SlideShare a Scribd company logo
Metabolic Syndrome, Diabetes, and Cardiovascular Disease: Implications for Preventive Cardiology   ,[object Object],[object Object],[object Object],[object Object],[object Object]
Overview of Diabetes in the United States
Diabetes Prevalence, 1990-1998
Age-adjusted prevalence of physician-diagnosed diabetes in Adults age 18 and older by race/ethnicity and sex  (NHANES: 1999-2004).  Source: NCHS and NHLBI.  NH – non-Hispanic.
 
 
Risk of Cardiovascular Events in  Diabetics   Framingham Study ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],_________________________________________________________________ _________________________________________________________________
Insulin Resistance
Natural History of Type 2 Diabetes
Development of Type 2 Diabetes
Hyperglycemia in Type 2 Diabetes Results From Three Major Metabolic Defects
Relationship Between Obesity and Insulin Resistance and Dyslipidemia
Insulin Resistance: Associated Conditions
New Cases of ESRD in the United States
New Cases of ESRD in the United States  by Cause and Ethnicity, 1998
Microalbuminuria
Cardiovascular Disease and Diabetes
Probability of Death From CHD in Patients With Type 2 Diabetes With or Without Previous MI
Framingham Heart Study 30-Year Follow-Up: CVD Events in Patients With Diabetes (Ages 35-64) 10 9 20 11 9 6 38 19 3* 30 0 2 4 6 8 10 Age-adjusted annual rate/1,000 Men Women Total CVD CHD Cardiac failure Intermittent   claudication Stroke Risk ratio P <0.001 for all values except * P <0.05. Wilson PWF, Kannel WB. In:  Hyperglycemia, Diabetes and Vascular Disease.  Ruderman N et al, eds. Oxford; 1992.
Presentation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Presentation (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Presentation (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Metabolic Syndrome Insulin Resistance Hypertension Type 2 Diabetes Disordered Fibrinolysis Complex Dyslipidemia TG, LDL HDL Endothelial Dysfunction Systemic Inflammation Athero- sclerosis Visceral Obesity Adapted from the ADA.  Diabetes Care.  1998;21:310-314; Pradhan AD et al.  JAMA.  2001;286:327-334.
Revised ATP III Metabolic Syndrome Oct 2005 *Diagnosis is established when   3 of these risk factors are present. † Abdominal obesity is more highly correlated with metabolic risk factors than is   BMI.  ‡ Some men develop metabolic risk factors when circumference is only marginally  increased. <40 mg/dL <50 mg/dL  or Rx for  ↓ HDL Men Women > 102 cm (>40 in) > 88 cm (>35 in) Men Women  100 mg/dL  or Rx for  ↑ glucose Fasting glucose  130/  85 mm Hg  or on HTN Rx Blood pressure HDL-C  150 mg/dL  or Rx for  ↑ TG TG Abdominal obesity †   (Waist circumference ‡ ) Defining Level Risk Factor
International Diabetes Federation Definition:  Abdominal obesity  plus  two other components:  elevated BP, low HDL, elevated TG, or impaired fasting glucose
 
 
 
 
 
 
Prevalence of the Metabolic Syndrome Among US Adults NHANES 1988-1994 Age (years) Ford E et al.  JAMA . 2002(287):356. 1999-2002 Prevalence by IDF vs. NCEP Definitions (Ford ES, Diabetes Care 2005; 28: 2745-9)  (unadjusted, age 20+) NCEP :  33.7% in men and 35.4% in women  IDF:  39.9% in men and 38.1% in women   Prevalence (%)  0 5 10 15 20 25 30 35 40 45 20-29 30-39 40-49 50-59 60-69 > 70 Men Women
Prevalence of the NCEP Metabolic Syndrome:  NHANES III by Sex and Race/Ethnicity Prevalence, % Men Ford ES et al.  JAMA  2002;287:356-359. Women 25% 16% 28% 21% 23% 26% 36% 20% White African American Mexican American Other
Cardiovascular Disease (CVD) and Total Mortality:  US Men and Women Ages 30-74 (age, gender, and risk-factor adjusted Cox regression) NHANES II Follow-Up (n=6255)(Malik and Wong, et al.,  Circulation 2004; 110: 1245-1250 ) * p<.05, ** p<.01, **** p<.0001 compared to none * *** *** *** ** *** *** *** *** *** ***
 
