Type I diabetes mellitus. Dr Laurence Lacroix
|
|
- Brook Simmons
- 5 years ago
- Views:
Transcription
1 mellitus Dr Laurence Lacroix
2 DEFINITION: Group of diseases characterized by a disorder of glucose homeostasis with high levels of blood glucose resulting from defects in : o insulin production o insulin action o both mechanisms 2
3 ETYMOLOGY: o 1500 BC: Egyptian manuscript mentioning "too great emptying of the urine o 230 BC: Diabetes comes from the ancient Greek "diabainen" (= to pass through) Démétrios d'apnée o Mellitus means sweet like honey in latin 3
4 TYPES of DIABETES MELLITUS: o Type 1 DM (insulin-dependent diabetes mellitus (IDDM) or juvenile diabetes) results from the body's failure to produce insulin (requires exogenous insulin). o Type 2 DM (non insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes) results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. 4
5 TYPES of DIABETES MELLITUS : o Gestational diabetes occurs when pregnant women without a previous diagnosis of diabetes develop a high blood glucose level. It may precede development of type 2 DM. o Other forms: congenital diabetes (due to genetic defects), pancreatic insufficiency related diabetes, glucocorticoid-induced diabetes and several forms of monogenic diabetes (MODY) 5
6 Let s focus on type I diabetes! 6
7 glucagon insuline somatostatine Pancreatic 7 polypeptide
8 PATHOPHYSIOLOGY Type I diabetes o Autoimmune destruction of insulinproducing islet β-cells in the pancreas 8
9 ETIOLOGY Impaired immunoregulation Low maternal vit D levels? Genetic susceptibility Autoimmune islet cells destruction Insulin deficiency Clinical type 1 diabetes Viral triggers? Vaccinations? Food? Cow milk proteins Cereals Root vegetables 9
10 10
11 10% 11
12 5% 12
13 GENETIC FACTORS Type I diabetes o Increased risk if any member of the family is affected: o mother: 1 4% o father: 4 8% o both parents: 20% o brother or sister: 6% o monozygotic twin: 30 70% o Association with HLA DR3-DQ2 and DR4-DQ8 o Association with over 40 genetic loci 13
14 EPIDEMIOLOGY: o o Type I diabetes T1D accounts for 5 10% of the total cases of diabetes worldwide 3% annual increase in incidence rate Newly reported cases of Type 1 Diabetes in children 0-14 years per children/year (2011) Adapted from the International Diabetes Federation Atlas 14
15 EPIDEMIOLOGY-AFRICA: o few data in African countries Type 1 diabetes mellitus in the African population: epidemiology and management challenges Acta Biomed 2008; 79:
16 SEASONAL VARIATIONS: Sloka S. et al. Pediatric Diabetes 2008; 9:
17 PHYSIOLOGY: 17
18 PATHOPHYSIOLOGY: Type I diabetes 18
19 PATHOPHYSIOLOGY: Type I diabetes 19
20 COMPLICATIONS: Type I diabetes o Microvascular disease o Nephropathy o Retinopathy o Neuropathy o Macrovascular disease (atherosclerosis) o Coronary artery disease o Peripheral vascular disease o Stroke importance of tight glycemic control! 20
21 ASSOCIATED AUTOIMMUNE DISORDERS: o Autoimmune thyroid dysfunction (20% in patients with T1DM) o TSH screening every 1-2 years o TSH screening at any time if clinical suspicion o Celiac disease (4.5% prevalence) o Tissue transglutaminase antibodies o Endomysial antibodies 21
22 SYMPTOMS: (1-2 weeks-few months before presentation): classic symptoms o Polyuria (nycturia!) /polydipsia o Polyphagia o Weight loss early symptoms o Fatigue o Vague abdominal pain o Recurrent infections recurrent UTIs, candida infections resistant to treatment 22
23 KETOACIDOSIS CLINICAL SIGNS: Previously described symptoms + Moderate to severe dehydration o Dry mucous membranes o Reduction in urine output o Decreased peripheral perfusion o delayed capillary refill time > 3 sec o cool and mottled extremities o Irritability o Reflex tachycardia +/- hypotension o Decreased skin turgor 23
24 KETOACIDOSIS CLINICAL SIGNS: Previously described symptoms +: o Labored breathing with polypnea(kussmaul) o Fruity smelling breath 24
25 KETOACIDOSIS CLINICAL SIGNS: Previously described symptoms +: o Labored breathing with polypnea(kussmaul) o Fruity smelling breath 25
26 SYMPTOMS OF KETOACIDOSIS: Previously described symptoms +: o Digestive symptoms o Nausea o Vomiting o Abdominal pain (acute abdomen! ) o Mental status alteration cerebral edema in 0.5%-1% of pediatric DKA cases 26
27 21-24% mortality 27
28 DIFFERENTIAL DIAGNOSIS: o Polyuria/polydypsia: o Other forms of diabetes o Diabetes insipidus o DKA: other causes of confusion with severe acidosis o Intoxications o Shock (sepsis) 28
29 29
30 COMPLEMENTARY EXAMINATION: o Blood: blood glucose level confirms the diagnosis o Serum fasting glucose 7.0 mmol/l (126 mg/dl) OR o A serum glucose 11.1 mmol/l (200 mg/dl) 2 hours after eating 1.75 g/kg (max. 75g) of glucose (oral glucose tolerance test) o Prepare an extra tube of blood for: o A1c Hemoglobin o Autoantibodies o Other viral serologies 30
31 COMPLEMENTARY EXAMINATION: o Urine: Urinary dipstick testing: o High levels of glucose o Ketones 31
