Diabetes mellitus, health and medicine homework help

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what is DKA?

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Diabetes mellitus
Dr Gwer

Introduction
• An endocrine disorder characterised
essentially by hyperglycemia
• Two main types; type 1 where there is insulin
deficiency as a result of pancreatic beta cell
damage
• Type 2: Here there is insulin resistance in the
peripheral tissue with variable β-cell damage

Introduction
• Type 1 diabetes is the most common
endocrine disease of childhood and
adolesence
• Type 2 diabetes may also occur in childhood.
• There are other types of diabetes – MODY 1-6,
acromegaly, Cushings, post pancreatitis,
haemochromatosis, hyperthyroidism,
glucagonoma, drug related eg steroids,
pentamidine

type

TYPE 1 DIABETES MELLITUS

Introduction
• Commonest type in paediatrics
• Results from autoimmune destruction of the
pancreatic β-cell with resultant absolute
deficiency of insulin
• Previously called IDDM or juvenile DM
• Commoner in whites but least common in
Chinese . In high incidence areas 2 peaks at 46 yrs and 10-14 yrs. Incidence increases with
distance from equator

Etiology
• The disease results from interaction between
environment and genetics in a susceptible
individual.
• This results in progressive β-cell damage with
symptoms appearing after 90% damage
• Genetic evidence: 2-3% chance if mother has DM,
5-6% if paternal DM and 30% both parents.
• Monozygotic twins lifetime concordance rate60% yet dizygotic risk or other sibling rate 8%.
• In the monozygotic the appearance occurring
after onset in one in 10 yrs is 30%

Etiology
• HLA II DR3 and DR4 are associated with DM
• Environmental factors thought to include viruses
(paradox- IDDM commoner in low infection
communities), cow milk proteins, chemicals , lack
of UV light exposure, Vit D lack
• Other causes include pancreatic damage of varied
causes
• There is increased risk in Downs, klinefelters,
prader willi and Turner’s syndromes

Prognosis
• With good control one may lead a full normal
life, but it is calculated that overall type 1 DM
reduces life expectancy by 13-19 yrs
• Long term complications include: Retinopathy
Cataracts, Gastroparesis, Hypertension,
Progressive renal failure, Early coronary artery
disease, Peripheral vascular disease.
Peripheral and autonomic neuropathy and
Increased risk of infection

Clinicals
• Hyperglycemia, Glycosuria, Polydypsia, weight
loss, mal...


Anonymous
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