By:By:

RobertoRoberto

ValdovinosValdovinos

What is Diabetes?What is Diabetes?

Medical disorder which raises the level Medical disorder which raises the level of sugar in blood, especially after a mealof sugar in blood, especially after a meal

Disease in which body does not produce Disease in which body does not produce or properly use insulin( hormone or properly use insulin( hormone needed to convert sugar into energy for needed to convert sugar into energy for life)life)

About 7% of Americans have itAbout 7% of Americans have it Affects Endocrine System Affects Endocrine System

Signs, Symptoms, and Signs, Symptoms, and Diagnosis Diagnosis

Frequent urination, increased thirst resulting in Frequent urination, increased thirst resulting in increased fluid intake, weight loss, increased increased fluid intake, weight loss, increased appetite, and irreducible fatigue, irritability, blurry appetite, and irreducible fatigue, irritability, blurry visionvision

DiagnosisDiagnosis Fasting glucose in the plasma at or above 7.0mmol/LFasting glucose in the plasma at or above 7.0mmol/L Plasma glucose at or above 11.1mmol/L two hours Plasma glucose at or above 11.1mmol/L two hours

after 75 gram load of glucose (as in meal)after 75 gram load of glucose (as in meal) Symptoms of diabetes and a random plasma glucose Symptoms of diabetes and a random plasma glucose

at or above 11.1mmol/L at or above 11.1mmol/L

Diabetes Type 1Diabetes Type 1 Most common in children and adolescentsMost common in children and adolescents Characterized by the β-cell destruction which leads to an absolute Characterized by the β-cell destruction which leads to an absolute

deficiency of insulin deficiency of insulin

Forms of diabetes Type 1Forms of diabetes Type 1 Immune mediated characterized by autoimmune destruction of Immune mediated characterized by autoimmune destruction of

the body's β-cells in the pancreas, destroying them or damaging the body's β-cells in the pancreas, destroying them or damaging them sufficiently to reduce insulin productionthem sufficiently to reduce insulin production

Another form is characterized by the loss of the body's β-cells Another form is characterized by the loss of the body's β-cells without evidence of autoimmunity without evidence of autoimmunity

5-10% of Americans have this type of diabetes5-10% of Americans have this type of diabetes Regular shots of insulin are needed Regular shots of insulin are needed Can cause long-term complications including kidney problems, Can cause long-term complications including kidney problems,

nerve damage, blindness, and early coronary heart disease and nerve damage, blindness, and early coronary heart disease and stroke stroke

Diabetes Type 2Diabetes Type 2 Characterized by when the body is unable to Characterized by when the body is unable to

respond to insulin normally respond to insulin normally Believed that excess body fat plays a role in the Believed that excess body fat plays a role in the

insulin resistance that characterizes the diseaseinsulin resistance that characterizes the disease More complex then diabetes Type 2, but is easier More complex then diabetes Type 2, but is easier

to treatto treat Symptoms are milder Symptoms are milder Severe complications can result from unnoticed Severe complications can result from unnoticed

type 2 diabetes, including renal failure, and type 2 diabetes, including renal failure, and coronary artery disease coronary artery disease

Treated by changes in diet and weight lossTreated by changes in diet and weight loss Most Americans who have diabetes have this typeMost Americans who have diabetes have this type

Gestational DiabetesGestational Diabetes

Appears in 2-5% of all pregnanciesAppears in 2-5% of all pregnancies Temporary and fully treatable, but if Temporary and fully treatable, but if

untreated it may cause problems with the untreated it may cause problems with the pregnancy, including macrosomia (high pregnancy, including macrosomia (high birth weight) of the childbirth weight) of the child

Requires careful medical supervision Requires careful medical supervision during the pregnancy during the pregnancy

20-50% of these women develop type 2 20-50% of these women develop type 2 diabetesdiabetes

With Proper Control of With Proper Control of InsulinInsulin

Causes of DiseaseCauses of Disease

Both type 1 and type 2 are at least partly Both type 1 and type 2 are at least partly inherited inherited

Type 1 diabetes appears to be triggered Type 1 diabetes appears to be triggered by infection, stress, or environmental by infection, stress, or environmental factorsfactors

The genetic element in the susceptibility The genetic element in the susceptibility of individuals to some of these triggers of individuals to some of these triggers which has been traced to particular HLA which has been traced to particular HLA genotypesgenotypes

Seems to require environmental trigger Seems to require environmental trigger

Causes of DiseaseCauses of Disease (continued)(continued)

There is a stronger inheritance pattern for There is a stronger inheritance pattern for Type 2 diabetes Type 2 diabetes

Those who have had ancestors who had Those who have had ancestors who had type 2, have a higher chance of getting ittype 2, have a higher chance of getting it

Age is also a contributing factor in getting Age is also a contributing factor in getting the disease the disease

