DIABETES AND INSULIN RESISTANCE DIABETES PREVALANCE

Size: px
Start display at page:

Download "DIABETES AND INSULIN RESISTANCE DIABETES PREVALANCE"

Transcription

1 DIABETES AND INSULIN RESISTANCE KARI KOHRS RD LDN CDE UICMC NUTRITION & WELLNESS CENTER DIABETES PREVALANCE Third leading cause of death-- United States 18 million diagnosed Growing at the rate of 3 new cases q 2 mins Alarming incidence of type 2 DM 18 yr old and younger type 2 DM skyrocking 1

2 THE OBESITY PROBLEM 80% of Type 2 DM are overweight Particular forms of obesity-- Abdominal Truncal Visceral Subcutaneous Central body obesity and insulin resistance are related--releases more FFA Insulin resistance has 2 causes-high levels of circulating fat and inheritance 2

3 Causes & Aggravating Factors of Insulin Resistance Combination of genetic and lifestyle factors Heredity--close relatives with Type 2 risk Ethnic group--native Americans, AA, Hispanics Abdominal obesity interferes w/ insulin action Lack of exercise and high caloric diet Stressful lifestyle stress hormones released Pregnancy-increase in weight and production of placental hormones that blood glucose levels INSULIN RESISTANCE DEFINED The body RESISTS taking sugar into the cells Insulin can t link with the receptors on the surfaces of cells because there aren t enough receptors Something goes wrong in the chemical reaction at the time of linking The body can t use the sugar in the blood & hi BG develops bringing on DM symptoms Certain proteins and/or enzymes released by stored fat act on muscle and liver cells to impair the way they read insulin signals to process glucose Visceral abdominal fat sheds more free fatty acids; elevated TG levels increases insulin production promoting further fat storage 3

4 Other notes.. Up to 92% of people with Type 2 diabetes demonstrate insulin resistance Insulin resistance and beta-cell dysfunction can precede diagnosis of Type 2 diabetes by up to 12 years Insulin resistance can be identified by these markers: 1) Hyperglycemia 2) Dyslipidemia- high triglyceride, low HDL 3) Central obesity 4) Hypertensiongreater than 130/80 FAT, TRIGLYCERIDES, AND INSULIN Abdominal fat continually releases triglycerides into the branch of the bloodstream that feeds the liver This increases the body s need for insulin release Demand for more insulin causes the pancreas to work harder to produce elevated insulin levels High levels of insulin in blood down-regulate the affinity for insulin that insulin receptors all over the body have naturally- tolerance causes > IR 4

5 INSULIN RESISTANCE The vicious cycle of insulin resistance Beta cell burnout Overeating Truncal obesity Excessive insulin production by reduced number of beta cells Insulin Resistance High blood sugar Craving carbohydrates Hunger The Culprit? FAT? And we aren t talking about dietary fat Triglycerides are in circulation at some level in the bloodstream at all times High triglyceride levels are not so much the result of intake of dietary fat as they are of excessive carbohydrate consumption and existing body fat Visceral fat-concentrated around middle of the body, surrounding the intestine 5

6 Or is the Culprit? Mutations & genetic error? The importance of PPARy--Peroxisome Proliferator Activated Receptors are found in or on cells in muscle, fat, and liver tissue and are involved in energy metabolism PPARs regulate the action of insulin Activation of PPARy results in decreased insulin resistance which in turn helps glucose enter the cells or..pc-1... PC-what? Researchers have identified a protein called PC-1 that shuts down the insulin receptor, which creates insulin resistance This protein is prevalent in most people with Type 2 diabetes compared to people without diabetes. Too much of the inhibitor protein is made in some people and the insulin receptor cannot do its job 6

7 How does it affect the chain? PC-1 desensitizes insulin receptors. The overproduction of PC-1 is a genetically determined trait The high levels of PC-1 protein lead to insulin resistance A series of defects limiting function exist FYI-Researchers are also now looking for an obesity gene 7

8 TREATMENT?--LOSE fat or ADD medicine or both Weight reduction can reduce insulin resistance, and reduce the need for medication. Eat less! Hypocaloric diet Exercise Biguanide---Metformin Thiazolidinediones--- Pioglitazone/Rosiglitazone 8

9 Biguanides vs TZD s Biguanides--Glucophage or Glucophage XR Most widely prescribed Don t cause hypoglycemia Does not promote weight gain Positive effect on blood lipid levels which can reduce insulin resistance Suppress liver glucose Enhances sensitivity of peripheral and hepatic tissues to insulin Thiazolidinediones--Actos (pioglitazone) or Avandia (rosiglitazone) Insulin sensitizers target insulin receptors in muscle and fat cells to increase insulin sensitivity in the body Lowers glucose-reduce hyperinsulinemia Can be effective in lowering TG levels & raising HDL s Activates PPAR receptors to control glucose transport In Conclusion..IR Upper body subcutaneous fat-obesity Genetics-inheritance gene mutation PPAR Protein PC-1 insulin receptor inhibitor Combination of? Prevention? What can an individual at risk do? Decrease upper body obesity or introduce a form of therapy than can correct the abnormal adipose tissue FFA release that may improve the metabolic abnormalities seen in upper body obesity even if weight loss is not successful 9

