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Epidemiology • The worldwide prevalence of DM has risen dramatically over the past two decades, from an estimated 30 million cases in 1985 to 177 million in 2000. Pathophysiology • Type 2 DM is characterized by impaired insulin secretion, insulin resistance, excessive hepatic glucose production, and abnormal fat metabolism. Metabolic Abnormalities • Abnormal Muscle and Fat Metabolism Insulin resistance, the decreased ability of insulin to act effectively on target tissues (especially muscle, liver, and fat), is a prominent feature of type 2 DM and results from a combination of genetic susceptibility and obesity. Impaired Insulin Secretion • In type 2 DM, insulin secretion initially increases in response to insulin resistance to maintain normal glucose tolerance. Increased Hepatic Glucose and Lipid Production • In type 2 DM, insulin resistance in the liver reflects the failure of hyperinsulinemia to suppress gluconeogenesis, which results in fasting hyperglycemia and decreased glycogen storage by the liver in the postprandial state. Acute Complications of DM • Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are acute complications of diabetes. Mechanisms of Complications • One theory is that increased intracellular glucose leads to the formation of advanced glycosylation end products (AGEs) via the nonenzymatic glycosylation of intra- and extracellular proteins. Ophthalmologic Complications of Diabetes Mellitus • Blindness is primarily the result of progressive diabetic retinopathy and clinically significant macular edema.
Renal Complications of Diabetes Mellitus • Like other microvascular complications, the pathogenesis of diabetic nephropathy is related to chronic hyperglycemia. Neuropathy and Diabetes Mellitus • As with other complications of DM, the development of neuropathy correlates with the duration of diabetes and glycemic control.
Cardiovascular Morbidity and Mortality • The increase in cardiovascular morbidity and mortality appears to relate to the synergism of hyperglycemia with other cardiovascular risk factors.
Lower Extremity Complications • The reasons for the increased incidence of these disorders in DM involve the interaction of several pathogenic factors: neuropathy, abnormal foot biomechanics, PAD, and poor wound healing. Goals of Treatment • Glycosylated hemoglobin (HbA1c) <7% is the goal for patients in general. Combination Therapy with Glucose-Lowering Agents • A number of combinations of therapeutic agents are successful in type 2 DM, and the dosing of agents in combination is the same as when the agents are used alone.
Insulin Treatments Insulin should be considered as the initial therapy in type 2 DM, particularly in lean individuals or those with severe weight loss, in individuals with underlying renal or hepatic disease that precludes oral glucose-lowering agents, or in individuals who are hospitalized or acutely ill. Prevention • Type 2 DM is preceded by a period of IGT, and a number of lifestyle modifications and pharmacologic agents prevent or delay the onset of DM. Assessment of Long-Term Glycemic Control • Measurement of glycated hemoglobin is the standard method for assessing long-term glycemic control.
O SlideShare utiliza cookies para otimizar a funcionalidade e o desempenho do site, assim como para apresentar publicidade mais relevante aos nossos usuarios. Doencas Cronicas – Uma visao Geral ? Doencas cronicas sao aquelas normalmente de desenvolvimento lento, que duram periodos extensos – mais de 6 meses – e apresentam efeitos de longo prazo, dificeis de prever. Hipertensao Arterial? Hipertensao Arterial e o aumento da pressao arterial que pode ter como causas a hereditariedade, a obesidade, o sedentarismo, o alcoolismo, o estresse, o fumo etc.? E considerada um problema de saude publica por sua magnitude, risco e dificuldades no seu controle. Hipertensao Arterial? Considera-se hipertenso o individuo que mantem uma pressao arterial acima de 140 por 90 mmHg ou 14x9, durante seguidos exames, de acordo com o protocolo medico.? Pressoes arteriais elevadas provocam alteracoes nos vasos sanguineos e na musculatura do coracao. Rim x Hipertensao? O rim e a hipertensao arterial interagem de maneira intima e complexa.? Enquanto a hipertensao primaria tem sido atribuida, em parte, a alteracoes intrinsecas no manuseio renal de sodio, a hipertensao secundaria e mais comumente causada por doenca renal parenquimatosa. RIM COMO CAUSA DE HIPERTENSAOARTERIAL PRIMARIA e SECUNDARIA PRIMARIA SECUNDARIAA) Sodio e Volume A.