Metabolic Syndrome, CVD Events, and Mortality ,[object Object],[object Object],[object Object]

More Related Content

What's hot

Diabetic dyslipidemia
Diabetic dyslipidemiaDiabetic dyslipidemia
Diabetic dyslipidemia
Aneesh Bhandary
 
Cardiovascular Risk in Diabetes
Cardiovascular Risk in DiabetesCardiovascular Risk in Diabetes
Cardiovascular Risk in Diabetes
Prof. Dr. Aswinikumar Surendran
 
obesity diabetes and metabolic syndrome
obesity diabetes and metabolic syndromeobesity diabetes and metabolic syndrome
obesity diabetes and metabolic syndrome
Dr. Geoffrey K. K. Maiyoh
 
Diabetic dyslipidemia
Diabetic dyslipidemiaDiabetic dyslipidemia
Diabetic dyslipidemia
FarragBahbah
 
Diabetic dyslipidemia and residual risk by Dr. Vaibhav Yawalkar MD DM Cardiol...
Diabetic dyslipidemia and residual risk by Dr. Vaibhav Yawalkar MD DM Cardiol...Diabetic dyslipidemia and residual risk by Dr. Vaibhav Yawalkar MD DM Cardiol...
Diabetic dyslipidemia and residual risk by Dr. Vaibhav Yawalkar MD DM Cardiol...
vaibhavyawalkar
 
Updates of Diabetes Management 2020- Dr Shahjada Selim
Updates of Diabetes Management 2020- Dr Shahjada SelimUpdates of Diabetes Management 2020- Dr Shahjada Selim
Updates of Diabetes Management 2020- Dr Shahjada Selim
Bangabandhu Sheikh Mujib Medical University
 
Hyperlipidemia
HyperlipidemiaHyperlipidemia
Hyperlipidemia
Faz Halim
 
Metabolic Syndrome
Metabolic SyndromeMetabolic Syndrome
Metabolic Syndrome
vlparry
 
Dyslipidemia lecture
Dyslipidemia lectureDyslipidemia lecture
Dyslipidemia lecture
drfarhatbashir
 
Dyslipidemia
DyslipidemiaDyslipidemia
Dyslipidemia
Risho1012
 
Guidelines in Obesity management
Guidelines in Obesity managementGuidelines in Obesity management
Guidelines in Obesity management
Usama Ragab
 
Hypertension guidelines comparison.pptx
Hypertension guidelines comparison.pptxHypertension guidelines comparison.pptx
Hypertension guidelines comparison.pptx
desktoppc
 
Role of diabetes education
Role of diabetes educationRole of diabetes education
Role of diabetes education
Riyad Banayot
 
Dyslipidemia [Compatibility Mode]
Dyslipidemia [Compatibility Mode]Dyslipidemia [Compatibility Mode]
Dyslipidemia [Compatibility Mode]Jimma university
 
Obesity
ObesityObesity
Obesity
Bhargav Kiran
 
Obesity and Cardiovascular Diseases
Obesity and Cardiovascular DiseasesObesity and Cardiovascular Diseases
Obesity and Cardiovascular Diseases
AYESHA KABEER
 
Obesity and heart disease
Obesity and heart diseaseObesity and heart disease
Obesity and heart disease
Prateek Singh
 
Cvd risk in dm
Cvd risk in dmCvd risk in dm
Cvd risk in dm
Naveen Kumar
 
Advances and Management of Diabetes Mellitus
Advances and Management of Diabetes MellitusAdvances and Management of Diabetes Mellitus
Advances and Management of Diabetes Mellitus
Pratiksha Doke
 
Obesity treatment
Obesity treatmentObesity treatment
Obesity treatment
helix1661
 

What's hot (20)

Diabetic dyslipidemia
Diabetic dyslipidemiaDiabetic dyslipidemia
Diabetic dyslipidemia
 
Cardiovascular Risk in Diabetes
Cardiovascular Risk in DiabetesCardiovascular Risk in Diabetes
Cardiovascular Risk in Diabetes
 
obesity diabetes and metabolic syndrome
obesity diabetes and metabolic syndromeobesity diabetes and metabolic syndrome
obesity diabetes and metabolic syndrome
 
Diabetic dyslipidemia
Diabetic dyslipidemiaDiabetic dyslipidemia
Diabetic dyslipidemia
 
Diabetic dyslipidemia and residual risk by Dr. Vaibhav Yawalkar MD DM Cardiol...
Diabetic dyslipidemia and residual risk by Dr. Vaibhav Yawalkar MD DM Cardiol...Diabetic dyslipidemia and residual risk by Dr. Vaibhav Yawalkar MD DM Cardiol...
Diabetic dyslipidemia and residual risk by Dr. Vaibhav Yawalkar MD DM Cardiol...
 