10 Resources 1) Haffner SM, D Agostino R Jr, Mykkaren L,et al. Insulin sensitivity in subjects with Type 2 diabetes: relationship to cardiovascular risk factors: the Insulin Resistance Atherosclerosis Study. Diabetes Care. 1999; 22: ) Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 4-7 years before clinical diagnosis. Diabetes Care. 1992;15: ) UK Prospective Diabetes Study 16: overview of 6 years therapy of type 2 diabetes: a progressive disease. Diabetes. 1995; 44: ) Marx N, Bourcier T, Sukhova GK, Libby P, Plutzky J. PPARy activation in human endothelial cells increases plasminogen activator inhibitor Type 1 expression: PPARy as a potential mediator in vascular disease. Arterioscler Thromb Vasc Biol. 1999; 19: ) Lovisach M, Rehman N, Carter L, et al. Distribution of peroxisome proliferatoractivated receptors (PPARs) in human skeletal muscle and adipose tissue: relation to insulin action. Diabetologia. 2000; 43: ) Touchette P, Sherrye L, American Diabetes Association Complete Guide to Diabetes. 1999: 1:25 7) Bernstein R.K., Dr. Bernstein s Diabetes Solution ) Beaser R.S., Joan V.C. Hill J.V.C, The Joslin Guide to Diabetes ) Saudek C.D., Rubin R.R., The Johns Hopkins Guide to Diabetes ) Ford-Martin P., Ian Blumer. The Everything Diabetes Book. 2004;3:22,

Cardiovascular Disease Risk Factors Part XII Insulin Resistance By James L. Holly, MD Your Life Your Health The Examiner September 15, 2005

Cardiovascular Disease Risk Factors Part XII Insulin Resistance By James L. Holly, MD Your Life Your Health The Examiner September 15, 2005 Cardiovascular Disease Risk Factors Part XII By James L. Holly, MD Your Life Your Health The Examiner September 15, 2005 As we approach the end of our extended series on cardiovascular disease risk factors,

More information

Diabetes mellitus. Lecture Outline

Diabetes mellitus. Lecture Outline Diabetes mellitus Lecture Outline I. Diagnosis II. Epidemiology III. Causes of diabetes IV. Health Problems and Diabetes V. Treating Diabetes VI. Physical activity and diabetes 1 Diabetes Disorder characterized

More information

Is Insulin Effecting Your Weight Loss and Your Health?

Is Insulin Effecting Your Weight Loss and Your Health? Is Insulin Effecting Your Weight Loss and Your Health? Teressa Alexander, M.D., FACOG Women s Healthcare Associates www.rushcopley.com/whca 630-978-6886 Obesity is Epidemic in the US 2/3rds of U.S. adults

More information

Your Life Your Health Cariodmetabolic Risk Syndrome Part VII Inflammation chronic, low-grade By James L. Holly, MD The Examiner January 25, 2007

Your Life Your Health Cariodmetabolic Risk Syndrome Part VII Inflammation chronic, low-grade By James L. Holly, MD The Examiner January 25, 2007 Your Life Your Health Cariodmetabolic Risk Syndrome Part VII Inflammation chronic, low-grade By James L. Holly, MD The Examiner January 25, 2007 The cardiometabolic risk syndrome is increasingly recognized

More information

Diabetes and Obesity in Children. Janie Berquist, RN, BSN, MPH, CDE Children s Mercy Hospitals and Clinics Kansas City, MO

Diabetes and Obesity in Children. Janie Berquist, RN, BSN, MPH, CDE Children s Mercy Hospitals and Clinics Kansas City, MO Diabetes and Obesity in Children Janie Berquist, RN, BSN, MPH, CDE Children s Mercy Hospitals and Clinics Kansas City, MO Diabetes and Obesity in Children What is Diabetes? How are Diabetes and Obesity

More information

Diabetes and Obesity. The diabesity epidemic

Diabetes and Obesity. The diabesity epidemic Diabetes and Obesity Frank B. Diamond, Jr. M.D. Professor of Pediatrics University of South Florida College of Medicine The diabesity epidemic Prevalence of diabetes worldwide was over 135 million people

More information

PowerPoint Lecture Outlines prepared by Dr. Lana Zinger, QCC CUNY. 12a. FOCUS ON Your Risk for Diabetes. Copyright 2011 Pearson Education, Inc.

PowerPoint Lecture Outlines prepared by Dr. Lana Zinger, QCC CUNY. 12a. FOCUS ON Your Risk for Diabetes. Copyright 2011 Pearson Education, Inc. PowerPoint Lecture Outlines prepared by Dr. Lana Zinger, QCC CUNY 12a FOCUS ON Your Risk for Diabetes Your Risk for Diabetes! Since 1980,Diabetes has increased by 50 %. Diabetes has increased by 70 percent

More information

Introduction. Pathogenesis of type 2 diabetes

Introduction. Pathogenesis of type 2 diabetes Introduction Type 2 diabetes mellitus (t2dm) is the most prevalent form of diabetes worldwide. It is characterised by high fasting and high postprandial blood glucose concentrations (hyperglycemia). Chronic

More information

Causes, incidence, and risk factors

Causes, incidence, and risk factors Causes, incidence, and risk factors Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes,

More information

INSULIN RESISTANCE, POLYCYSTIC OVARIAN SYNDROME

INSULIN RESISTANCE, POLYCYSTIC OVARIAN SYNDROME 1 University of Papua New Guinea School of Medicine and Health Sciences Division of Basic Medical Sciences Discipline of Biochemistry and Molecular Biology PBL SEMINAR INSULIN RESISTANCE, POLYCYSTIC OVARIAN

More information

Nutrition. Type 2 Diabetes: A Growing Challenge in the Healthcare Setting NAME OF STUDENT

Nutrition. Type 2 Diabetes: A Growing Challenge in the Healthcare Setting NAME OF STUDENT 1 Nutrition Type 2 Diabetes: A Growing Challenge in the Healthcare Setting NAME OF STUDENT 2 Type 2 Diabetes: A Growing Challenge in the Healthcare Setting Introduction and background of type 2 diabetes:

More information

Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both.

Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. Diabetes Definition Diabetes is a chronic (lifelong) disease marked by high levels of sugar in the blood. Causes Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused

More information

Department Of Biochemistry. Subject: Diabetes Mellitus. Supervisor: Dr.Hazim Allawi & Dr.Omar Akram Prepared by : Shahad Ismael. 2 nd stage.

