect of exenatide and metformin
on the insulin resistance variation after 3 months of
treatment in type 2 diabetes patients receiving insulin.
This study confirm that association of exenatide + insulin
treatment at obese T2DM patients seems to decrease the
total insulin daily dose, but the insulin resistance compared
for the group treated with metformin and the group treated
with exenatide seems to be not statistically different.
(P-1380, Romania)
Management of IR
Exenatide & metformin
42. Management of IR
Dietary omega-3 (PUFAs)
Omega-3 PUFAs administered exert a number of
beneficial effects on diabetes associated metabolic
disorders (glycemic control, FFA, antioxidative defense),
attenuate IR parameters,
increase plasma adiponectin and decrease osteoprotegerin
levels thus lowering cardiovascular risk of T2Ds
(P-1403, Ukraine & Netherlands)
43. Management of IR
Exenatide & glimepiride
A multicenter, randomised, single-blind study on the
effects of exenatide or glimepiride on insulin resistance
in patient intolerant to metformin at maximum dose.
Exenatide and glimepiridel improved diabetes control
when added to metformin, but only Ex improved insulin
resistance related-parameters.
(D-0815, Italy)
44. Management of IR correction with fetal
stem cells in metabolic syndrome
Results:-
IR Reduction, insulin-sensitivity restoration in all
groups.
Reduction of basal and stimulated hyperinsulinemia in
IGT-group
Reduction of serum C-peptide
Other effects: reduced glycemia, lipid count, weight loss,
blood pressure decrease.
Conclusions:-
In MS, TFSC ( Transplantation of Fetal Stem Cell )
results in reliable subsidence of IR symptoms.
(P-1391, Ukraine)
45. Prevention of Diabetes
Alfa Glucosidase
The STOP-NIDDM trial demonstrated The STOP-
NIDDM trial demonstrated that the alpha-glucosidase
inhibitor acarbose reduced the risk of diabetes by 25% in
subjects with
It is suggested that the effect of acarbose on the
prevention of diabetes in subjects with IGT was in part
mediated by an effect on the disposition index, thus an
improvement in insulin secretion adjusted for insulin
resistance.
(O-0440, Canada)
46. Pharmacologic intervention with medications that reverse
known pathophysiologic abnormalities - beta cell dysfunction
and insulin resistance - uniformly prevent IGT progression
toT2DM. (DREAM, DPP, TRIPOD, PIPOD, ACT NOW)
Metformin in the US DPP and Indian DPP reduced the
development of T2DM by ~30% and has been recommended
by the ADA.
Metformin consistently reduces the rate of conversion of IGT
to T2DM.
(Abstract: 49, USA)
Prevention of Diabetes
47. Prevention of Diabetes
A recent analysis of the 10 year follow up of the DPP
demonstrated that metformin treatment was highly cost
effective in diabetes prevention.
Pharmacologic intervention with a variety of agents
(thiazolidinediones, metformin, acarbose, GLP-1
analogues) consistently reduces the rate of conversion of
IGT to T2DM.
( Abstract: 49, USA)