Updates of Diabetes Management 2020- Dr Shahjada Selim
Updates of Diabetes Management 2020- Dr Shahjada SelimUpdates of Diabetes Management 2020- Dr Shahjada Selim
Updates of Diabetes Management 2020- Dr Shahjada Selim
 
Hyperlipidemia
HyperlipidemiaHyperlipidemia
Hyperlipidemia
 
Metabolic Syndrome
Metabolic SyndromeMetabolic Syndrome
Metabolic Syndrome
 
Dyslipidemia lecture
Dyslipidemia lectureDyslipidemia lecture
Dyslipidemia lecture
 
Dyslipidemia
DyslipidemiaDyslipidemia
Dyslipidemia
 
Guidelines in Obesity management
Guidelines in Obesity managementGuidelines in Obesity management
Guidelines in Obesity management
 
Hypertension guidelines comparison.pptx
Hypertension guidelines comparison.pptxHypertension guidelines comparison.pptx
Hypertension guidelines comparison.pptx
 
Role of diabetes education
Role of diabetes educationRole of diabetes education
Role of diabetes education
 
Dyslipidemia [Compatibility Mode]
Dyslipidemia [Compatibility Mode]Dyslipidemia [Compatibility Mode]
Dyslipidemia [Compatibility Mode]
 
Obesity
ObesityObesity
Obesity
 
Obesity and Cardiovascular Diseases
Obesity and Cardiovascular DiseasesObesity and Cardiovascular Diseases
Obesity and Cardiovascular Diseases
 
Obesity and heart disease
Obesity and heart diseaseObesity and heart disease
Obesity and heart disease
 
Cvd risk in dm
Cvd risk in dmCvd risk in dm
Cvd risk in dm
 
Advances and Management of Diabetes Mellitus
Advances and Management of Diabetes MellitusAdvances and Management of Diabetes Mellitus
Advances and Management of Diabetes Mellitus
 
Obesity treatment
Obesity treatmentObesity treatment
Obesity treatment
 

Similar to Metabolic Syndrome, Diabetes, and Cardiovascular Disease ... Metabolic Syndrome, Diabetes, and Cardiovascular Disease .

Ndei Cardiovascular Disease In Diabetes Epidemiology
Ndei Cardiovascular Disease In Diabetes EpidemiologyNdei Cardiovascular Disease In Diabetes Epidemiology
Ndei Cardiovascular Disease In Diabetes Epidemiology
david7s
 
Hypertension: New Concepts, Guidelines, and Clinical Management Hypertensio...
Hypertension: New Concepts, Guidelines, and Clinical Management 	 Hypertensio...Hypertension: New Concepts, Guidelines, and Clinical Management 	 Hypertensio...
Hypertension: New Concepts, Guidelines, and Clinical Management Hypertensio...MedicineAndFamily
 
Hypertension
HypertensionHypertension
Hypertension
Anac09
 
Coronary Artery Disease in Women
Coronary Artery Disease in WomenCoronary Artery Disease in Women
Coronary Artery Disease in WomenHealthSignals
 
Impact of obesity on cardiometabolic risk: Will we lose the battle?
Impact of obesity on cardiometabolic risk: Will we lose the battle?Impact of obesity on cardiometabolic risk: Will we lose the battle?
Impact of obesity on cardiometabolic risk: Will we lose the battle?
My Healthy Waist
 
Overweight and obesity in adults health consequences
Overweight and obesity in adults health consequencesOverweight and obesity in adults health consequences
Overweight and obesity in adults health consequences
Dr. Darayus P. Gazder
 
The role of exercise in medicine
The role of exercise in medicineThe role of exercise in medicine
The role of exercise in medicineNursing Hi Nursing
 