Department Of Biochemistry. Subject: Diabetes Mellitus. Supervisor: Dr.Hazim Allawi & Dr.Omar Akram Prepared by : Shahad Ismael. 2 nd stage. Department Of Biochemistry Subject: Diabetes Mellitus Supervisor: Dr.Hazim Allawi & Dr.Omar Akram Prepared by : Shahad Ismael. 2 nd stage. Diabetes mellitus : Type 1 & Type 2 What is diabestes mellitus?

More information

Diabetes and Heart Disease

Diabetes and Heart Disease Diabetes and Heart Disease Diabetes and Heart Disease According to the American Heart Association, diabetes is one of the six major risk factors of cardiovascular disease. Affecting more than 7% of the

More information

Type 2 Diabetes and Prediabetes: A New Understanding of Cause and Treatment. Bruce Latham, M.D. Endocrine Specialists Greenville Health System

Type 2 Diabetes and Prediabetes: A New Understanding of Cause and Treatment. Bruce Latham, M.D. Endocrine Specialists Greenville Health System Type 2 Diabetes and Prediabetes: A New Understanding of Cause and Treatment Bruce Latham, M.D. Endocrine Specialists Greenville Health System Objectives for this presentation - Understand the thrifty genotype

More information

Calculating and Graphing Glucose, Insulin, and GFR HASPI Medical Biology Activity 19c

Calculating and Graphing Glucose, Insulin, and GFR HASPI Medical Biology Activity 19c Calculating and Graphing Glucose, Insulin, and GFR HASPI Medical Biology Activity 19c Name: Period: Date: Part A Background The Pancreas and Insulin The following background information has been provided

More information

Getting Off the Chronic Disease Merry-Go-Round: What s the Weight of the Research?

Getting Off the Chronic Disease Merry-Go-Round: What s the Weight of the Research? Getting Off the Chronic Disease Merry-Go-Round: What s the Weight of the Research? Jody Dushay, MD MMSc Beth Israel Deaconess Medical Center Boston, MA Session 445 No disclosures Disclosure Jody Dushay,

More information

Type 2 Diabetes Mellitus and Insulin resistance syndrome in Children

Type 2 Diabetes Mellitus and Insulin resistance syndrome in Children Type 2 Diabetes Mellitus and Insulin resistance syndrome in Children Anil R Kumar MD Pediatric Endocrinology MCV/VCU, Richmond VA Introduction Type 2 diabetes mellitus (T2 DM) has increased in children

More information

Overview of Diabetes Management. By Cindy Daversa, M.S.,R.D.,C.D.E. UCI Health

Overview of Diabetes Management. By Cindy Daversa, M.S.,R.D.,C.D.E. UCI Health Overview of Diabetes Management By Cindy Daversa, M.S.,R.D.,C.D.E. UCI Health Objectives: Describe the pathophysiology of diabetes. From a multiorgan systems viewpoint. Identify the types of diabetes.

More information

The Diabetes Epidemic

The Diabetes Epidemic The Diabetes Epidemic O 2118 Wilshire Blvd. Ste. 723 O Santa Monica, California 90403 O www.susandopart.com O susan@susandopart.com What to look for and how you can help your clients O 310-828-4476 Trends

More information

Diabetes Mellitus Type 2

Diabetes Mellitus Type 2 Diabetes Mellitus Type 2 What is it? Diabetes is a common health problem in the U.S. and the world. In diabetes, the body does not use the food it digests well. It is hard for the body to use carbohydrates

More information

Role of Body Weight Reduction in Obesity-Associated Co-Morbidities

Role of Body Weight Reduction in Obesity-Associated Co-Morbidities Obesity Role of Body Weight Reduction in JMAJ 48(1): 47 1, 2 Hideaki BUJO Professor, Department of Genome Research and Clinical Application (M6) Graduate School of Medicine, Chiba University Abstract:

More information

Regulation of Metabolism. By Dr. Carmen Rexach Physiology Mt San Antonio College

Regulation of Metabolism. By Dr. Carmen Rexach Physiology Mt San Antonio College Regulation of Metabolism By Dr. Carmen Rexach Physiology Mt San Antonio College Energy Constant need in living cells Measured in kcal carbohydrates and proteins = 4kcal/g Fats = 9kcal/g Most diets are

More information

1. PATHOPHYSIOLOGY OF METABOLIC SYNDROME

1. PATHOPHYSIOLOGY OF METABOLIC SYNDROME 1. PATHOPHYSIOLOGY OF METABOLIC SYNDROME Izet Aganović, Tina Dušek Department of Internal Medicine, Division of Endocrinology, University Hospital Center Zagreb, Croatia 1 Introduction The metabolic syndrome

More information

Cardiovascular Disease Risk Factors

Cardiovascular Disease Risk Factors Cardiovascular Disease Risk Factors Risk factors are traits and life-style habits that increase a person's chances of having coronary artery and vascular disease. Some risk factors cannot be changed or

More information

TYPE 2 DIABETES MELLITUS: NEW HOPE FOR PREVENTION. Robert Dobbins, M.D. Ph.D.