32 CASE DEFINITION: o Serum fasting glucose 7.0 mmol/l (126 mg/dl) OR o Postprandial serum glucose 11.1 mmol/l (200 mg/dl) 2 hours after ingesting 1.75 g/kg (max. 75g) of glucose (oral glucose tolerance test) OR o A1c Hemoglobin 6.5% AND hyperglycemia AND No other cause of hyperglycemia 32
33 TREATMENT GOALS: Type I diabetes o Restore euglycemia o Facilitate o metabolism o storage of consumed food 33
34 TREATMENT: Insulin o 0.5 and 1.0 units/kg/day for children with longstanding diabetes o prepubertal chidren o during puberty 50% longacting insulin 50% rapid or short-acting insulin Total daily dose of insulin 34
35 The «basal-bolus» or «multiple dailyinjection» regimen: Physiologic insulin secretion of a healthy pancreas. Source: Current Paediatrics, Vol 16, Thompson R, Christie D, Hindmarsh PC, The role for insulin analogs in diabetes care, pp o rapid-acting insulin : given with meals and snacks o long-acting insulin : steady amount of insulin with little to no peak between mealtimes 35
36 DKA TREATMENT: o Fluid and electrolyte therapy o o cautious rehydration over the next 48 hours Monitor K + and give IV K + supplements (intracellular shift of potassium with insulin and reduction of acidosis) o Insulin o Treatment of cerebral edema o Mannitol o Hypertonic saline (3%) 36
37 TREATMENT: injection pump 37
38 TREATMENT: Diet o Essential component of a good glycemic control o Medical nutrition therapy 38
39 TREATMENT: Exercise positively affects the overall: o Physical o Mental o Social health In youth with T1DM Should be encouraged with careful glucose monitoring 39
40 FAMILY EDUCATION: Type I diabetes Caregivers should be able to: o Check and record blood glucose concentrations using a home blood glucometer o Deliver insulin (syringe or pump) o Detect and treat hypoglycemia o Ideally, multidisciplinary team: pediatric endocrinologist, nurse educator, dietetician, social worker, child life specialist, mental health professional. 40
41 CONCLUSION: Type 1 diabetes Mellitus can present: o With classic symptoms (polyuria, polydipsia, polyphagia, and weight loss) o With diabetic ketoacidosis (vomiting, abdominal pain, and lethargy in addition to the classic symptoms) o As an incidental finding discovered on urine or blood testing performed for other reasons. o Prompt recognition is important in order to avoid lifethreatening complications o Lifelong careful treatment is important in order to avoid complications 41
42 SUGGESTED READING: Type I diabetes o Type 1 diabetes mellitus. Gregory JM, Moore DJ, Simmons JH. Pediatr Rev May;34(5): o Epidemiology of Type 1 Diabetes. Maahs DM, West NA, Lawrence JM, Mayer-Davis EJ. Endocrinol Metab Clin North Am. Sep 2010; 39(3): o Insulin Therapy in Children and Adolescents with Type 1 Diabetes. Malik FS, Taplin CE. Paediatr Drugs Jan 24. DOI /s
43 QUESTIONS 43
DIABETES MELLITUS. IAP UG Teaching slides
DIABETES MELLITUS 1 DIABETES MELLITUS IN CHILDREN Introduction, Definition Classification, pathogenesis Clinical features Investigations and diagnosis Therapy and follow up Complications Carry home message
More informationType 1 Diabetes-Pathophysiology, Diagnosis, and Long-Term Complications. Alejandro J de la Torre Pediatric Endocrinology 10/17/2014
Type 1 Diabetes-Pathophysiology, Diagnosis, and Long-Term Complications Alejandro J de la Torre Pediatric Endocrinology 10/17/2014 Objectives Understand the pathophysiology of Type 1 diabetes. Be familiar
More informationCARBOHYDRATE METABOLISM Disorders
CARBOHYDRATE METABOLISM Disorders molecular formula C12H22O11 Major index which describes metabolism of carbohydrates, is a sugar level in blood. In healthy people it is 4,4-6,6 mmol/l (70-110 mg/dl)
More informationAACN PCCN Review. Endocrine
AACN PCCN Review Endocrine Presenter: Carol A. Rauen, RN, MS, CCNS, CCRN, PCCN, CEN Independent Clinical Nurse Specialist & Education Consultant rauen.carol104@gmail.com Endocrine I. INTRODUCTION Disorders
More informationDiabetes Mellitus. Mohamed Ahmed Fouad Lecturer of Pediatrics Jazan Faculty of Medicine
Diabetes Mellitus Mohamed Ahmed Fouad Lecturer of Pediatrics Jazan Faculty of Medicine Define DM in children Differentiate types of DM Discus Etiology and Risk Factor Reason clinical presentations Set
More informationDiabetes Mellitus in the Pediatric Patient
Diabetes Mellitus in the Pediatric Patient William Bryant, M.D. Chief of Section Pediatric Endocrinology Children s Hospital at Scott & White Texas A&M University Temple, Texas Disclosures None Definitions
More informationObjectives / Learning Targets: The learner who successfully completes this course will be able to demonstrate understanding of the following concepts:
Objectives / Learning Targets: The learner who successfully completes this course will be able to demonstrate understanding of the following concepts: Insulin s function in the body. The basics of diabetes
More informationDiabetic Ketoacidosis: When Sugar Isn t Sweet!!!