Macrovascular disease in diabetes
Macrovascular disease in diabetesMacrovascular disease in diabetes
Macrovascular disease in diabetesPeninsulaEndocrine
 
The Health Effects of Reducing Sodium and Improving Overall Diet
The Health Effects of Reducing Sodium and Improving Overall DietThe Health Effects of Reducing Sodium and Improving Overall Diet
The Health Effects of Reducing Sodium and Improving Overall Diet
National Restaurant Association
 
Diabetes lecture
Diabetes lectureDiabetes lecture
Diabetes lecture
aswhite
 
Renal disease in diabetes from prediabetes to late vasculopathy complication...
Renal disease in diabetes from prediabetes  to late vasculopathy complication...Renal disease in diabetes from prediabetes  to late vasculopathy complication...
Renal disease in diabetes from prediabetes to late vasculopathy complication...
nephro mih
 
THE ROLLER COASTER RIDE OF DYSLIPIDEMIA & CAD
THE ROLLER COASTER RIDE OF DYSLIPIDEMIA & CADTHE ROLLER COASTER RIDE OF DYSLIPIDEMIA & CAD
THE ROLLER COASTER RIDE OF DYSLIPIDEMIA & CAD
Sunil Wadhwa
 
Jennifer Tremmel - Sex Differences In Cardiovascular Disease
Jennifer Tremmel - Sex Differences In Cardiovascular DiseaseJennifer Tremmel - Sex Differences In Cardiovascular Disease
Jennifer Tremmel - Sex Differences In Cardiovascular DiseaseClayman Institute
 
DIABETES AND CARDIOVASCULAR DISEASE - THE CONTINUUM
DIABETES AND CARDIOVASCULAR DISEASE - THE CONTINUUMDIABETES AND CARDIOVASCULAR DISEASE - THE CONTINUUM
DIABETES AND CARDIOVASCULAR DISEASE - THE CONTINUUM
Praveen Nagula
 
Plant Based Diets - A Cure?
Plant Based Diets - A Cure?Plant Based Diets - A Cure?
Plant Based Diets - A Cure?
Walk with a Doc-Colorado
 
DM and Heart, What more can we do for patient heart.pdf
DM and Heart, What more can we do for patient heart.pdfDM and Heart, What more can we do for patient heart.pdf
DM and Heart, What more can we do for patient heart.pdf
SolidaSakhan
 
Diabetic Nephropathy 2009
Diabetic Nephropathy 2009Diabetic Nephropathy 2009
Diabetic Nephropathy 2009
Joel Topf
 

Similar to Metabolic Syndrome, Diabetes, and Cardiovascular Disease ... Metabolic Syndrome, Diabetes, and Cardiovascular Disease . (20)

Ndei Cardiovascular Disease In Diabetes Epidemiology
Ndei Cardiovascular Disease In Diabetes EpidemiologyNdei Cardiovascular Disease In Diabetes Epidemiology
Ndei Cardiovascular Disease In Diabetes Epidemiology
 
Strive Teleconf Presentation Oct11 2006
Strive Teleconf Presentation Oct11 2006Strive Teleconf Presentation Oct11 2006
Strive Teleconf Presentation Oct11 2006
 
Hypertension: New Concepts, Guidelines, and Clinical Management Hypertensio...
Hypertension: New Concepts, Guidelines, and Clinical Management 	 Hypertensio...Hypertension: New Concepts, Guidelines, and Clinical Management 	 Hypertensio...
Hypertension: New Concepts, Guidelines, and Clinical Management Hypertensio...
 
Hypertension
HypertensionHypertension
Hypertension
 
Diabetes
DiabetesDiabetes
Diabetes
 
Coronary Artery Disease in Women
Coronary Artery Disease in WomenCoronary Artery Disease in Women
Coronary Artery Disease in Women
 
Impact of obesity on cardiometabolic risk: Will we lose the battle?
Impact of obesity on cardiometabolic risk: Will we lose the battle?Impact of obesity on cardiometabolic risk: Will we lose the battle?
Impact of obesity on cardiometabolic risk: Will we lose the battle?
 