TYPE 2 DIABETES MELLITUS: NEW HOPE FOR PREVENTION. Robert Dobbins, M.D. Ph.D. TYPE 2 DIABETES MELLITUS: NEW HOPE FOR PREVENTION Robert Dobbins, M.D. Ph.D. Learning Objectives Recognize current trends in the prevalence of type 2 diabetes. Learn differences between type 1 and type

More information

ETIOLOGIC CLASSIFICATION. Type I diabetes Type II diabetes

ETIOLOGIC CLASSIFICATION. Type I diabetes Type II diabetes DIABETES MELLITUS DEFINITION It is a common, chronic, metabolic syndrome characterized by hyperglycemia as a cardinal biochemical feature. Resulting from absolute lack of insulin. Abnormal metabolism of

More information

The PCOS - Diabetes Connection

The PCOS - Diabetes Connection PCOS Awareness Symposium 2015 Philadelphia Saturday, April 18 th, 2015 The PCOS - Diabetes Connection Preventing Stroke, Kidney Disease, Liver Disease & Other Complications Katherine Sherif, MD Professor

More information

4/4/2013. Mike Rizo, Pharm D, MBA, ABAAHP THE PHARMACIST OF THE FUTURE? METABOLIC SYNDROME AN INTEGRATIVE APPROACH

4/4/2013. Mike Rizo, Pharm D, MBA, ABAAHP THE PHARMACIST OF THE FUTURE? METABOLIC SYNDROME AN INTEGRATIVE APPROACH METABOLIC SYNDROME AN INTEGRATIVE APPROACH AN OPPORTUNITY FOR PHARMACISTS TO MAKE A DIFFERENCE Mike Rizo, Pharm D, MBA, ABAAHP THE EVOLUTION OF THE PHARMACIST 1920s 1960s 2000s THE PHARMACIST OF THE FUTURE?

More information

1333 Plaza Blvd, Suite E, Central Point, OR 97502 * www.mountainviewvet.net

1333 Plaza Blvd, Suite E, Central Point, OR 97502 * www.mountainviewvet.net 1333 Plaza Blvd, Suite E, Central Point, OR 97502 * www.mountainviewvet.net Diabetes Mellitus (in cats) Diabetes, sugar Affected Animals: Most diabetic cats are older than 10 years of age when they are

More information

YOUR LAST DIET IDEAL PROTEIN

YOUR LAST DIET IDEAL PROTEIN YOUR LAST DIET IDEAL PROTEIN OBJECTIVES Explain the science and history that supports the Ideal Protein Diet method. Describe the risks and benefits of diet participation. Give you the details of what

More information

Body Composition & Longevity. Ohan Karatoprak, MD, AAFP Clinical Assistant Professor, UMDNJ

Body Composition & Longevity. Ohan Karatoprak, MD, AAFP Clinical Assistant Professor, UMDNJ Body Composition & Longevity Ohan Karatoprak, MD, AAFP Clinical Assistant Professor, UMDNJ LONGEVITY Genetic 25% Environmental Lifestyle Stress 75% BMI >30 OBESE 25-30 OVERWEIGHT 18-25 NORMAL WEIGHT 18

More information

Endocrine System: Practice Questions #1

Endocrine System: Practice Questions #1 Endocrine System: Practice Questions #1 1. Removing part of gland D would most likely result in A. a decrease in the secretions of other glands B. a decrease in the blood calcium level C. an increase in

More information

Diabetes and Stroke. Understanding the connection between diabetes and the increased risk of stroke

Diabetes and Stroke. Understanding the connection between diabetes and the increased risk of stroke Diabetes and Stroke Understanding the connection between diabetes and the increased risk of stroke Make the Connection Almost 26 million people in the U.S. roughly 8 percent of the population have diabetes.

More information

Subject Index. Bariatric surgery, obesity management 134

Subject Index. Bariatric surgery, obesity management 134 Subject Index Acromegaly, PCOS differential diagnosis 149, 150, 154, 155 Adipokines, see specific adipokines Adiponectin, metabolic syndrome role 41 43 Adolescents, PCOS diagnosis 16, 17 Adrenal hyperplasia,

More information

Statistics of Type 2 Diabetes

Statistics of Type 2 Diabetes Statistics of Type 2 Diabetes Of the 17 million Americans with diabetes, 90 percent to 95 percent have type 2 diabetes. Of these, half are unaware they have the disease. People with type 2 diabetes often

More information

DIABETES MEDICATION-ORAL AGENTS AND OTHER HYPOGLYCEMIC AGENTS

DIABETES MEDICATION-ORAL AGENTS AND OTHER HYPOGLYCEMIC AGENTS Section Two DIABETES MEDICATION-ORAL AGENTS AND OTHER HYPOGLYCEMIC AGENTS This section will: Describe oral agents (pills) are specific for treating type 2 diabetes. Describe other hypoglycemic agents used

More information

CME Test for AMDA Clinical Practice Guideline. Diabetes Mellitus

CME Test for AMDA Clinical Practice Guideline. Diabetes Mellitus CME Test for AMDA Clinical Practice Guideline Diabetes Mellitus Part I: 1. Which one of the following statements about type 2 diabetes is not accurate? a. Diabetics are at increased risk of experiencing

More information

Abdulaziz Al-Subaie. Anfal Al-Shalwi

Abdulaziz Al-Subaie. Anfal Al-Shalwi Abdulaziz Al-Subaie Anfal Al-Shalwi Introduction what is diabetes mellitus? A chronic metabolic disorder characterized by high blood glucose level caused by insulin deficiency and sometimes accompanied

More information

Type 2 diabetes Definition

Type 2 diabetes Definition Type 2 diabetes Definition Type 2 diabetes is a lifelong (chronic) disease in which there are high levels of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes. Causes Diabetes

More information

Metabolic Syndrome Overview: Easy Living, Bitter Harvest. Sabrina Gill MD MPH FRCPC Caroline Stigant MD FRCPC BC Nephrology Days, October 2007

Metabolic Syndrome Overview: Easy Living, Bitter Harvest. Sabrina Gill MD MPH FRCPC Caroline Stigant MD FRCPC BC Nephrology Days, October 2007 Metabolic Syndrome Overview: Easy Living, Bitter Harvest Sabrina Gill MD MPH FRCPC Caroline Stigant MD FRCPC BC Nephrology Days, October 2007 Evolution of Metabolic Syndrome 1923: Kylin describes clustering

More information

Chapter 2 What Is Diabetes?

