to Prevent Diabetes The key to diabetes prevention is taking small steps toward 45 and overweight, you are at increased risk for pre-diabetes. …
Mrs Sailers Dizziness
Learning Objectives
Spokesperson: Kristen
I Metabolism changes in Diabetes
A Sugar metabolism
i TNF-
ii insulin
a insulin receptor pathway
i what are lesions in someone with Type II?
b insulin-like growth factor pathway
iii what induces second phase of Type II
iv description of metabolic syndrome
a relationship to type II diabetes
B Lipid metabolism
i lipoprotein lipase
ii triglycerides
a possible link to pancreatitis
b link between EtOH and elevated triglycerides
iii different effects on different organs
II Molecular Factors/causes
A Insulin Resistance
a Genetic predisposition
i Indigenous peoples predisposition in Southwest
B Failure of Beta Cells to secrete enough insulin
C New ideas regarding the molecular causes of type II diabetes and
the likely implications of these ideas for the treatment of the
disease
III Laboratory Values
A Blood
a Blood glucose
i Fasting/not fasting
b HgbA1c
c C-peptide
d Cholesterol
e BUN
f Creatinine
g Sodium
h Potassium
i Bicarb
j Chloride
B Urine
a Microalbumin
b Glucose
c Ketones
d WBCs
e RBCs
f LE
C Comparison of initial/second sets of lab values
IV Symptoms/causes :
if blood sugar levels rise slowly over a period of several years,
patients may be asymptomatic
elevated blood glucose levels cause damage to blood vessels and
nerves, mechanism is not well defined
A Dizziness w/ standing: due to blood pressure drop
B Blood pressure drop w/ standing: Increased water excretion
dehydration leads to decreased blood volume; autonomic
neuropathy can cause decreased blood pressure
C Increase in pulse w/ standing: Heart tries to compensate for
decreased blood volume/blood pressure by beating more quickly to
increase circulation
D
Frequent urination: Normally, kidneys compensate for high blood
glucose levels by excreting excess glucose in the urine When
glucose levels become elevated, more water is removed by the
kidneys diabetic hyperglycemic hyperosmolarity
E Increased thirst: Excess water is removed by kidneys in
hyperglycemia, so thirst increases to replace the excreted
water
F Blurry vision: changing levels of glucose in blood also can
affect the balance of fluid in the lens of the eye, which works
like a flexible camera lens to focus images If the lens absorbs
more water than normal and swells, its focusing power changes
Diabetes also may affect the function of nerves that control
eyesight, causing blurred vision
G Fatigue: obesity, sleep apnea, not getting glucose into
peripheral tissues
H UTI is her tendency to get UTIs related to her diabetes?:
Diabetes can affect the nerves that control the bladder, making
it difficult for a person to empty his or her bladder
completely Bacteria can form in the unemptied bladder
and the
tubes leading from it, eventually causing infection
I Interrelatedness of fluid-related symptoms thirst, urination,
blood pressure, dry mucous membranes, dry skin, poor turgor
V Risk factors
A Genetics role in insulin resistance and glycemic control
B Obesity
a effects on insulin production
b effects on insulin resistance
C Other risk factors?
VI Complications/secondary effects
A Heart disease
B Kidney failure
C Circulation
a Need for amputations
D Retinopathy
E Stroke
F Neuropathy
G Immune deficiency
VII Treatments
A What they are
a Surgical
b Medical/drugs
i What drugs are available
ii Effects they have
iii Indications for medication treatment
iv Contraindications
v specific to her question whether there is anything she
can take for her kidneys
c Dietary control
i Costs of nutritious foods vs junk food
ii Timing of food
iii
Quantity
iv Types of foods
d Exercise
e Others
B How they work metabolically
C Lifestyle constraints on treatments how to incorporate
treatments/diet with stressful schedule other life stressors
D Whether they can prevent/control long-term complications of
diabetes
Source:med.unc.edu
