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Type 2 diabetes is closely linked to obesity and places people who have the ... Type 1 diabetes is an autoimmune disorder where B-cells are destroyed by antibodies. ... – PowerPoint PPT presentation

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Gross Anatomy
  • Endocrine
  • Gland
  • Hormone
  • Blood
  • Target tissues

Anatomy of Pancreas
Microscopic Pancreas
Islet of Langerhans
Protein Hormone
Control of Hormone Secretion
What is Diabetes?
  • Diabetes is a disease in which the body doesn't
    produce or properly use insulin, a hormone that
    allows sugar, starches and other food to be
    converted into energy.
  • Type 2 diabetes is closely linked to obesity and
    places people who have the disease at greater
    risk of cardiovascular disease.
  • Type 1 diabetes is an autoimmune disorder where
    B-cells are destroyed by antibodies.

  • Symptoms such as thirst and frequent urination,
    complications like heart trouble or signs of
    excess glucose or sugar in blood and urine tests.
    From there the doctor can decide, based on these
    tests and a physical exam, whether someone has
    diabetes. If a blood test is borderline abnormal,
    the doctor may want to monitor the person's blood
    glucose regularly. If a person is overweight, he
    or she probably will be advised to lose weight.
  • In type 2 diabetes, the disease can be present
    while the person feels completely asymptomatic.

How Common is Diabetes?
  • About 18.2 million people in the United States --
    6.3 of the population -- have diabetes.
  • Incidence is increasing due to obesity. Its
    type 2 that is a major health issue in America.
  • 1.3 million new cases diagnosed annually. The
    disease kills more than 200,000 Americans every
    year, making it the sixth leading cause of death
    in the United States.
  • Since 1990, obesity has increased by more than 60
    percent in the United States.

Who Gets It
  • Family medical history is a strong indicator for
    many chronic diseases, including diabetes,
    stroke, obesity, cancer and heart disease.
  • Lack of exercise, excess weight often lead to
    Type 2 diabetes.

Trend for Acquiring Diabetes in US
Trend by State
Diabetic Retinopathy
  • Damage to blood

vessels in the retina.
Foot Amputations
  • 1995 doctors perform some 54,000 amputations on
    diabetics each year because of diabetic ulcers.

Diabetic Kidney Disease
  • Symptoms occur after extensive damage.
  • swelling -- usually around the eyes in the
    mornings later, general body swelling may result
  • foamy appearance or excessive frothing of the
  • unintentional weight gain (from fluid
  • swelling of the legs
  • poor appetite
  • nausea and vomiting
  • general ill feeling
  • fatigue
  • headache
  • frequent hiccups
  • generalized itching

Type 2 Diabetes
  • Type 2 diabetes, formally known as adult onset
    diabetes, often develops when people are
    overweight and inactive.
  • In the past, the cause of high blood sugar levels
    in children was type 1 diabetes, which was then
    known as juvenile diabetes. But today, more and
    more children and teenagers are being diagnosed
    with type 2 diabetes.

Insulin and Type 2 Diabetes
  • There are at least two problems with insulin in
    type 2 diabetes.
  • Insulin resistance, when your cells do not
    respond properly to the insulin signal and blood
    sugar is not stored or used
  • Poor insulin secretion, where the cells of the
    pancreas cannot make enough insulin to overcome
    the insulin resistance. In type 1 diabetes, there
    is an autoimmune process that destroys the cells
    that make insulin, so it's purely a problem with
    insulin production and secretion.

Diabetes Type 2 in Children
  • At least part of the rise is due to the presence
    of insulin resistance in some kids today,
    probably from obesity and being less active. Some
    youth don't have the ability to make more insulin
    to compensate for this resistance, and therefore
    they develop diabetes. According to a nationwide
    survey, 15 percent of kids are obese. And there's
    an even larger population that's at risk of
    becoming obese or overweight. Where exercise is
    not always a part of daily life puts a child at

Which Children Should Be Screened?
  • The American Diabetes Association recommends
    screening for kids who have a body mass index
    (BMI) greater than the 85th percentile for their
    age and sex and who have at least two other risk
    factors. For these children, testing should be
    done every two years in children starting at age
    10 or earlier if puberty begins sooner. Youth
    with multiple risk factors (obesity,
    hypertension, family history, inactive, high LDL,
    low HDL) and those who have symptoms should be

How to Manage Type 2 Diabetes
  • In kids who come in very critically ill and with
    very high blood sugars, you begin with insulin
    therapy. Once you get the blood sugar under
    control with insulin, you then begin lifestyle
    changes and oral medication and try to wean them
    off the insulin.
  • With the kids in whom diabetes is found
    incidentally on a routine physical, or who have a
    few mild symptoms, we start with just exercise
    and nutrition if it's safe. Then we continue with
    lifestyle management and add oral medication as
    needed. And then, as the disease progresses, we
    may need to start insulin therapy.

Symptoms in Children
  • If they notice that the child is drinking more or
    going to the bathroom more, they should contact
    their pediatrician. Some kids will complain of
    blurry vision or vague abdominal pain and females
    may have yeast infections. In severe cases,
    nausea, vomiting, abdominal pain, and extreme
    fatigue or confusion can develop.
  • Many children don't have these symptoms, so the
    parents of children with excessive weight gain or
    something called acanthosis nigricans (a
    darkening or thickening of the skin in the back
    of the neck or under the arms, thought to be due
    to high insulin levels), should contact their
    pediatrician to see if they should be screened
    for diabetes.

  • Pre-diabetes, the period when people at high risk
    of full-blown diabetes exhibit elevated
    blood-sugar levels. But they're still capable of
    processing that glucose -- the energy that fuels
    the body's cells.
  • But if those people don't take the necessary
    steps to bring their blood sugar levels under
    control, they could eventually succumb to such
    devastating diabetes-induced complications as
    heart disease, blindness, kidney failure and
  • Some 41 million Americans are estimated to have

Diagnosing Pre-diabetes
  • Pre-diabetes is diagnosed for sugar levels
    between 100 and 125 mg/dl after 8-hr fast.
  • Those elevated levels are doing harm to the body
    even though the person isn't suffering from
    diabetes. If you look at people whose blood
    sugars are at that level, you can already find
    evidence of the damage caused by diabetes.
  • People with pre-diabetes 50 percent greater
    risk of heart attack and stroke. Once they
    actually have diabetes, their risk of heart
    disease increases to two to four times that of
    someone without diabetes.
  • Blood sugar between 100 and 110 have a 20 percent
    higher chance of developing diabetes than those
    whose blood sugar is healthier. Those with blood
    sugar between 110 and 125 are at 40 percent
    greater risk. Levels of 126 or above are
    considered diabetes.
  • The American Diabetes Association believes the
    rampant spread of diabetes and its precursors are
    caused by factors that can be managed by the

Preventing DiabetesType 2
  • Lose weight by eating less and choosing more
    nutritious food.
  • Exercise.
  • Its as simple as that!
  • Read Diabetes Are You at Risk? Time Dec. 8,
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