Chapter 2 What Is Diabetes? Chapter 2 What Is Diabetes? TYPE 1 (INSULIN-DEPENDENT) DIABETES Type 1 (also known as insulin-dependent diabetes mellitus [IDDM] or juvenile or childhood) diabetes is the most common type found in children

More information

Menopause. Weight Loss. A Special Report on Weight Gain During Menopause. contact us. FROM THE DESK OF: Carolyn J. Cederquist, M.D. Dr.

Menopause. Weight Loss. A Special Report on Weight Gain During Menopause. contact us. FROM THE DESK OF: Carolyn J. Cederquist, M.D. Dr. Weight Loss & A Special Report on Weight Gain During Menopause Menopause FROM THE DESK OF: Carolyn J. Cederquist, M.D. Dr. Cederquist Caroline J. Cederquist, M.D., has appeared as a weight-management expert

More information

Nonalcoholic Fatty Liver Disease. Dietary and Lifestyle Guidelines

Nonalcoholic Fatty Liver Disease. Dietary and Lifestyle Guidelines Nonalcoholic Fatty Liver Disease Dietary and Lifestyle Guidelines Risk factors for NAFLD Typically, but not always seen in patients who are overweight. May have Diabetes and or insulin resistance high

More information

Diabetes and Drug Development

Diabetes and Drug Development Diabetes and Drug Development Metabolic Disfunction Leads to Multiple Diseases Hypertension ( blood pressure) Metabolic Syndrome (Syndrome X) LDL HDL Lipoproteins Triglycerides FFA Hyperinsulinemia Insulin

More information

The Natural History of Type 2 Diabetes: Practical Points to Consider in Developing Prevention and Treatment Strategies

The Natural History of Type 2 Diabetes: Practical Points to Consider in Developing Prevention and Treatment Strategies CLINICAL DIABETES VOL. 18 NO. 2 Spring 2000 PRACTICAL POINTERS The Natural History of Type 2 Diabetes: Practical Points to Consider in Developing Prevention and Treatment Strategies Barbara A. Ramlo-Halsted,

More information

Prevention of and the Screening for Diabetes Part I Insulin Resistance By James L. Holly, MD Your Life Your Health The Examiner January 19, 2012

Prevention of and the Screening for Diabetes Part I Insulin Resistance By James L. Holly, MD Your Life Your Health The Examiner January 19, 2012 Prevention of and the Screening for Diabetes Part I Insulin Resistance By James L. Holly, MD Your Life Your Health The Examiner January 19, 2012 In 2002, SETMA began a relationship with Joslin Diabetes

More information

Cardiovascular disease physiology. Linda Lowe-Krentz Bioscience in the 21 st Century October 14, 2011

Cardiovascular disease physiology. Linda Lowe-Krentz Bioscience in the 21 st Century October 14, 2011 Cardiovascular disease physiology Linda Lowe-Krentz Bioscience in the 21 st Century October 14, 2011 Content Introduction The number 1 killer in America Some statistics Recommendations The disease process

More information

Lesson 3: Blood glucose

Lesson 3: Blood glucose Lesson 3: Blood glucose Inquiry Focus: How does the body deliver the energy in food to its parts? Student Learning Objectives: By the end of the lesson, students will be able to do the following: Describe

More information

X-Plain Hypoglycemia Reference Summary

X-Plain Hypoglycemia Reference Summary X-Plain Hypoglycemia Reference Summary Introduction Hypoglycemia is a condition that causes blood sugar level to drop dangerously low. It mostly shows up in diabetic patients who take insulin. When recognized

More information

Pharmaceutical Management of Diabetes Mellitus

Pharmaceutical Management of Diabetes Mellitus 1 Pharmaceutical Management of Diabetes Mellitus Diabetes Mellitus (cont d) Signs and symptoms 2 Elevated fasting blood glucose (higher than 126 mg/dl) or a hemoglobin A1C (A1C) level greater than or equal

More information

Type 1 Diabetes. Pennington Nutrition Series. Overview. About Insulin

Type 1 Diabetes. Pennington Nutrition Series. Overview. About Insulin Pennington Nutrition Series Healthier lives through education in nutrition and preventive medicine Pub No. 32 Type 1 Diabetes Overview Type 1 Diabetes (DM) is usually diagnosed in children and young adults.

More information

Markham Stouffville Hospital

Markham Stouffville Hospital Markham Stouffville Hospital Adult Diabetes Education Frequently Asked Questions What is diabetes? Diabetes is a disease in which blood glucose levels are above normal. Most of the food we eat is turned

More information

HOW TO CARE FOR A PATIENT WITH DIABETES

HOW TO CARE FOR A PATIENT WITH DIABETES HOW TO CARE FOR A PATIENT WITH DIABETES INTRODUCTION Diabetes is one of the most common diseases in the United States, and diabetes is a disease that affects the way the body handles blood sugar. Approximately

More information

Clinical aspects of type 2 diabetes

Clinical aspects of type 2 diabetes Clinical aspects of type 2 diabetes Soria Moria 26 August 2009 Henning Beck-Nielsen Professor, MD, DMSc Odense University Hospital/ University of Southern Denmark Extrapopulation models for prevalence

More information

Diagnosis, classification and prevention of diabetes

Diagnosis, classification and prevention of diabetes Diagnosis, classification and prevention of diabetes Section 1 1 of 4 Curriculum Module II 1 Diagnosis, classification and presentation of diabetes Slide 2 of 48 Polyurea Definition of diabetes Slide 3

More information

Double Diabetes: Definition, Diagnosis, Treatment, Prediction and Prevention.