Overweight and obesity in adults health consequences
Overweight and obesity in adults health consequencesOverweight and obesity in adults health consequences
Overweight and obesity in adults health consequences
 
The role of exercise in medicine
The role of exercise in medicineThe role of exercise in medicine
The role of exercise in medicine
 
Macrovascular disease in diabetes
Macrovascular disease in diabetesMacrovascular disease in diabetes
Macrovascular disease in diabetes
 
The Health Effects of Reducing Sodium and Improving Overall Diet
The Health Effects of Reducing Sodium and Improving Overall DietThe Health Effects of Reducing Sodium and Improving Overall Diet
The Health Effects of Reducing Sodium and Improving Overall Diet
 
Diabetes lecture
Diabetes lectureDiabetes lecture
Diabetes lecture
 
Renal disease in diabetes from prediabetes to late vasculopathy complication...
Renal disease in diabetes from prediabetes  to late vasculopathy complication...Renal disease in diabetes from prediabetes  to late vasculopathy complication...
Renal disease in diabetes from prediabetes to late vasculopathy complication...
 
THE ROLLER COASTER RIDE OF DYSLIPIDEMIA & CAD
THE ROLLER COASTER RIDE OF DYSLIPIDEMIA & CADTHE ROLLER COASTER RIDE OF DYSLIPIDEMIA & CAD
THE ROLLER COASTER RIDE OF DYSLIPIDEMIA & CAD
 
Jennifer Tremmel - Sex Differences In Cardiovascular Disease
Jennifer Tremmel - Sex Differences In Cardiovascular DiseaseJennifer Tremmel - Sex Differences In Cardiovascular Disease
Jennifer Tremmel - Sex Differences In Cardiovascular Disease
 
DIABETES AND CARDIOVASCULAR DISEASE - THE CONTINUUM
DIABETES AND CARDIOVASCULAR DISEASE - THE CONTINUUMDIABETES AND CARDIOVASCULAR DISEASE - THE CONTINUUM
DIABETES AND CARDIOVASCULAR DISEASE - THE CONTINUUM
 
Erectile Dysfunction
Erectile DysfunctionErectile Dysfunction
Erectile Dysfunction
 
Plant Based Diets - A Cure?
Plant Based Diets - A Cure?Plant Based Diets - A Cure?
Plant Based Diets - A Cure?
 
DM and Heart, What more can we do for patient heart.pdf
DM and Heart, What more can we do for patient heart.pdfDM and Heart, What more can we do for patient heart.pdf
DM and Heart, What more can we do for patient heart.pdf
 
Diabetic Nephropathy 2009
Diabetic Nephropathy 2009Diabetic Nephropathy 2009
Diabetic Nephropathy 2009
 

More from MedicineAndFamily

Dental Implant Reliability Improvement
Dental Implant Reliability ImprovementDental Implant Reliability Improvement
Dental Implant Reliability ImprovementMedicineAndFamily
 
Nitrous Oxide Sedation in Pediatric Dentistry
Nitrous Oxide Sedation in Pediatric DentistryNitrous Oxide Sedation in Pediatric Dentistry
Nitrous Oxide Sedation in Pediatric DentistryMedicineAndFamily
 
Emergency In Dentistry Part 1
Emergency In Dentistry Part 1Emergency In Dentistry Part 1
Emergency In Dentistry Part 1MedicineAndFamily
 
Evidenced Based Dentistry Spring 2006 Group 4 Kevin Hancock Jess ... Eviden...
Evidenced Based Dentistry Spring 2006 Group 4 Kevin Hancock Jess ... 	 Eviden...Evidenced Based Dentistry Spring 2006 Group 4 Kevin Hancock Jess ... 	 Eviden...
Evidenced Based Dentistry Spring 2006 Group 4 Kevin Hancock Jess ... Eviden...MedicineAndFamily
 
Recent Developments in the Treatment of Hypertension Recent Developments in...
Recent Developments in the Treatment of Hypertension 	 Recent Developments in...Recent Developments in the Treatment of Hypertension 	 Recent Developments in...
Recent Developments in the Treatment of Hypertension Recent Developments in...MedicineAndFamily
 
Subcutaneous emphysema as a complication of tooth extraction Subcutaneous e...
Subcutaneous emphysema as a complication of tooth extraction 	 Subcutaneous e...Subcutaneous emphysema as a complication of tooth extraction 	 Subcutaneous e...
Subcutaneous emphysema as a complication of tooth extraction Subcutaneous e...MedicineAndFamily
 