Obesity is also a contributing factor that Obesity is also a contributing factor that seems to contributeseems to contribute

Diagnosis Diagnosis

Usually involves recent-onset symptomsUsually involves recent-onset symptoms Symptoms worsen after a few weeksSymptoms worsen after a few weeks Diabetes is also diagnosed by health Diabetes is also diagnosed by health

screenings, detection of hyperglycemia screenings, detection of hyperglycemia when a doctor is investigating a when a doctor is investigating a complication of longstanding, complication of longstanding, unrecognized diabetes, and less unrecognized diabetes, and less commonly , new signs or symptoms that commonly , new signs or symptoms that come from the diseasecome from the disease

Diabetes ScreeningDiabetes Screening

recommended for many types of recommended for many types of people at various stages of life or people at various stages of life or with several different risk factors with several different risk factors

40-50 year olds are recommended to 40-50 year olds are recommended to get a screeningget a screening

Earlier screenings are recommended Earlier screenings are recommended to those that are obese, have a to those that are obese, have a family history of diabetes, or high-family history of diabetes, or high-risk ethnicity risk ethnicity

Diabetic factorsDiabetic factors

Patients with fasting blood sugars Patients with fasting blood sugars between 100 and 125 mg/dL are between 100 and 125 mg/dL are considered to have "impaired fasting considered to have "impaired fasting glucose", "pre-diabetes" is considered and glucose", "pre-diabetes" is considered and a major risk factor for progression to full-a major risk factor for progression to full-blown diabetesblown diabetes

2 hours after eating, if blood sugar is 2 hours after eating, if blood sugar is between 140 and 199 mg/dL is called between 140 and 199 mg/dL is called "glucose intolerance" and is also a "pre-"glucose intolerance" and is also a "pre-diabetic" diagnosis diabetic" diagnosis

Diabetic coma and Diabetic coma and ketoacidosisketoacidosis

Diabetic Diabetic KetoacidosisKetoacidosis Acute, dangerous complication and is always an emergency and Acute, dangerous complication and is always an emergency and

results in a visit to the emergency roomresults in a visit to the emergency room If treated properly, it usually goes away, but if not treated, death If treated properly, it usually goes away, but if not treated, death

may occurmay occur

Diabetic ComaDiabetic Coma Other acute problem associated with improper management of Other acute problem associated with improper management of

diabetesdiabetes Anyone with very high glucose levels, water will be osmotically Anyone with very high glucose levels, water will be osmotically

removed out of the cells into the blood removed out of the cells into the blood Kidneys will dump glucose into the urine, resulting in concomitant Kidneys will dump glucose into the urine, resulting in concomitant

loss of water, causing an increase in blood osmolality loss of water, causing an increase in blood osmolality With the combination of the changes, symptoms will be similar to With the combination of the changes, symptoms will be similar to

those of ketoacidosis and loss of consciousness those of ketoacidosis and loss of consciousness

HypoglycemiaHypoglycemia Almost always arises as a result of poor Almost always arises as a result of poor

management of the diseasemanagement of the disease If blood glucose levels are low enough, the If blood glucose levels are low enough, the

patient maybe become agitated, sweaty, and patient maybe become agitated, sweaty, and have many symptoms of sympathetic activation have many symptoms of sympathetic activation of the autonomic nervous system where they of the autonomic nervous system where they would experience dread and panicwould experience dread and panic

An injection of glucagon is a way to treat itAn injection of glucagon is a way to treat it The glucagon causes the liver to convert its The glucagon causes the liver to convert its

internal storages of glycogen to be released as internal storages of glycogen to be released as sugar into the blood sugar into the blood

Treating the diseaseTreating the disease

Chronic disease with no cureChronic disease with no cure Lifetime modification of achieving or Lifetime modification of achieving or

maintaining proper weight, diet, maintaining proper weight, diet, exercise, and foot careexercise, and foot care

May involve the use of oral May involve the use of oral medications or the insulin therapy medications or the insulin therapy

Possibility of curingPossibility of curing the disease the disease

The disease consists of the failure of a single The disease consists of the failure of a single organ the pancreas with a relatively simple organ the pancreas with a relatively simple function should admit of a curefunction should admit of a cure

Type 2 diabetes is more complex and difficult but Type 2 diabetes is more complex and difficult but to the extent it is regarded as an excursion by to the extent it is regarded as an excursion by the organism from the control envelope of the the organism from the control envelope of the metabolic functions around glucose metabolism, metabolic functions around glucose metabolism, correcting body mass to reverse that excursion correcting body mass to reverse that excursion approaches a cureapproaches a cure

At present cures for islet cell failure are At present cures for islet cell failure are experimental or theoretical, however recent experimental or theoretical, however recent developments strongly suggest they should be developments strongly suggest they should be achievable later onachievable later on