Double Diabetes: Definition, Diagnosis, Treatment, Prediction and Prevention. Double Diabetes: Definition, Diagnosis, Treatment, Prediction and Prevention. Professor Paolo Pozzilli University Campus Bio-Medico, Rome Institute of Cell & Molecular Science, Queen Mary, University of

More information

Disability Evaluation Under Social Security

Disability Evaluation Under Social Security Disability Evaluation Under Social Security Revised Medical Criteria for Evaluating Endocrine Disorders Effective June 7, 2011 Why a Revision? Social Security revisions reflect: SSA s adjudicative experience.

More information

DRUGS FOR GLUCOSE MANAGEMENT AND DIABETES

DRUGS FOR GLUCOSE MANAGEMENT AND DIABETES Page 1 DRUGS FOR GLUCOSE MANAGEMENT AND DIABETES Drugs to know are: Actrapid HM Humulin R, L, U Penmix SUNALI MEHTA The three principal hormones produced by the pancreas are: Insulin: nutrient metabolism:

More information

Section 2. Overview of Obesity, Weight Loss, and Bariatric Surgery

Section 2. Overview of Obesity, Weight Loss, and Bariatric Surgery Section 2 Overview of Obesity, Weight Loss, and Bariatric Surgery What is Weight Loss? How does surgery help with weight loss? Short term versus long term weight loss? Conditions Improved with Weight Loss

More information

Other Noninfectious Diseases. Chapter 31 Lesson 3

Other Noninfectious Diseases. Chapter 31 Lesson 3 Other Noninfectious Diseases Chapter 31 Lesson 3 Diabetes Diabetes- a chronic disease that affects the way body cells convert food into energy. Diabetes is the seventh leading cause of death by disease

More information

ACTOS (pioglitazone HCl) in the Management of Type 2 Diabetes PRODUCT INFORMATION GUIDE

ACTOS (pioglitazone HCl) in the Management of Type 2 Diabetes PRODUCT INFORMATION GUIDE MARCH 2008 PRODUCT INFORMATION GUIDE JIM DOWDALLS / PHOTO RESEARCHERS, INC. ACTOS (pioglitazone HCl) in the Management of Type 2 Diabetes PHG0801 SPECIAL ADVERTISING SECTION This Product Information Guide

More information

Insulin Resistance and PCOS: A not uncommon reproductive disorder

Insulin Resistance and PCOS: A not uncommon reproductive disorder Insulin Resistance and PCOS: A not uncommon reproductive disorder Joyce L. Ross, MSN, CRNP, CS, FNLA, FPCNA Diplomate Accrediation Council for Clinical Lipidology President Preventive Cardiovascular Nurses

More information

GLUCOSE HOMEOSTASIS-II: An Overview

GLUCOSE HOMEOSTASIS-II: An Overview GLUCOSE HOMEOSTASIS-II: An Overview University of Papua New Guinea School of Medicine & Health Sciences, Division of Basic Medical Sciences Discipline of Biochemistry & Molecular Biology, M Med Part I

More information

What is Type 2 Diabetes?

What is Type 2 Diabetes? Type 2 Diabetes What is Type 2 Diabetes? Diabetes is a condition where there is too much glucose in the blood. Our pancreas produces a hormone called insulin. Insulin works to regulate our blood glucose

More information

Medications and Diabetes

Medications and Diabetes monitor track manage A TRUEinsight Guide manage Medications and Diabetes Understanding the Importance of Oral Medications The importance of oral medications Understanding the importance of oral medications

More information

Diabetes: Beyond the D50. Leslie Huntington, BS, Paramedic Mobile Training Unit Oregon OHA-EMS and Trauma Systems

Diabetes: Beyond the D50. Leslie Huntington, BS, Paramedic Mobile Training Unit Oregon OHA-EMS and Trauma Systems Diabetes: Beyond the D50 Leslie Huntington, BS, Paramedic Mobile Training Unit Oregon OHA-EMS and Trauma Systems The EMS View of Diabetes Management BG low? Give some form of sugar. Hero! BG somewhere

More information

Diabetes. Patient Education. What you need to know. Diabetes Facts. Improving Health Through Education. What is Diabetes?

Diabetes. Patient Education. What you need to know. Diabetes Facts. Improving Health Through Education. What is Diabetes? Diabetes What you need to know Diabetes Facts More than 3 million Canadians have diabetes (Canadian Diabetes Association, 2009). It is the 4th leading cause of death in the world (CDA, 2009). Patient Education

More information

My Doctor Says I Need to Take Diabetes Pills and Insulin... What Do I Do Now? BD Getting Started. Combination Therapy

My Doctor Says I Need to Take Diabetes Pills and Insulin... What Do I Do Now? BD Getting Started. Combination Therapy My Doctor Says I Need to Take Diabetes Pills and Insulin... What Do I Do Now? BD Getting Started Combination Therapy How Can Combination Therapy Help My Type 2 Diabetes? When you have type 2 diabetes,

More information

Effects of macronutrients on insulin resistance and insulin requirements

Effects of macronutrients on insulin resistance and insulin requirements Effects of macronutrients on insulin resistance and insulin requirements Dr Duane Mellor RD Assistant Professor in Dietetics, The University of Nottingham, UK Outline of Discussion Issues of determining

More information

A Calorie is a Calorie Or is It? 6 th Biennial Childhood Obesity Conference, June 30, 2011

A Calorie is a Calorie Or is It? 6 th Biennial Childhood Obesity Conference, June 30, 2011 A Calorie is a Calorie Or is It? 6 th Biennial Childhood Obesity Conference, June 30, 2011 Jeff S. Volek, Ph.D., R.D. Human Performance Laboratory Department of Kinesiology University of Connecticut Storrs,

More information

ALPHA (TNFa) IN OBESITY

ALPHA (TNFa) IN OBESITY THE ROLE OF TUMOUR NECROSIS FACTOR ALPHA (TNFa) IN OBESITY Alison Mary Morris, B.Sc (Hons) A thesis submitted to Adelaide University for the degree of Doctor of Philosophy Department of Physiology Adelaide