Diabetic Ketoacidosis: When Sugar Isn t Sweet!!! W Ricks Hanna Jr MD Assistant Professor of Pediatrics University of Tennessee Health Science Center LeBonheur Children s Hospital Introduction Diabetes
More informationI have no financial disclosures
Athina Sikavitsas DO Children's Emergency Services University of Michigan Discuss DKA Presentation Assessment Treatment I have no financial disclosures 1 6 Y/O male presents with vomiting and abdominal
More informationDiabetic Emergencies. Chapter 15
Diabetic Emergencies Chapter 15 Diabetes- is a disorder of glucose metabolism or difficulty metabolizing carbohydrates, fats and proteins Full name is diabetes mellitus which refers to the presence of
More informationassociated with serious complications, but reduce occurrences with preventive measures
Wk 9. Management of Clients with Diabetes Mellitus 1. Diabetes Mellitus body s inability to metabolize carbohydrates, fats, proteins hyperglycemia associated with serious complications, but reduce occurrences
More informationType 1 Diabetes Update Robin Goland, MD
Naomi Berrie Diabetes Center Type 1 Diabetes Update 2008 Robin Goland, MD Type 1 diabetes is: A manageable condition A chronic condition Often challenging Entirely compatible with a happy and healthy childhood
More informationDiabetes: What is the scope of the problem?
Diabetes: What is the scope of the problem? Elizabeth R. Seaquist MD Division of Endocrinology and Diabetes Department of Medicine Director, General Clinical Research Center Pennock Family Chair in Diabetes
More informationDiabetes and Related Emergencies. *** CME Version *** Aaron J. Katz, AEMT-P, CIC
Diabetes and Related Emergencies *** CME Version *** Aaron J. Katz, AEMT-P, CIC www.es26medic.net Agenda BLS Level review of normal physiology of glucose metabolism What happens when normal becomes abnormal
More informationGeorge Ford MD MS Assistant Professor Pediatric Endocrinology ETSU and Niswonger Children s Hospital
George Ford MD MS Assistant Professor Pediatric Endocrinology ETSU and Niswonger Children s Hospital Disclosure Statement of Financial Interest I, George Ford MD MS, DO NOT have a financial interest/arrangement
More informationChapter 24 Diabetes Mellitus
Chapter 24 Diabetes Mellitus Classification of Diabetes Mellitus Acute Effects of Diabetes Mellitus Chronic Complications of Diabetes Mellitus: Early Stages Chronic Complications of Diabetes Mellitus:
More informationCDE Exam Preparation Presented by Wendy Graham RD CDE May 4, 2017
CDE Exam Preparation Presented by Wendy Graham RD CDE May 4, 2017 DKA at organ level 3 Diabetic Ketoacidosis Characteristics Ketones positive Anion Gap > 12 (High) Blood Sugar > 14 (High) Bicarbonate
More informationDAYTON CHILDREN S HOSPITAL CLINICAL PRACTICE GUIDELINES
DAYTON CHILDREN S HOSPITAL CLINICAL PRACTICE GUIDELINES DISCLAIMER: This Clinical Practice Guideline (CPG) generally describes a recommended course of treatment for patients with the identified health
More informationDiabetes Mellitus. Raja Nursing Instructor. Acknowledgement: Badil 09/03/2016
Diabetes Mellitus Raja Nursing Instructor 09/03/2016 Acknowledgement: Badil Objective: Define Diabetes Mellitus (DM) & types of DM. Understand the pathophysiology of Type-I & II DM. List the clinical features
More informationWith Dr. Sarah Reid and Dr. Sarah Curtis
5. Headaches 6. Known diabetes 7. Specific high risk groups (ie. Teenagers, children on insulin pumps and those from lower socio-economic status). Episode 63 Pediatric Diabetic Ketoacidosis With Dr. Sarah
More informationDiabetes mellitus is a complex of syndromes characterized metabolically by hyperglycemia and altered glucose metabolism, and associated
Diabetes mellitus is a complex of syndromes characterized metabolically by hyperglycemia and altered glucose metabolism, and associated pathologically with specific microvascular and macrovascular complications.
