Type II Diabetes by Gunnar Spethman
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Transcript of Type II Diabetes by Gunnar Spethman
Type II Diabetesby Gunnar Spethman
Famous People with NIDDMElvis PresleyHalle BerryBret MichealsRay KrocThomas EdisonGeorge Lucas
Non-Insulin-dependent diabetesAdult-onset or Type II diabetesMetabolic disorderAffects approximately 15 million90% of all diabetics9-10 NIDDM’s are obeseObesity not cause of diabetes
NIDDM FactsType II – primary genetic component –secondary environmental componentGene’s responsible for obesity?80% of identical twins who have it, both have itA leading cause of death
More FactsChief reason for:BlindnessKidney failureLimb amputationsDialysis alone costs over $1 billion annually
Genes and NIDDMWebMD/Lycos - Article - Genetics of Diabetes Mellitus (Type 2)
PhysiologyMcDonaldsSmall IntestineGlucose Pancreas – beta cells InsulinPhospholipid layer—muscle’s receptors
Physiology Cont.Liver—glycogenGlucose—fatty acidsFatty acids—fat cellsTriglycerides
PathophysiologyType I—no insulinType II—insulin resistance or insensitivityPancreatic compensationGlucotoxicityCells starveComplications
ComplicationsHypo/hyperglycemiaKetoacidosis/hyperosmolar nonketotic comaNeuropathyCVDInfectionsGum diseaseSkin problems
ComplicationsKidney DiseaseImpaired wound healingObesity
Hypoglycemia (Low Blood Sugar)Shakiness. Dizziness. Sweating.
Hunger. Headache. Pale skin color.
HypoglycemiaSudden moodiness or behavior changes,such as crying for no apparent reason.
Clumsy or jerky movements. Difficulty paying attention, or
confusion. Tingling sensations around the
mouth.
Hyperglycemia (High Blood Sugar)Increased urinationIncreased thirstHigh Levels of sugar in urineCan cause ketoacidosis
KetoacidosisLife threatening condition caused by a build-up of ketones in the blood. Caused by breakdown of fatSymptoms include: tired, flushed skin, nausea, vomiting, abdominal pain, SOB, fruity breath, confusionMust be medically treated
RetinopathyDisorders of the retina caused by diabetes2 typesNonproliferativeProliferative
TreatmentPhotocoagulationFocal photocoagulationScatter photocoagulationvitrectomy
NeuropathyCommon complication for diabeticsAffect peripheral nerves: motor, sensory, and autonomicNerve fibers are lostComplications correlate with the type of nerve affected
NeuropathyDiabetic footCaused by lost sensation and reduced healing capabilityPoor circulation and observation
Cardiovascular DiseaseOf all cases of diabetes, 80% die of cardiovascular diseaseMore than half, especially women, likely to be hypertensive by age 50Prevalence of hypertension in NIDDM is two to three times greater than non-diabetic
Cardiovascular Disease2-3 times the incidence of MI than non-diabeticInsulin resistance inc. vascular resistance & sympathetic tone (ACE inhibitor or beta-blocker)Greater incidence of atherosclerosisSilent ischemiaCongestive heart failure
Cardiovascular DiseaseHypertension, obesity, coronary heart disease, and diabetes linked by insulin resistanceCalled metabolic syndrome, syndrome x, or civilization syndrome
Diagnostic StudiesFinger stick (glucose—fasting < 120mg%Urine dipstick for glucose (if can’t get stick)Hgb A1C every 3-4 months <8%Urine micro albuminuria <30If elevated ACE inhibitorLipid panel (LDL < 100, total <200--yearly
Diagnostic StudiesOphthalmologic exam (yearly)Podiatrist (yearly or more if symptomatic)Dental preventative care yearly or biannuallyEducation (dietician, exercise, smoking & alcohol cessation, identification bracelet, and foot care)
PhamacologySulfonylureasBiquanideGlucosidase inhibitorThiazolidinedioneMeglitinideInsulinBIDS
Exercise/DietExercise—probably the best treatment for type II diabetesLowers blood sugarDecrease insulin resistanceRaise metabolismImprove blood flow through capillaries
Exercise/DietIncrease stroke volumeImprove blood lipidsControl & prevent moderate hypertensionDecrease body massDecrease stress/cigarette smoking
DietReduce caloric intake—drop blood sugarSmaller more frequent mealsReduce intake of simple sugarComplex carbs for slower digestion
Exercise Precautions/Recommendations
Oral medications/insulinRetinopathySilent ischemiaProper footwareFluidsTemperatureNot if sugar >300 or <100
Exercise Precautions/Recommendations
KetoacidosisCarry a snack (if needed)4-6 days/week at low to moderate intensity50-85% of max VO2Maximize caloric expenditure
QuizAmerican Diabetes Association - Exercise your brain