The Long QT Syndrome: Overview and Management The Long QT Syndrome: Overvie...
The Long QT Syndrome: Overview and Management 	 The Long QT Syndrome: Overvie...The Long QT Syndrome: Overview and Management 	 The Long QT Syndrome: Overvie...
The Long QT Syndrome: Overview and Management The Long QT Syndrome: Overvie...MedicineAndFamily
 
Dental Care of the Future: Part I
Dental Care of the Future: Part IDental Care of the Future: Part I
Dental Care of the Future: Part IMedicineAndFamily
 
Community Dentistry Years I - IV
Community Dentistry Years I - IVCommunity Dentistry Years I - IV
Community Dentistry Years I - IVMedicineAndFamily
 
Preventive Dentistry Lecture Cde Course
Preventive Dentistry Lecture Cde CoursePreventive Dentistry Lecture Cde Course
Preventive Dentistry Lecture Cde CourseMedicineAndFamily
 
Diabetes Mellitus patients in dental management
Diabetes Mellitus patients in dental managementDiabetes Mellitus patients in dental management
Diabetes Mellitus patients in dental managementMedicineAndFamily
 
Minimal Intervention Dentistry – The Challenge for Materials
Minimal Intervention Dentistry – The Challenge for MaterialsMinimal Intervention Dentistry – The Challenge for Materials
Minimal Intervention Dentistry – The Challenge for MaterialsMedicineAndFamily
 
ANATOMY of TEETH 2 1. Anatomy of a tooth. a. Anatomical crown ...
ANATOMY of TEETH 2 1. Anatomy of a tooth. a. Anatomical crown ...ANATOMY of TEETH 2 1. Anatomy of a tooth. a. Anatomical crown ...
ANATOMY of TEETH 2 1. Anatomy of a tooth. a. Anatomical crown ...MedicineAndFamily
 

More from MedicineAndFamily (20)

Dental Implant Reliability Improvement
Dental Implant Reliability ImprovementDental Implant Reliability Improvement
Dental Implant Reliability Improvement
 
Dental Radiography Safety
Dental Radiography SafetyDental Radiography Safety
Dental Radiography Safety
 
Nitrous Oxide Sedation in Pediatric Dentistry
Nitrous Oxide Sedation in Pediatric DentistryNitrous Oxide Sedation in Pediatric Dentistry
Nitrous Oxide Sedation in Pediatric Dentistry
 
Primary angioplasty
Primary angioplastyPrimary angioplasty
Primary angioplasty
 
Emergency In Dentistry Part 1
Emergency In Dentistry Part 1Emergency In Dentistry Part 1
Emergency In Dentistry Part 1
 
Evidenced Based Dentistry Spring 2006 Group 4 Kevin Hancock Jess ... Eviden...
Evidenced Based Dentistry Spring 2006 Group 4 Kevin Hancock Jess ... 	 Eviden...Evidenced Based Dentistry Spring 2006 Group 4 Kevin Hancock Jess ... 	 Eviden...
Evidenced Based Dentistry Spring 2006 Group 4 Kevin Hancock Jess ... Eviden...
 
How to Use Dental Floss
How to Use Dental FlossHow to Use Dental Floss
How to Use Dental Floss
 
Face Eye Trauma
Face Eye TraumaFace Eye Trauma
Face Eye Trauma
 
Dental Caries
Dental CariesDental Caries
Dental Caries
 
Recent Developments in the Treatment of Hypertension Recent Developments in...
Recent Developments in the Treatment of Hypertension 	 Recent Developments in...Recent Developments in the Treatment of Hypertension 	 Recent Developments in...
Recent Developments in the Treatment of Hypertension Recent Developments in...
 
Subcutaneous emphysema as a complication of tooth extraction Subcutaneous e...
Subcutaneous emphysema as a complication of tooth extraction 	 Subcutaneous e...Subcutaneous emphysema as a complication of tooth extraction 	 Subcutaneous e...
Subcutaneous emphysema as a complication of tooth extraction Subcutaneous e...
 
Psychology in Dentistry
Psychology in DentistryPsychology in Dentistry
Psychology in Dentistry
 
The Long QT Syndrome: Overview and Management The Long QT Syndrome: Overvie...
The Long QT Syndrome: Overview and Management 	 The Long QT Syndrome: Overvie...The Long QT Syndrome: Overview and Management 	 The Long QT Syndrome: Overvie...
The Long QT Syndrome: Overview and Management The Long QT Syndrome: Overvie...
 
