Although type 1 diabetes continues to remain the most common form of childhood diabetes in most of the
countries including India, the prevalence of type 2 diabetes is increasing worldwide. This increase is attributed to the modern sedentary lifestyle causing a phenotype of insulin resistance in genetically predisposed individuals. The differentiation between type 1 and type 2 diabetes can be done in most of the cases but may be difficult in obese adolescents with relatively acute presentation. The demonstration of various antibodies is helpful in such circumstances. The earlier age of onset puts patients at risk of earlier age of complications. The management is very challenging as lifestyle modification by the patient and the family is the mainstay of the management. Emphasis should be done on primary prevention with a focus on
healthier lifestyles among children.
The journey of low birth weight infant Khaled Saad
Previously known as ‘failure to thrive’ (FTT), also known as weight faltering
Infant or children whose current weight or rate of weight gain is significantly below that expected of similar children of the same age, sex and ethnicity
Can occur in both infants (< 1 year of age) and in children (> 1 year of age)
Although type 1 diabetes continues to remain the most common form of childhood diabetes in most of the
countries including India, the prevalence of type 2 diabetes is increasing worldwide. This increase is attributed to the modern sedentary lifestyle causing a phenotype of insulin resistance in genetically predisposed individuals. The differentiation between type 1 and type 2 diabetes can be done in most of the cases but may be difficult in obese adolescents with relatively acute presentation. The demonstration of various antibodies is helpful in such circumstances. The earlier age of onset puts patients at risk of earlier age of complications. The management is very challenging as lifestyle modification by the patient and the family is the mainstay of the management. Emphasis should be done on primary prevention with a focus on
healthier lifestyles among children.
The journey of low birth weight infant Khaled Saad
Previously known as ‘failure to thrive’ (FTT), also known as weight faltering
Infant or children whose current weight or rate of weight gain is significantly below that expected of similar children of the same age, sex and ethnicity
Can occur in both infants (< 1 year of age) and in children (> 1 year of age)
Diabetes [2019]
There is little research into pae and diabetes. What there is indicates that further research should be done.
The attached research has been done from the perspective of prenatal alcohol consumption.
A search of diabetes research failed to find any mention of prenatal alcohol.
definition of malnutrition, the definition of protein-energy malnutrition , the etiology 0f protein-energy malnutrition, the pathophysiology of malnutrition, features of marasmus, features of kwashiorkor, vitamins and micronutrient deficiencies, signs of micronutrients deficiency, diagnosis, management of malnutrition,prognosis of malnutrition ,prevention of malnutrition
Inpatient case study on the Multifactorial Conditions of Failure to Thrive in adulthood. Outlines the literature review, hospital course, and nutrition care plan, including the nutritional assessments and educations conducted. This case study was presented at Johns Hopkins Bavyiew Medical Center.
definition what is FPIES, what it defers from other food allergy, what are the signs and symptoms ,what are the different types of food allergy ,how to diagnose FPIES ,what are the oral food challenge (OFC) ,what is the treatment , the prognosis of FPIES
Diabetes [2019]
There is little research into pae and diabetes. What there is indicates that further research should be done.
The attached research has been done from the perspective of prenatal alcohol consumption.
A search of diabetes research failed to find any mention of prenatal alcohol.
definition of malnutrition, the definition of protein-energy malnutrition , the etiology 0f protein-energy malnutrition, the pathophysiology of malnutrition, features of marasmus, features of kwashiorkor, vitamins and micronutrient deficiencies, signs of micronutrients deficiency, diagnosis, management of malnutrition,prognosis of malnutrition ,prevention of malnutrition
Inpatient case study on the Multifactorial Conditions of Failure to Thrive in adulthood. Outlines the literature review, hospital course, and nutrition care plan, including the nutritional assessments and educations conducted. This case study was presented at Johns Hopkins Bavyiew Medical Center.