More information

Kansas Behavioral Health Risk Bulletin

Kansas Behavioral Health Risk Bulletin Kansas Behavioral Health Risk Bulletin Kansas Department of Health and Environment November 7, 1995 Bureau of Chronic Disease and Health Promotion Vol. 1 No. 12 Diabetes Mellitus in Kansas Diabetes mellitus

More information

METABOLIC SYNDROME. Rebecca Rovay-Hazelton, Licensed Nutritionist

METABOLIC SYNDROME. Rebecca Rovay-Hazelton, Licensed Nutritionist METABOLIC SYNDROME Rebecca Rovay-Hazelton, Licensed Nutritionist Blood Sugar Basics Glucose=a simple sugar used for energy from diet, primarily starches, sugar and carbohydrate Insulin=a hormone made in

More information

CASE B1. Newly Diagnosed T2DM in Patient with Prior MI

CASE B1. Newly Diagnosed T2DM in Patient with Prior MI Newly Diagnosed T2DM in Patient with Prior MI 1 Our case involves a gentleman with acute myocardial infarction who is newly discovered to have type 2 diabetes. 2 One question is whether anti-hyperglycemic

More information

Am I at Risk for type 2 Diabetes? Taking Steps to Lower the Risk of Getting Diabetes NATIONAL DIABETES INFORMATION CLEARINGHOUSE

Am I at Risk for type 2 Diabetes? Taking Steps to Lower the Risk of Getting Diabetes NATIONAL DIABETES INFORMATION CLEARINGHOUSE NATIONAL DIABETES INFORMATION CLEARINGHOUSE Am I at Risk for type 2 Diabetes? Taking Steps to Lower the Risk of Getting Diabetes U.S. Department of Health and Human Services National Institutes of Health

More information

NASH: It is not JUST a Fatty Liver. Karen F. Murray, M.D. Director of Hepatobiliary Program Children s Hospital and Regional Medical Center

NASH: It is not JUST a Fatty Liver. Karen F. Murray, M.D. Director of Hepatobiliary Program Children s Hospital and Regional Medical Center NASH: It is not JUST a Fatty Liver Karen F. Murray, M.D. Director of Hepatobiliary Program Children s Hospital and Regional Medical Center Stages of Fatty Liver Disorders Fatty Liver 16-35% of Western

More information

EFFIMET 1000 XR Metformin Hydrochloride extended release tablet

EFFIMET 1000 XR Metformin Hydrochloride extended release tablet BRAND NAME: Effimet XR. THERAPEUTIC CATEGORY: Anti-Diabetic PHARMACOLOGIC CLASS: Biguanides EFFIMET 1000 XR Metformin Hydrochloride extended release tablet COMPOSITION AND PRESENTATION Composition Each

More information

Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) UW MEDICINE PATIENT EDUCATION Polycystic Ovarian Syndrome (PCOS) Signs, symptoms, and treatments What is PCOS? Polycystic ovarian syndrome (PCOS) is a disorder that affects up to 1 in 10 women of reproductive

More information

WHAT IS DIABETES MELLITUS? CAUSES AND CONSEQUENCES. Living your life as normal as possible

WHAT IS DIABETES MELLITUS? CAUSES AND CONSEQUENCES. Living your life as normal as possible WHAT IS DIABETES MELLITUS? CAUSES AND CONSEQUENCES DEDBT01954 Lilly Deutschland GmbH Werner-Reimers-Straße 2-4 61352 Bad Homburg Living your life as normal as possible www.lilly-pharma.de www.lilly-diabetes.de

More information

The Background for the Diabetes Detection Model

The Background for the Diabetes Detection Model The Background for the Diabetes Detection Model James K. Peterson Department of Biological Sciences and Department of Mathematical Sciences Clemson University November 23, 2014 Outline The Background for

More information

Type 2 Diabetes. What is diabetes? Understanding blood glucose and insulin. What is Type 2 diabetes? Page 1 of 5

Type 2 Diabetes. What is diabetes? Understanding blood glucose and insulin. What is Type 2 diabetes? Page 1 of 5 Page 1 of 5 Type 2 Diabetes Type 2 diabetes occurs mainly in people aged over 40. The 'first-line' treatment is diet, weight control and physical activity. If the blood glucose level remains high despite

More information

Historically, diabetes has been considered

Historically, diabetes has been considered THE LINK BETWEEN TYPE 2 DIABETES AND CARDIOVASCULAR DISEASE* Thomas G. Bartol, NP, CDE ABSTRACT The link between type 2 diabetes and cardiovascular disease has been amply demonstrated in numerous studies.

More information

Low-Carb Diets in Sweden

Low-Carb Diets in Sweden Senior Professor Göran Petersson May 2013 Chemical- and Biological Engineering, Chalmers University of Technology, Göteborg, Sweden FAST CARBOHYDRATES INSULIN RESISTANCE DIABETES 2 OBESITY Low-Carb Diets

More information

Distinguishing between Diabetes Mellitus Type 1 and Type 2, (with Overview of Treatment Strategies)

Distinguishing between Diabetes Mellitus Type 1 and Type 2, (with Overview of Treatment Strategies) Distinguishing between Diabetes Mellitus Type 1 and Type 2, (with Overview of Treatment Strategies) Leann Olansky, MD, FACP, FACE Cleveland Clinic Endocrinology Glucose Tolerance Categories FPG Diabetes

More information

Glucose Tolerance Categories. Distinguishing between Diabetes Mellitus Type 1 and Type 2, (with Overview of Treatment Strategies)