Dental Care of the Future: Part I
Dental Care of the Future: Part IDental Care of the Future: Part I
Dental Care of the Future: Part I
 
Community Dentistry Years I - IV
Community Dentistry Years I - IVCommunity Dentistry Years I - IV
Community Dentistry Years I - IV
 
Preventive Dentistry Lecture Cde Course
Preventive Dentistry Lecture Cde CoursePreventive Dentistry Lecture Cde Course
Preventive Dentistry Lecture Cde Course
 
Diabetes Mellitus patients in dental management
Diabetes Mellitus patients in dental managementDiabetes Mellitus patients in dental management
Diabetes Mellitus patients in dental management
 
Minimal Intervention Dentistry – The Challenge for Materials
Minimal Intervention Dentistry – The Challenge for MaterialsMinimal Intervention Dentistry – The Challenge for Materials
Minimal Intervention Dentistry – The Challenge for Materials
 
ANATOMY of TEETH 2 1. Anatomy of a tooth. a. Anatomical crown ...
ANATOMY of TEETH 2 1. Anatomy of a tooth. a. Anatomical crown ...ANATOMY of TEETH 2 1. Anatomy of a tooth. a. Anatomical crown ...
ANATOMY of TEETH 2 1. Anatomy of a tooth. a. Anatomical crown ...
 
Dental Anatomy
Dental AnatomyDental Anatomy
Dental Anatomy
 

Recently uploaded

HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
GL Anaacs
 
How to Give Better Lectures: Some Tips for Doctors
How to Give Better Lectures: Some Tips for DoctorsHow to Give Better Lectures: Some Tips for Doctors
How to Give Better Lectures: Some Tips for Doctors
LanceCatedral
 
Knee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdfKnee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdf
vimalpl1234
 
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptxTriangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
Evaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animalsEvaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animals
Shweta
 
basicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdfbasicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdf
aljamhori teaching hospital
 
Flu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore KarnatakaFlu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore Karnataka
addon Scans
 
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptxMaxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
Physiology of Special Chemical Sensation of Taste
Physiology of Special Chemical Sensation of TastePhysiology of Special Chemical Sensation of Taste
Physiology of Special Chemical Sensation of Taste
MedicoseAcademics
 
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
VarunMahajani
 
Couples presenting to the infertility clinic- Do they really have infertility...
Couples presenting to the infertility clinic- Do they really have infertility...Couples presenting to the infertility clinic- Do they really have infertility...
Couples presenting to the infertility clinic- Do they really have infertility...
Sujoy Dasgupta
 
POST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its managementPOST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its management
touseefaziz1
 
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdfAlcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Dr Jeenal Mistry
 
NVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control programNVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control program
Sapna Thakur
 
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Oleg Kshivets
 
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Savita Shen $i11
 
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists  Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Saeid Safari
 
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptxPharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
Non-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdfNon-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdf
MedicoseAcademics
 
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model SafeSurat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Savita Shen $i11
 

Recently uploaded (20)

HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
 
How to Give Better Lectures: Some Tips for Doctors
How to Give Better Lectures: Some Tips for DoctorsHow to Give Better Lectures: Some Tips for Doctors
How to Give Better Lectures: Some Tips for Doctors
 
Knee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdfKnee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdf
 
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptxTriangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
 
Evaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animalsEvaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animals
 
basicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdfbasicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdf
 
Flu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore KarnatakaFlu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore Karnataka
 
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptxMaxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
 
Physiology of Special Chemical Sensation of Taste
Physiology of Special Chemical Sensation of TastePhysiology of Special Chemical Sensation of Taste
Physiology of Special Chemical Sensation of Taste
 
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
 
Couples presenting to the infertility clinic- Do they really have infertility...
Couples presenting to the infertility clinic- Do they really have infertility...Couples presenting to the infertility clinic- Do they really have infertility...
Couples presenting to the infertility clinic- Do they really have infertility...
 
POST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its managementPOST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its management
 
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdfAlcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
 
NVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control programNVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control program
 
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
 
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
 
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists  Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
 
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptxPharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
 
Non-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdfNon-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdf
 
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model SafeSurat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
 

Metabolic Syndrome, Diabetes, and Cardiovascular Disease ... Metabolic Syndrome, Diabetes, and Cardiovascular Disease .