definition what is FPIES, what it defers from other food allergy, what are the signs and symptoms ,what are the different types of food allergy ,how to diagnose FPIES ,what are the oral food challenge (OFC) ,what is the treatment , the prognosis of FPIES
The Journal of NutritionSymposium Nutritional Experiences.docxarnoldmeredith47041
The Journal of Nutrition
Symposium: Nutritional Experiences in Early Life as Determinants of the
Adult Metabolic Phenotype
Mechanisms Linking Suboptimal
Early Nutrition and Increased Risk of
Type 2 Diabetes and Obesity1–3
Malgorzata S. Martin-Gronert and Susan E. Ozanne*
Institute of Metabolic Science-Metabolic Research Laboratories, University of Cambridge, Addenbrooke’s Hospital,
Cambridge CB2 0QQ, UK
Abstract
Epidemiological studies have revealed a relationship between poor early growth and development of type 2 diabetes and
other features of metabolic syndrome. The mechanistic basis of this relationship is not known. However, compelling
evidence suggests that early environmental factors, including nutrition, play an important role. Studies of individuals in
utero during a period of famine showed a direct relationship between maternal nutrition and glucose tolerance. Further
evidence has come from studies of monozygotic twins who were discordant for type 2 diabetes. Nutrition during the early
postnatal period has also been shown to have long-term consequences on metabolic health. Excess nutrition and
accelerated growth during the neonatal period has been suggested to be particularly detrimental. Animal models, including
maternal protein restriction, have been developed to elucidate mechanisms linking the early environment and future
disease susceptibility. Maternal protein restriction in rats leads to a low birth weight and development of type 2 diabetes in
the offspring. This is associated with b cell dysfunction and insulin resistance. The latter is associated with changes in
expression of key components of the insulin-signaling cascade in muscle and adipocytes similar to that observed in tissue
from young men with a low birth weight. These differences occur prior to development of disease and thus may represent
molecular markers of early growth restriction and disease risk. The fundamental mechanisms by which these
programmed changes occur remain to be fully defined but are thought to involve epigenetic mechanisms. J. Nutr. 140:
662–666, 2010.
Introduction
It is well established that poor growth in utero is associated with
increased risk of developing diseases such as type 2 diabetes in
later life (1). There is strong evidence from both human and
animal studies that the early environment and in particular early
nutrition play an important role. However, the molecular
mechanisms by which a phenomenon that occurs in early life
has a phenotypic consequence many years later are only just
starting to emerge.
Epidemiological data
The first study to link birth weight to increased risk of type 2
diabetes was conducted in a group of men born in Hertfordshire,
UK, who were 64 y old at the time of the study. Those men who
had the lowest birth weight were 6 times more likely to currently
have either impaired glucose tolerance or type 2 diabetes than
those men who were heaviest at birth (2). These findings have
been reproduce.
Diabetes Type 1 Sara MartinezChamberlain College of Nursing.docxlynettearnold46882
Diabetes Type 1
Sara Martinez
Chamberlain College of Nursing
NR 507 Advanced Pathophysiology
2018
1
1
What is Diabetes
Body Does not make or properly use insulin: (ADA,2005)
No insulin production
Insufficient insulin production
Resistance to insulin’s effects
No insulin to move glucose from blood into cells
High blood glucose means:
Fuel loss, cells starve
Short and long term complications
2
Diabetes is a chronic disease in which the body does not make or properly
use insulin, a hormone that is needed to convert sugar, starches, and other
food into energy by moving glucose from blood into the cells ( American Diabetes Association, 2005).
People with diabetes have increased blood glucose (sugar) levels for one or
more of the following three reasons: Either
No insulin is being produced,
Insulin production is insufficient, and/or
The body is resistant to the effects of insulin.
As a result, high levels of glucose build up in the blood, and spill into the
urine and out of the body. The body loses its main source of fuel and cells
are deprived of glucose, a needed source of energy. High blood glucose
levels may result in short and long term complications over time ( Centers for Disease Control and Prevention, 2017).
2
Understanding Diabetes Type 1
Auto immune disorder
Insulin – producing cells destroyed
Daily insulin replacement necessary
Age of onset: usually childhood, young adults
Most prevalent type of diabetes in children and adolescent’s
(CDC,2017)
3
Diabetes mellitus (DM) is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both (CDC,2017).