DIABETES MELLITUS? Diabetes Mellitus e uma doenca do metabolismo da glicose causada pela falta ou ma absorcao de insulina, hormonio produzido pelo pancreas e cuja funcao e quebrar as moleculas de glicose para transforma-las em energia a fim de que seja aproveitada por todas as celulas.? A ausencia total ou parcial desse hormonio interfere nao so na queima do acucar como na sua transformacao em outras substancias (proteinas, musculos e gordura). Nefropatia Diabetica? Constitui-se por alteracoes nos vasos dos rins, fazendo com que haja a perda de proteina na urina. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.
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Diabetes Type 2 symptoms include high blood presure excessive thirst & visual impairment but many people with Type 2 diabetes have no symptoms or general symptoms. Sample Of Invoices Fpr Independent Contractors – The Impact of Planned Care and a Diabetes Electronic using.
I usually ended up spending a lot of money loving the results but only having them for about a week.
The treatment of cancer patients with IPT is it appears harmless at worst Gestational diabetes develops during pregnancy (gestation).


This filter does give a glare so I took it off and just attach it when I’m not using it. The “Oral Glucose Tolerance” test is a standard medical test for determining if someone has diabetes? Several distinct types of DM are caused by a complex interaction of genetics and environmental factors. If you interesting in "DIABETES MELLITUS TYPE 2" powerpoint themes, you can download to use this powerpoint template for your own presentation template. Insulin resistance impairs glucose utilization by insulin-sensitive tissues and increases hepatic glucose output; both effects contribute to the hyperglycemia. DKA was formerly considered a hallmark of type 1 DM, but it also occurs in individuals who lack immunologic features of type 1 DM • HHS is primarily seen in individuals with type 2 DM.
Among other actions, PKC alters the transcription of genes for fibronectin, type IV collagen, contractile proteins, and extracellular matrix proteins in endothelial cells and neurons. The mechanisms by which chronic hyperglycemia leads to ESRD, though incompletely defined, involve the effects of soluble factors (growth factors, angiotensin II, endothelin, AGEs), hemodynamic alterations in the renal microcirculation (glomerular hyperfiltration or hyperperfusion, increased glomerular capillary pressure), and structural changes in the glomerulus (increased extracellular matrix, basement membrane thickening, mesangial expansion, fibrosis).
The presence of cardiovascular disease, elevated triglycerides, and hypertension is also associated with diabetic peripheral neuropathy. It most frequently presents with distal sensory loss, but up to 50% of patients do not have symptoms of neuropathy. The reasons for this include incompletely defined abnormalities in cell-mediated immunity and phagocyte function associated with hyperglycemia, as well as diminished vascularization. The goal for the individual patient is an HbA1c as close to normal (<6%) as possible without significant hypoglycemia.
One drink is defined as 12 oz of beer, 5 oz of wine or 1.5 oz of distilled spirits (each of which contains 15g of alcohol). Sulfonylurea (SU)- increases insulin secretion (pancreas), ideal for lean patient, early in disease, use with caution in kidney diseasea. Non-SU insulin secretagogue – increases insulin secretion (pancreas), ideal for post-meal hyperglycemia, variable schedule, alternative to sulfonylurea, may use in renal insufficiency a. Alpha-Glucosidase inhibitor – delays GI absorption of carbohydrates (GUT), ideal for post-meal hyperglycemia a.
Because mechanisms of action of the first and second agents are different, the effect on glycemic control is usually additive. E tambem reconhecida como um dos mais importantes fatores de risco para o desenvolvimento do acidente vascular cerebral e infarto do miocardio. Pode ocorrer hipertrofia do ventriculo esquerdo, acidente vascular cerebral (AVC), infarto do miocardio, morte subita, insuficiencia renal e cardiacas, etc. A instalacao da doenca ocorre mais na infancia e adolescencia e e insulinodependente, isto e, exige a aplicacao de injecoes diarias de insulina; ? b) Diabetes tipo II – as celulas sao resistentes a acao da insulina. E uma situacao em que o orgao pode reduzir sua funcao lentamente, porem de forma progressiva, ate a paralisacao total.? A nefropatia diabetica se desenvolve em 35 a 45% dos pacientes com diabete tipo I (DMI) e acomete uma proporcao variavel entre 6 e 20% daqueles com diabete do tipo II (DMII) podendo nestes ultimos atingir uma prevalencia de 50%, na dependencia do grupo etnico considerado. B: Excessively high blood sugar or prolonged hyperglycemia can cause diabetic ketoacidosis the oral medication for type ii diabetes diabetes uk eating well with type 2 diabetes poor type 1 diabetes control good food for diabetics list Janghorbani M Dehghani M Salehi-Marzijarani M. The test is usually used to test for diabetes insulin resistance and sometimes reactive hypoglycemia. The writer is not just one who has written a book on the theory of wellness (there are enough of those) but is a daily practitioner and coach to those he sees in his welness center. It is important to know how to draw and inject insulin so that you can give your injection accurately quickly and with comfort.
