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30 terms

Obesity and Diabetes

4 aspects of treating diabetes
Regulating: Diet, Weight, Exercises, Drugs
Symptoms of Diabetes
Thirst, Weight Loss, Hunger, Dry mouth, Increased urination, Blurred vision, Frequent infections, slow healing of cuts and bruises
Type 1 diabetes
insulin dependent diabetes; need insulin injections
Glucose units
multiply or dive by 18;
Two types of secretions:
1. Secretes half of insulin as bolus after a meal
2. secretes other half gradually during the day and night (basal secretion)
Types of insulin to cover meals
rapid acting insulin: Clear
short acting insulin: clear
Intermediate acting: Cloudy
Long acting: Clear and colourless
most prominent adverse effect of injection
Location of injection
absorption depends on location; Blood vessels vs. Fat content; abdomen injections are better than butt injections; Need to change the location of injection or allergic response may occur
Type 2 diabetes
insulin resistant; eventually end up insulin dependent; Insulin resistance ß cell dysfunction; obesity; No ketoacidosis;
Increased sugar -> increased insulin production all the time -> Down regulation of insulin receptors -> insulin doesn't do anything
south asians
become diabetic sooner before anyone else
progression of T2DM
predisposing factors -> Insulin resistance -> impaired glucose tolerance -> increased ß cell production of insulin -> ß cell exhaustion -> inadequate insulin for the degree of insulin resistance -> T2DM
Fate of glucose in T2DM
stored as fat
Lifestyle modifications
exercise; Diet
pharmacological management
oral hypoglycemics; sulfonylureas; biguanides; alpha-glucosidase inhibitors; thiazolidinediones
increase insulin
increases insulin sensitivity
allows glucose to enter muscle cell
alpha-glucosidase inhibitors
makes you think your full; complex sugars persist for longer
PPAR activators; induce production of peroxisomes that decrease fat from circulation; Fat is a major contributor to insulin resistance -> destroys ß cells
Peroxisome Proliferator Activator Receptors
nuclear receptors involved in expression of genes that regulate storage and catabolism of fats; PPARy; Peroxisomes have enzymes that breakdown fat and toxic substances
harmful chemical released by fat
stimulates insulin secretion; suppresses glucagon secretion; slows gastric emptying; improves insulin sensitivity; reduces food intake; maintains ß cell function; can't get hypoglycemic
Two primary incretins
Glucagon-like peptide (GLP-1)
DPP-4 inhibitors
increases glucose uptake; decreased glucose output; controls blood glucose
tells you a history of glucose management; goal is to reduce HbA1C
when to use incretin therapy
A1C not at target with metformin + sulfonylureas; weight gain is of concern; Hypoglycemia is undesirable
complication (macrovascular)
coronary artery disease, peripheral vascular disease, cerbrovascular disease
complication (microvascular)
leading cause of blindness, kidney failure and amputations
take away message
1. Diabetes is a progressive disease
2. Most diabetics die of cardiovascular complications
3. Treatment of diabetes is a partnership
4. Insulin types 1 and 2
5. oral hypoglycemics (T2DM)