The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both.
The effects of diabetes mellitus include long–term damage, dysfunction and failure of various organs.
Diabetes is a condition where the body fails to utilize the ingested glucose properly. This could be due to lack of the hormone insulin or because the insulin that is available is not working effectively. Diabetes is the fastest growing long term disease that affects millions of people worldwide (CDC,2017). According to the charity Diabetes UK, more than two million people in the UK have the condition and up to 750,000 more are unaware of having the condition. In the United States 25.8 million people or 8.3% of the population have diabetes. Of these, 7.0 million have undiagnosed diabetes. In 2010, about 1.9 million new cases of diabetes were diagnosed in population over 20 years. It is said that if this trend continues, 1 in 3 Americans would be diabetic by 2050 (Mayo Clinic, 2017).
Type 1 diabetes is a disease of the immune system, which is the body’s system for fighting infection.
In people with type 1 diabetes, the .
Diagnosis of diabetes using classification mining techniques [IJDKP
Diabetes has affected over 246 million people worldwide with a majority of them being women. According to the WHO report, by 2025 this number is expected to rise to over 380 million. The disease has been named the fifth deadliest disease in the United States with no imminent cure in sight. With the rise of information technology and its continued advent into the medical and healthcare sector, the cases of diabetes as well as their symptoms are well documented. This paper aims at finding solutions to diagnose the disease by analyzing the patterns found in the data through classification analysis by employing
Decision Tree and Naïve Bayes algorithms. The research hopes to propose a quicker and more efficient technique of diagnosing the disease, leading to timely treatment of the patients.
Diabetes is the condition in which the body does not properly process food for use as energy. Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy.
The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn't make enough insulin or can't use its own insulin as well as it should. This causes sugars to build up in your blood.
This is why many people refer to diabetes as ―sugar‖ Diabetes can cause serious health complications including, heart disease, blindness, kidney failure, and lower-extremity amputations.
Outcome of pregnancy among Pre-existing Type-2 Diabetic Womeniosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
1. Effects of Early Onset Diabetes in Children
By Omar Padilla Vélez
ABSTRACT
Diabetes is one of the main causes of child death, but it is ignored. New and current
research has shown that early onset diabetes is harmful for anyone. Type1 and Type 2 diabetes
are both hereditary diseases. Experiments with diabetic patients who have diabetic parents show
that diabetes is inherited, especially via paternal lineage. Even though diabetes is a hereditary
disease it is preventable by keeping a healthy lifestyle. Diabetes in children has been
demonstrated to develop serious health problems. Studies have concluded that diabetic children
under 15 have more chances of developing microalbuminaria. This is high levels of protein in the
urine, which can lead to kidney failure. As this disease progresses new treatments are being
developed. The current method for diabetic children consists of multiple daily insulin injections.
This treatment causes a great amount of stress in the children and decreasing their quality of life.
The insulin pump therapy is being introduced as a new method for children. The pump regulates
the glucose levels automatically, releasing the worries and stress of the children and their
parents.
INTRODUCTION
The human body functions using the energy that is consumed daily. In every activity that
is performed, energy is essential. Even when a person sleeps, they still need energy for the
proper function of the body’s systems and processes. The main way that the body gets energy is
by eating. Food is digested in the stomach for the extraction of nutrients which carry energy for
growth and development. Most of the energy comes from glucose, which is a form of sugar in
the blood. This glucose is the main source of fuel for the body. Glucose comes into the
bloodstream and spreads throughout the whole body.
The body’s cells use hormones to complete several processes. To take in the glucose
from the blood into the cells, the body uses insulin. A specific amount of insulin is produced by
the pancreas when food is eaten to move the glucose into the cells. This way, sugar levels in the
bloodstream are lowered and the body gets the energy it needs to work properly. A healthy
pancreas is able to can adjust the amount of insulin needed based on the glucose levels in the
blood.
