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Diabetes

Diabetes. Diabetes Mellitus. Diabetes– Latin meaning “run through” Mellitus– “honeyed urine” Until 1922 no effective treatment, people were treated with diet and usually died of starvation In 1922, 4 Canadian researcher extracted and purified insulin from dog’s pancreas.

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Diabetes

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  1. Diabetes

  2. Diabetes Mellitus • Diabetes– Latin meaning “run through” • Mellitus– “honeyed urine” Until 1922 no effective treatment, people were treated with diet and usually died of starvation In 1922, 4 Canadian researcher extracted and purified insulin from dog’s pancreas

  3. http://www.diabetes.org/diabetes-statistics/prevalence.jsp

  4. Prevalence • 3.2 million, or 13.3% non-Hispanic blacks 20 years or older • 1.8 times more likely to have Diabetes than non-Hispanic whites • Nearly 1/3 of all patients do not know that they have the disease

  5. Normal Metabolism • Carbohydrates taken in through foodstuff and broken down to monosaccharide such as glucose • Glucose moves through blood into cells with help of insulin: • Into brain cells etc and used inside cell • Into muscle cells, stored and used when muscles need energy • Into liver where stored and taken out when needed • Controlled so the level in the blood stays somewhat level (70-130 mg/dl)

  6. Diabetes • When the blood glucose does not stay somewhat level • Types • Type I- insulin dependent; don’t make enough insulin so glucose stays in blood; 5-10% • Type 2- non insulin dependent; make enough insulin but lack receptors on cells; 90-95% • Gestational– during pregnancy • Secondary– as a complication to other illnesses

  7. Abnormal Metabolism • Since blood glucose is elevated • Glucose does readily move into cells so they are deficient of energy • Body uses fat as a source for energy producing a compound called ketones • As blood passes through kidney, the kidney removes the excess glucose from blood

  8. Symptoms • Thirsty • Frequent urination • Weight lose • Tired • Fruity smelling breathe and urine from ketones

  9. Complications • Arteriosclerosis/ coronary heart disease • Skin infections • Amputations • Impotence • Nephropathy– kidney failure • Neuropathy– nerve loss • Loss of eyesight

  10. Test for Diabetes • Urine Glucose • Blood tests • Fasting Blood Sugar • 2 hr post prandial Blood Sugar • Hemoglobin A1C • Glucose Tolerance Test

  11. www.opt.pacificu.edu/.../Figure3.jpg

  12. Treatment • Diet; In pre-diabetics, lose 5-7% of body weight • Exercise—30 minutes/day for 5 days • Insulin

  13. Oral Hyperglycemic Agents • Sulfonylurea (Glucotrol, Glynase etc) • Increase release of insulin • Meglitinides–(Metformin/Glucophage) • stimulate pancreas to secrete insulin • Thiazolidinediones (Avandia, Actos) • Decrease liver production of glucose • Help move glucose into muscle • DPP-4 Inhibitors (Januvia) • Enhances a cmpd (GLP-1) • Alpha-glucosidase inhibitors (Precose, Glyset) • Block breakdown of starches and slow breakdown of sugar

  14. Medical Implications for African Americans • 2.7X more likely to have amputations than whites • 2.6 to 5.6 more likely to have secondary kidney failure • 50% more likely to develop blindness • What the ethnic, behavioral and medical reasons that may account for this?

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