TYPE 1 DIABETES

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Insulin-dependent diabetes mellitus, also known
as juvenile-onset diabetes Prevalence of 0.4
(stable over the past decades) Absolute
deficiency of insulin May be autoimmune
based Management requires exogenous
insulin Patients are prone to ketosis
TYPE 1 DIABETES
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Non-insulin-dependent diabetes, also known as
maturity onset or adult-onset diabetes Approximat
ely 90 of all diabetics are type II Prevalence
of 6.6 (1520 million patients in United
States) Relative deficiency of
insulin/peripheral resistance to
insulin/excessive hepatic glucose
release Generally seen in obese adults Patients
produce adequate amounts of insulin to prevent
ketosis but are at risk for hyperosmolar
state Initially managed with diet control,
weight loss, and oral hypoglycemic
agents Patients may require insulin as their
disease progresses
TYPE 2 DIABETES
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The most common medical problem of pregnancy
(14 of pregnancies) Increased risk of maternal
and neonatal complications At least 3050
acquire type II diabetes within 20 years after
pregnancy Usually require insulin during
pregnancy
GESTATIONAL DIABETES
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Pancreatic disease (decreased insulin
production) Drug induced Secondary to
endocrinopathies such as Cushings disease,
acromegaly, pheochromocytoma
SECONDARY DIABETES
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1985 to 2002
OBESITY TRENDS AMONG US ADULTS
Obesity Having a very high amount of body fat
in relation to lean body mass. Body Mass Index
(BMI) of 30 or higher Body Mass Index (BMI) A
measure of an adults weight in relation to his
or her height, specifically the adults weight in
kilograms divided by the square of his or her
height in meters
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1985
OBESITY TRENDS AMONG US ADULTS
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1986
OBESITY TRENDS AMONG US ADULTS
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1987
OBESITY TRENDS AMONG US ADULTS
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1988
OBESITY TRENDS AMONG US ADULTS
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1989
OBESITY TRENDS AMONG US ADULTS
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1990
OBESITY TRENDS AMONG US ADULTS
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1991
OBESITY TRENDS AMONG US ADULTS
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1992
OBESITY TRENDS AMONG US ADULTS
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1993
OBESITY TRENDS AMONG US ADULTS
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1994
OBESITY TRENDS AMONG US ADULTS
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1995
OBESITY TRENDS AMONG US ADULTS
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1996
OBESITY TRENDS AMONG US ADULTS
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1997
OBESITY TRENDS AMONG US ADULTS
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1998
OBESITY TRENDS AMONG US ADULTS
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1999
OBESITY TRENDS AMONG US ADULTS
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2000
OBESITY TRENDS AMONG US ADULTS
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2001
OBESITY TRENDS AMONG US ADULTS
No Data lt10 1014 1519
2024 25
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2002
OBESITY TRENDS AMONG US ADULTS
(BMI ?30, or 30 lbs overweight for 54 person)
No Data lt10 1014 1519
2024 25
Source Behavioral Risk Factor Surveillance
System, CDC
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THE EFFECT PRODUCED ON DIABETES BY EXTRACTS OF
PANCREAS BANTING, BEST, COLLIP, CAMPBELL,
FLETCHER, MACLEOD NOBLE TRANSACTIONS OF THE
ASSOCIATION OF AMERICAN PHYSICIANS 1922
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New Strategy For The Prevention of Type 2
Diabetes Six recent large-scale clinical
studies reported a remarkably consistent
reduction in the incidence of type 2 diabetes in
hypertensive patients treated with either ACE
inhibitors or ARAs for 3-6 years, compared with a
thiazide diuretic, beta-adrenoceptor antagonist,
the calcium channel antagonist amlodipine or even
placebo. These encouraging observations led to
the initiation of two large, prospective,
placebo-controlled randomized clinical trials
whose primary outcome is the prevention of type 2
diabetes the DREAM trial with the ACE inhibitor
ramipril and the NAVIGATOR trial with the ARA
valsartan. The consistent observations of a
14-34 reduction of the development of diabetes
in hypertensive patients receiving ACE inhibitors
or ARAs are exciting. From a theoretical point of
view, they emphasize that there are many aspects
of the pathogenesis, prevention and treatment of
type 2 diabetes that still need to be uncovered.
From a practical point of view, they may offer a
new strategy to reduce the ongoing epidemic and
burden of type 2 diabetes. Drugs.
200464(22)2537-65.
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Vaccine May Prevent Onset Of Type 1 Diabetes
Prof Harrison has devised a test to detect
children and young adults in the early stages of
the disease. He said the insulin in the nasal
spray could stop the type 1 rogue immune response
and trigger a healthy response. "That good
immune response . . . will block the kind of
immune response that would cause destruction of
insulin-producing cells," he said. A five-year
trial involving 38 children at Royal Melbourne
Hospital and the Hall Institute proved the
vaccine protected against the development of
diabetes. Of the 38 children, 12 who began with
very little or no insulin-producing function went
on to develop diabetes within one or two years.
None of the 26 who began the trial while still
producing some of their own insulin developed
diabetes. http//www.diabetesincontrol.com/
modules.php?nameNewsfilearticlesid2278
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New Blood Sugar Sensor Improves Diabetes
Control People with type 1 diabetes have to
constantly check their blood sugar levels, a
chore that involves finger pricks and test strips
and a special meter. Although intensive
diabetes control is associated with better
outcomes, it is also linked to more frequent
episodes of hypoglycemia, researchers at the
University of Colorado Health Sciences Center in
Denver theorized that real-time continuous
glucose readings would increase the amount of
time patients maintained blood sugar levels in
the normal range. For their study, 15 patients
with type 1 diabetes had DexCom glucose sensors
implanted under the skin of the abdomen. The
device is about the size of an AA battery that
transmits radio signals to a pager-sized
receiver. Glucose levels are determined every 30
seconds, and data are transmitted to the receiver
every 5 minutes. Vibratory and auditory alarms go
off when glucose levels are too high or too
low. Studies suggest that infrequent
self-monitored blood glucose measurements fail to
provide patients with enough information to avoid
low blood sugar levels. By decreasing high and
low swings in the glucose levels, continuous
glucose readings may reduce the long-term
complications of diabetes. Diabetes Care, March
2004.
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