Glucose Tolerance Categories. Distinguishing between Diabetes Mellitus Type 1 and Type 2, (with Overview of Treatment Strategies) Distinguishing between Diabetes Mellitus Type 1 and Type 2, (with Overview of Treatment Strategies) Leann Olansky, MD, FACP, FACE Cleveland Clinic Endocrinology Glucose Tolerance Categories FPG Diabetes

More information

Diabetes Fundamentals

Diabetes Fundamentals Diabetes Fundamentals Prevalence of Diabetes in the U.S. Undiagnosed 10.7% of all people 20+ 23.1% of all people 60+ (12.2 million) Slide provided by Roche Diagnostics Sources: ADA, WHO statistics Prevalence

More information

trends in the treatment of Diabetes type 2 - New classes of antidiabetic drugs. IAIM, 2015; 2(4): 223-

trends in the treatment of Diabetes type 2 - New classes of antidiabetic drugs. IAIM, 2015; 2(4): 223- Review Article Pharmacological trends in the treatment of Diabetes type 2 - New classes of antidiabetic Silvia Mihailova 1*, Antoaneta Tsvetkova 1, Anna Todorova 2 1 Assistant Pharmacist, Education and

More information

Antipsychotic Medications and the Risk of Diabetes and Cardiovascular Disease

Antipsychotic Medications and the Risk of Diabetes and Cardiovascular Disease Antipsychotic Medications and the Risk of Diabetes and Cardiovascular Disease Patient Tool #1 Understanding Diabetes and Psychiatric Illness: A Guide for Individuals, Families, and Caregivers Type 2 Diabetes,

More information

EXPLORING THE INTERACTION BETWEEN EXERCISE AND MEDICATION FOR CHRONIC DISEASE: CONSIDERATIONS FOR FITNESS PROFESSIONALS

EXPLORING THE INTERACTION BETWEEN EXERCISE AND MEDICATION FOR CHRONIC DISEASE: CONSIDERATIONS FOR FITNESS PROFESSIONALS EXPLORING THE INTERACTION BETWEEN EXERCISE AND MEDICATION FOR CHRONIC DISEASE: CONSIDERATIONS FOR FITNESS PROFESSIONALS Steven T. Johnson, PhD 1 Introduction The prevalence of chronic diseases like cardiovascular

More information

Triglycerides: Frequently Asked Questions

Triglycerides: Frequently Asked Questions Triglycerides: Frequently Asked Questions Why are triglycerides important? The amount of triglycerides (or blood fats) in blood are one important barometer of metabolic health; high levels are associated

More information

INJEX Self Study Program Part 1

INJEX Self Study Program Part 1 INJEX Self Study Program Part 1 What is Diabetes? Diabetes is a disease in which the body does not produce or properly use insulin. Diabetes is a disorder of metabolism -- the way our bodies use digested

More information

Type II diabetes: How to use the new oral medications

Type II diabetes: How to use the new oral medications Type II diabetes: How to use the new oral medications A TWO-PART INTERVIEW WITH NANCY J.V. BOHANNON, MD, BY DAVID B. JACK, MD Several new oral drugs have been approved for the management of type II diabetes.

More information

DR. Trinh Thi Kim Hue

DR. Trinh Thi Kim Hue TYPE 2 DIABETES IN THE CHILD AND ADOLESCENT DR. Trinh Thi Kim Hue CONTENTS Definition Diagnosis Treatment Comorbidities and Complications Comorbidities and Complications Screening for T2D References DEFINITION

More information

An Interview with Gerald Reaven: Syndrome X : The Risks of Insulin Resistance

An Interview with Gerald Reaven: Syndrome X : The Risks of Insulin Resistance An Interview with Gerald Reaven: Syndrome X : The Risks of Insulin Resistance Gerald Reaven, M.D., is Professor Emeritus (Active) of Medicine at Stanford University. He has served as director of the Division

More information

Using Family History to Improve Your Health Web Quest Abstract

Using Family History to Improve Your Health Web Quest Abstract Web Quest Abstract Students explore the Using Family History to Improve Your Health module on the Genetic Science Learning Center website to complete a web quest. Learning Objectives Chronic diseases such

More information

Reversing type 2 diabetes: pancreas composition and function during return to normal glucose tolerance

Reversing type 2 diabetes: pancreas composition and function during return to normal glucose tolerance Reversing type 2 diabetes: pancreas composition and function during return to normal glucose tolerance Dr Sarah Steven Clinical Research Fellow to Professor Roy Taylor Observations from bariatric surgery

More information

It s time to TALK Targets A guide to taking control of your type 2 diabetes

It s time to TALK Targets A guide to taking control of your type 2 diabetes It s time to TALK Targets A guide to taking control of your type 2 diabetes The TALK Targets campaign was initiated and fully funded by Novo Nordisk. By supporting you and your healthcare team, TALK Targets

More information

Nancy S. Swayze. 2 ND YEAR RESEARCH ELECTIVE RESIDENT S JOURNAL Volume V, 2000-2001. A. Background

Nancy S. Swayze. 2 ND YEAR RESEARCH ELECTIVE RESIDENT S JOURNAL Volume V, 2000-2001. A. Background Efficacy Of Insulin Sensitizing Agents In Subjects With Metabolic Syndrome X And Impaired Glucose Tolerance After 6 Months Of Diet And Exercise Therapy Nancy S. Swayze A. Background Impaired glucose tolerance

More information

TABLE OF CONTENTS. The Cost of Diabesity... 3. Employer Solutions... 4 Provide a Worksite Weight Loss Program Tailored for Diabetes...

TABLE OF CONTENTS. The Cost of Diabesity... 3. Employer Solutions... 4 Provide a Worksite Weight Loss Program Tailored for Diabetes... TH E TABLE OF CONTENTS The Cost of Diabesity... 3 Employer Solutions... 4 Provide a Worksite Weight Loss Program Tailored for Diabetes... 4 Provide Healthy Food Options at the Workplace... 4 Make it Easy

More information