  • 1.
  • 2. Overview of Diabetes in the United States
  • 4. Age-adjusted prevalence of physician-diagnosed diabetes in Adults age 18 and older by race/ethnicity and sex (NHANES: 1999-2004). Source: NCHS and NHLBI. NH – non-Hispanic.
  • 5.  
  • 6.  
  • 7.
  • 9. Natural History of Type 2 Diabetes
  • 10. Development of Type 2 Diabetes
  • 11. Hyperglycemia in Type 2 Diabetes Results From Three Major Metabolic Defects
  • 12. Relationship Between Obesity and Insulin Resistance and Dyslipidemia
  • 14. New Cases of ESRD in the United States
  • 15. New Cases of ESRD in the United States by Cause and Ethnicity, 1998
  • 18. Probability of Death From CHD in Patients With Type 2 Diabetes With or Without Previous MI
  • 19. Framingham Heart Study 30-Year Follow-Up: CVD Events in Patients With Diabetes (Ages 35-64) 10 9 20 11 9 6 38 19 3* 30 0 2 4 6 8 10 Age-adjusted annual rate/1,000 Men Women Total CVD CHD Cardiac failure Intermittent claudication Stroke Risk ratio P <0.001 for all values except * P <0.05. Wilson PWF, Kannel WB. In: Hyperglycemia, Diabetes and Vascular Disease. Ruderman N et al, eds. Oxford; 1992.
  • 20.
  • 21.
  • 22.
  • 23. The Metabolic Syndrome Insulin Resistance Hypertension Type 2 Diabetes Disordered Fibrinolysis Complex Dyslipidemia TG, LDL HDL Endothelial Dysfunction Systemic Inflammation Athero- sclerosis Visceral Obesity Adapted from the ADA. Diabetes Care. 1998;21:310-314; Pradhan AD et al. JAMA. 2001;286:327-334.
  • 24. Revised ATP III Metabolic Syndrome Oct 2005 *Diagnosis is established when  3 of these risk factors are present. † Abdominal obesity is more highly correlated with metabolic risk factors than is  BMI. ‡ Some men develop metabolic risk factors when circumference is only marginally increased. <40 mg/dL <50 mg/dL or Rx for ↓ HDL Men Women > 102 cm (>40 in) > 88 cm (>35 in) Men Women  100 mg/dL or Rx for ↑ glucose Fasting glucose  130/  85 mm Hg or on HTN Rx Blood pressure HDL-C  150 mg/dL or Rx for ↑ TG TG Abdominal obesity † (Waist circumference ‡ ) Defining Level Risk Factor
  • 25. International Diabetes Federation Definition: Abdominal obesity plus two other components: elevated BP, low HDL, elevated TG, or impaired fasting glucose
  • 26.  
  • 27.  
  • 28.  
  • 29.  
  • 30.  
  • 31.  
  • 32. Prevalence of the Metabolic Syndrome Among US Adults NHANES 1988-1994 Age (years) Ford E et al. JAMA . 2002(287):356. 1999-2002 Prevalence by IDF vs. NCEP Definitions (Ford ES, Diabetes Care 2005; 28: 2745-9) (unadjusted, age 20+) NCEP : 33.7% in men and 35.4% in women IDF: 39.9% in men and 38.1% in women Prevalence (%) 0 5 10 15 20 25 30 35 40 45 20-29 30-39 40-49 50-59 60-69 > 70 Men Women
  • 33. Prevalence of the NCEP Metabolic Syndrome: NHANES III by Sex and Race/Ethnicity Prevalence, % Men Ford ES et al. JAMA 2002;287:356-359. Women 25% 16% 28% 21% 23% 26% 36% 20% White African American Mexican American Other
  • 34. Cardiovascular Disease (CVD) and Total Mortality: US Men and Women Ages 30-74 (age, gender, and risk-factor adjusted Cox regression) NHANES II Follow-Up (n=6255)(Malik and Wong, et al., Circulation 2004; 110: 1245-1250 ) * p<.05, ** p<.01, **** p<.0001 compared to none * *** *** *** ** *** *** *** *** *** ***
  • 35.  
  • 36.