This was the first time I ever had any problems with it at all, but I just hate that I only got two years use out of it. Depending on the etiology of the DM, factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization, and increased glucose production. For viewing only, you can play with our flash based presentation viewer instead of downloading the ppt file. The assumption is that a second genetic defect—superimposed upon insulin resistance—leads to beta cell failure.
Both disorders are associated with absolute or relative insulin deficiency, volume depletion, and acid-base abnormalities. Three or more times daily for those using multiple insulin injections – Optimal frequency and timing of SMBG for those on oral agents is not known.


Entretanto, varias delas podem ser prevenidas ou controladas por meio da deteccao precoce, adocao de dieta e habitos saudaveis, pratica de exercicios e acesso a tratamento adequado recomendado pelo profissional de saude. Ademais, a grande maioria dos pacientes com doenca renal desenvolve ou agrava a hipertensao sistemica a medida que a funcao renal diminui.
Compare Symptoms Type 1 2 Diabetes journal Impact Factor 2003 Abbreviation Journal Title ISSN NCBI ID IF 2003.
But then they decided diabetic vegetarian diet menu that didn’t go far enough and they added some actual maple syrup to the recipe which ruined it for me. Insulin sensitivity appears to be reliably improved following the treatment of PCOS in women.
Accept that we show our love through words, gifts and kind acts, not facial muscles and theatrical displays of emotion. The metabolic dysregulation associated with DM causes secondary pathophysiologic changes in multiple organ systems that impose a tremendous burden on the individual with diabetes and on the health care system.
The ADA recommends screening for distal symmetric neuropathy beginning with the initial diagnosis of diabetes and screening for autonomic neuropathy 5 years after diagnosis of type 1 DM and at the time of diagnosis of type 2 DM.
Insulin resistance, as reflected by elevated serum insulin levels, is associated with an increased risk of cardiovascular complications in individuals with and without DM. Thiazolidinedione (TZD) – increases insulin sensitivity (muscles and fats), ideal for insulin- resitance, inappropriate for metformin, can be used for renal insufficiency a. Individuals with a strong family history of type 2 DM and individuals with IFG or IGT should be strongly encouraged to maintain a normal BMI and engage in regular physical activity. I also had this genetic thing that affected thyroid and metabolism which are important factors in weight loss and gain. I have had this cane for three days and I tend to prop it against things like walls counter tops work benches desks etc. Herbs and i>Compare diabetes therapy ppt Symptoms Type 1 2 Diabetes Vitamins for Diabetes.
In the United States, DM is the leading cause of end-stage renal disease (ESRD), nontraumatic lower extremity amputations, and adult blindness. A further decline in insulin secretion and an increase in hepatic glucose production lead to overt diabetes with fasting hyperglycemia. The most prominent GI symptoms are delayed gastric emptying (gastroparesis) and altered small- and large-bowel motility (constipation or diarrhea).
Certain types of insulin: NPH Lente and Ultralente insulin Rolling the insulin between your hands is a good way to mix insulin in a vial without making a lot of little bubbles in the insulin itself. Researchers said their results were adjusted for other contributing factors like diabetes status, leisure-time physical activity level and age.
Gastroparesis may present with symptoms of anorexia, nausea, vomiting, early satiety, and abdominal bloating.
Untreated insulin resistance leads to fatigue diabetes Official Partner of the LIVE STRONG Foundation Food How to Treat Insulin Resistance Naturally Last Updated: Sep 11 2010 sugar and saturated dietary fat.
I did five years in Feds and while I was waiting for a ConAir flight I was at MDC Brooklyn for a few months during the summer.
With an increasing incidence worldwide, DM will be a leading cause of morbidity and mortality for the foreseeable future.Spectrum of glucose homeostasis and diabetes mellitus (DM). Diabetes Links Since the current advances in the treatment of both type 1 and 2 diabetes still cannot prevent diabetes Natural Treatments for Diabetes. Symptoms of pre-diabetes are the same, as the diabetes symptoms, most notably lesser and some do not have any symptoms. Individualize Insulin Dose • Use outpatient dose for baseline and increase (infection, steroids) or decrease (fewer calories ingested than when at home) as needed. Glargine 21 units qhs or Ultralente 10 units bid), and the other half as mealtime insulin ( Lispro 7 units with each meal).



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