A person with diabetes has a condition in which the levels of glucose in the blood are too
high. This is an effect of the body cells not responding to the insulin the pancreas produces, not
producing enough insulin or any amount of insulin. Without insulin the glucose does not enter
the cells and no energy for growth and development will be available. This is why diabetes in
considered a metabolism disorder. There are two main types of diabetes, type 1 and type 2.
People who suffer Type 1 diabetes are completely unable to produce insulin. People with Type 2
diabetes can produce insulin, but their cells do not respond to it. In either case, the glucose
cannot move into the cells causing high glucose levels in the blood. Over time, these high
2. glucose levels can cause serious complications in the body like: high blood pressure, high
cholesterol, loss of sight, kidney disease and even nerve damage.
Type 2 diabetes as a hereditary disease
It is believed that people who have offspring. They selected three groups of
family members that have been diagnosed individuals: 1) offspring of fathers with
with type 2 diabetes have a great risk of early onset of diabetes, 2) offspring of
developing it themselves. It is not mothers with early onset of diabetes, and 3)
guaranteed, but a person’s family history offspring, in which neither parent developed
and lifestyle plays an important part in diabetes. Body composition (percentage of
determining they have diabetes. Researchers body fat [%BF]), insulin action (M), and
have tested whether or not paternal and acute insulin response (AIR) were compared
maternal type 2 diabetes may occur in their to formulate conclusions.
offspring and tried to identify it for a better
diagnosis. They specifically examined the Body composition was measured by
metabolic phenotype in three different dual energy X-ray absorptiometry using a
groups of offspring to see distinct paternal total body scanner (DPX-L; Lunar,
versus maternal effects. The offspring Madison, WI). Insulin action was assessed at
phenotype may vary depending on which physiological insulin concentrations during
parent is affected and whether the offspring the hyperinsulinemic-euglycemic clamp
was exposed to diabetes in utero. technique. Blood samples were taken at
specific time to determine the insulin action
Low birth weight (LBW), was by comparing and calculating the glucose
thought to result from in utero maternal infusion with the plasma activity in the
undernutrition. It is one of the phenotypic blood.
features and has been shown to predict the
development of type 2 diabetes. Recent From all the experimentation they
studies with mice demonstrated that concluded that offspring of fathers with
although a LBW phenotype, first generated early-onset diabetes are leaner and have
using maternal undernutrition, confers lower early insulin secretion compared to
impaired glucose tolerance via both individuals who both parents remained
subsequent parental lines, the LBW without diabetes up to 50 years of age.
phenotype is passed on via paternal Insulin action was very similar in all three
inheritance only. As these mice reach groups of offspring. These results indicate
maturity, paternal offspring continue to have an important role of paternal heritability in
lower body weight but similar degrees of body composition. Paternal transmission
impairment in glucose tolerance and patterns for susceptibility to diabetes
impaired insulin secretion. indicate that epigenetic mechanisms are
involved in the predisposition to diabetes.
With this data the researchers made (Penesova et. al 2010).
an experiment to separate parental effects in
3. Health risks on children with diabetes
Type 1 diabetes is the most common screening program, the North Wales
type of diabetes in children today. Usually Diabetic Retinopathy Screening Program,
children under the age of 16 are being hospital departments of chemical pathology,
revealed with the disease. Type 1 diabetes in and general practitioners (GPs). Urine
children is known as an autoimmune disease samples were asked for and patients who did
because the body’s immune system will not attend hospital clinics send their samples
attack one of the body’s own tissues or by postal request. A nephropathy score was
organs. It is believed that the younger the set for each age group from renal outcome
patient suffering Type 1 diabetes the worse and were ranked as: normal, 1;
the outcome. Studies have shown that young macroalbuminuria, 2; established diabetic
onset Type 1 diabetes is associated with an nephropathy, 3; progressive renal failure, 4;
increased incidence of macroalbuminuria, or end-stage renal failure (ESRF), 5.
