type 1 diabetes insulin-dependent diabetes mellitus, also known as juvenile-onset diabetes...

TYPE 1 DIABETES

Insulin-dependent diabetes mellitus, also known as juvenile-onset diabetes

Prevalence of 0.4% (stable over the past decades)

Absolute deficiency of insulin

May be autoimmune based

Management requires exogenous insulin

Patients are prone to ketosis

TYPE 2 DIABETES

Non-insulin-dependent diabetes, also known as maturity onset or adult-onset diabetes

Approximately 90% of all diabetics are type II

Prevalence of 6.6% (15–20 million patients in United States)

Relative deficiency of insulin/peripheral resistance to insulin/excessive hepatic glucose release

Generally seen in obese adults

Patients produce adequate amounts of insulin to prevent ketosis but are at risk for hyperosmolar state

Initially managed with diet control, weight loss, and oral hypoglycemic agents

Patients may require insulin as their disease progresses

GESTATIONAL DIABETES

The most common medical problem of pregnancy (1–4% of pregnancies)

Increased risk of maternal and neonatal complications

At least 30–50% acquire type II diabetes within 20 years after pregnancy

Usually require insulin during pregnancy

SECONDARY DIABETES

Pancreatic disease (decreased insulin production)

Drug induced

Secondary to endocrinopathies such as

Cushing’s disease, acromegaly, pheochromocytoma

OBESITY TRENDS AMONG US ADULTS 1985 to 2002

Obesity: Having a very high amount of body fat in relation to lean body mass.Body Mass Index (BMI) of 30 or higher

Body Mass Index (BMI): A measure of an adult’s weight in relation to his or her height, specifically the adult’s weight in kilograms divided by the square of his or her height in meters

No Data <10% 10%–14%

OBESITY TRENDS AMONG US ADULTS 1985

No Data <10% 10%–14%


No Data <10% 10%–14% 15%–19%


No Data <10% 10%–14% 15%–19%

1994OBESITY TRENDS AMONG US ADULTS

No Data <10% 10%–14% 15%–19%


No Data <10% 10%–14% 15%–19% ≥20


No Data <10% 10%–14% 15%–19% 20%–24% ≥25%


Source: Behavioral Risk Factor Surveillance System, CDC

(*BMI 30, or ~ 30 lbs overweight for 5’4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%


THE EFFECT PRODUCED ON DIABETESBY EXTRACTS OF PANCREAS

BANTING, BEST, COLLIP, CAMPBELL, FLETCHER, MACLEOD & NOBLE

TRANSACTIONS OF THE ASSOCIATIONOF AMERICAN PHYSICIANS 1922

New Strategy For The Prevention of Type 2 Diabetes

Six recent large-scale clinical studies reported a remarkably consistent reduction in the incidence of type 2 diabetes in hypertensive patients treated with either ACE inhibitors or ARAs for 3-6 years, compared with a thiazide diuretic, beta-adrenoceptor antagonist, the calcium channel antagonist amlodipine or even placebo.

These encouraging observations led to the initiation of two large, prospective, placebo-controlled randomized clinical trials whose primary outcome is the prevention of type 2 diabetes: the DREAM trial with the ACE inhibitor ramipril and the NAVIGATOR trial with the ARA valsartan.

The consistent observations of a 14-34% reduction of the development of diabetes in hypertensive patients receiving ACE inhibitors or ARAs are exciting. From a theoretical point of view, they emphasize that there are many aspects of the pathogenesis, prevention and treatment of type 2 diabetes that still need to be uncovered. From a practical point of view, they may offer a new strategy to reduce the ongoing epidemic and burden of type 2 diabetes.

Drugs. 2004;64(22):2537-65.

Vaccine May Prevent Onset Of Type 1 Diabetes

Prof Harrison has devised a test to detect children and young adults in the early stages of the disease. He said the insulin in the nasal spray could stop the type 1 rogue immune response and trigger a healthy response.

"That good immune response . . . will block the kind of immune response that would cause destruction of insulin-producing cells," he said.

A five-year trial involving 38 children at Royal Melbourne Hospital and the Hall Institute proved the vaccine protected against the development of diabetes. Of the 38 children, 12 who began with very little or no insulin-producing function went on to develop diabetes within one or two years. None of the 26 who began the trial while still producing some of their own insulin developed diabetes.

http://www.diabetesincontrol.com/modules.php?name=News&file=article&sid=2278

New Blood Sugar Sensor Improves Diabetes Control

People with type 1 diabetes have to constantly check their blood sugar levels, a chore that involves finger pricks and test strips and a special meter.

Although intensive diabetes control is associated with better outcomes, it is also linked to more frequent episodes of hypoglycemia, researchers at the University of Colorado Health Sciences Center in Denver theorized that real-time continuous glucose readings would increase the amount of time patients maintained blood sugar levels in the normal range.

For their study, 15 patients with type 1 diabetes had DexCom glucose sensors implanted under the skin of the abdomen. The device is about the size of an AA battery that transmits radio signals to a pager-sized receiver. Glucose levels are determined every 30 seconds, and data are transmitted to the receiver every 5 minutes. Vibratory and auditory alarms go off when glucose levels are too high or too low.

Studies suggest that infrequent self-monitored blood glucose measurements fail to provide patients with enough information to avoid low blood sugar levels. By decreasing high and low swings in the glucose levels, continuous glucose readings may reduce the long-term complications of diabetes.

Diabetes Care, March 2004.

type 1 diabetes insulin-dependent diabetes mellitus, also known as juvenile-onset diabetes...

Documents

pregnancy slide

ketosis slide

pheochromocytoma slide

gestational diabetes

exogenous insulin patients

adultonset diabetes

adults weight

insulin production drug