20 - 200 µg/min albumin proteins in the
urine, and increased incidence of The study resulted that compared
background retinopathy. The aim of this with adult-onset controls, the nephropathy
study was to quantify the influence of age at outcome was worse in childhood-onset
onset on long-term renal and retinal outcome diabetes. The risk of developing
of childhood onset Type 1 diabetes by macroalbuminuria was greater in childhood
comparing the rates at which renal and onset diabetes. The number of patients
retinal pathology occur. developing background retinopathy did not
differ with age at onset but younger onset
patients were more likely to need laser
An ethical committee approval was
treatment. Patients with onset of Type 1
obtained for the study. The data was
diabetes before age 15 had worse renal
provided by three hospital units and all 74
outcome and require more treatment than
general practices serving the area. The
adult-onset patients. Differences between
patients were 98% Type 1 diabetic patients
those with onset before age 5, onset at 5–9
with onset before age 15. They divided
and 10–14 years are small compared with
patients who developed Type 1 diabetes in
the difference between childhood onset and
groups by age: before age 5 (group 1), from
adult onset. Kidney disease and diabetes will
age 5 to 9 (group 2) and from age 10 to 14
progress and the child will not be able to get
years (group 3), and a reference group
rid of the waste that is their blood. This
comprising all patients diagnosed with Type
waste will build up and become toxic to the
1 diabetes between ages 21 and 25 years
body turning into uremia. Developing
(group 4).
diabetes in the teenage years appears to have
a major effect on the risk of developing
The data on these patients was
long-term micro vascular complications.
obtained from the diabetes register, patients’
(Harvey and Allagoa 2003).
case notes, the local microalbuminuria
Insulin pump therapy
4. As technology is developed in quality of life and it decreases parental stress
medicine, it is important that new treatments because the glucose levels are maintained
are efficient and harmful for the patients. In and the children do not argue that much. A
the U.S., 186,300 children have been research was conducted using sixty-two
diagnosed with type 1 diabetes and each middle and high school children (ages 12–
year 15,000 more are diagnosed. Type 1 17) with type 1 diabetes, and the parents in
diabetes can result and develop in serious charge of them. Twenty-six (42%) of the
like cardiovascular disease, blindness, nerve children were using the pumps at the time of
damage and kidney damage. Researchers are the study and 36 (58%) were using MDI. A
focusing on establishing effective methods written informed consent was obtained from
to control blood glucose levels. Currently, the parents. The data collected was:
insulin levels are managed via multiple daily children’s age, date of diabetes diagnosis,
injections (MDI), but an increasing number and most recent blood glucose levels. Also,
of children are using insulin pumps. Insulin the parents completed a measure of
pumps deliver insulin 24 hours a day parenting stress and the children completed
through a catheter. This allows more a measure of quality of life.
flexibility nutrition choices and may lead to
more stable glucose levels. These insulin The outcome of the study indicated
pumps better mimic pancreatic insulin that children on insulin pump therapy are
delivery and provide a more predictable not very different from children receiving
insulin effect on blood glucose levels than MDI in terms of metabolic control, quality
injections. of life and parenting stress. These results are
similar to previous studies. The similar
The insulin pumps have three results may be associated with advances in
advantages over MDI. The children achieve MDI therapy. (Yelena et al. 2010).
better metabolic control, they have a higher
CONCLUSION
Studies have shown that diabetes is a hereditary disease. By following the condition’s
metabolic phenotypes in offspring, researchers demonstrated that the disease is inherited from
parent to child. Symptoms and conditions that lead to diabetes such as low birth weight and
insulin secretion are seen in children with parents with who suffer the same conditions. Even
though diabetes is hereditary, it is preventable.
Children with diabetic family history and who do not keep a healthy life style are at great
risk of developing the disease. Diabetes in children is very serious because it leads to big health
issues at an early age. A study with children under and over 15 year of age showed that children
fewer than 15 diagnosed with diabetes have more renal problems. This is caused by
microalbuminaria, high levels of protein in the urine. This can lead to kidney problems and even
kidney failure. It is important to develop an effective treatment for children because they are not
capable on understanding the risk of diabetes. Children care for having a good time, which is
why the new insulin pump therapy is ideal for them. The pump regulates the glucose levels in the
5. blood automatically. This releases the kid’s worries and let’s them have a good quality of life
while at the same time having a better control over their condition.
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