More informationDiabetes in Pregnancy
Diabetes in Pregnancy Susan Drummond RN MSN C-EFM Objectives 1. Describe types of diabetes and diagnosis of gestational diabetes 2. Identify a management plan for diabetes during pregnancy 3. Describe
More informationPedsCases Podcast Scripts
PedsCases Podcast Scripts This is a text version of a podcast from Pedscases.com on Diabetic Ketoacidosis. These podcasts are designed to give medical students an overview of key topics in pediatrics.
More informationJanice Lazear, DNP, FNP-C, CDE DIAGNOSIS AND CLASSIFICATION OF DIABETES
Janice Lazear, DNP, FNP-C, CDE DIAGNOSIS AND CLASSIFICATION OF DIABETES Objectives u At conclusion of the lecture the participant will be able to: 1. Differentiate between the classifications of diabetes
More informationSYNDROMS OF HYPERGLYCEMIA AND HYPOGLYCEMIA LECTURE IN INTERNAL MEDICINE PROPAEDEUTICS
2017/2018 Spring Semester SYNDROMS OF HYPERGLYCEMIA AND HYPOGLYCEMIA LECTURE IN INTERNAL MEDICINE PROPAEDEUTICS M. Yabluchansky L. Bogun, L.Martymianova, O. Bychkova, N. Lysenko, M. Brynza V.N. Karazin
More informationDedicated To. Course Objectives. Diabetes What is it? 2/18/2014. Managing Diabetes in the Athletic Population. Aiden
Managing Diabetes in the Athletic Population Dedicated To Aiden Michael Prybicien, LA, ATC, CSCS, CES, PES Athletic Trainer, Passaic High School Overlook Medical Center & Adjunct Faculty, William Paterson
More informationDiabetes Mellitus. Diabetes Mellitus. Insulin. Glucose. Classifications of DM. Other glucose regulating Hormones
Diabetes Mellitus Diabetes Mellitus Pathophysiology Literally sweet urine Defined by excess blood serum glucose Normally all glucose in the PCT is reabsorbed by active transport When blood glucose is elevated,
More informationChapter Goal. Learning Objectives 9/12/2012. Chapter 25. Diabetic Emergencies
Chapter 25 Diabetic Emergencies Chapter Goal Use assessment findings to formulate field impression & implement treatment plan for patients with diabetic emergencies Learning Objectives Describe pathophysiology
More informationDiabetes mellitus - diagnosis, classification and acute complications. David Karásek 3rd Department of Internal Medicine University Hospital Olomouc
Diabetes mellitus - diagnosis, classification and acute complications David Karásek 3rd Department of Internal Medicine University Hospital Olomouc Diabetes mellitus is a group of metabolic diseases, characterized
More information1/3/2008. Karen Burke Priscilla LeMone Elaine Mohn-Brown. Medical-Surgical Nursing Care, 2e Karen Burke, Priscilla LeMone, and Elaine Mohn-Brown
Medical-Surgical Nursing Care Second Edition Karen Burke Priscilla LeMone Elaine Mohn-Brown Chapter 17 Caring for Clients with Diabetes Mellitus Diabetes Mellitus Chronic disease Not a single disorder
More information9/11/2012. Chapter 11. Learning Objectives. Learning Objectives. Endocrine Emergencies. Differentiate type 1 and type 2 diabetes
Chapter 11 Endocrine Emergencies Learning Objectives Differentiate type 1 and type 2 diabetes Explain roles of glucagon, glycogen, and glucose in hypoglycemia Learning Objectives Discuss following medications
More informationNHS Greater Glasgow & Clyde Managed Clinical Network for Diabetes
Guidelines for the Diagnosis of Diabetes Mellitus NHS Greater Glasgow & Clyde Managed Clinical Network for Diabetes Lead Authors: Dr Brian Kennon, Dr David Carty June 2015 Review due: December 2016 Diagnosis
More informationDIABETES AND PREGNANCY. CDE Exam Preparation March 22 & 27, 2018 Presented by Wendy Graham RD CDE Mentor
DIABETES AND PREGNANCY CDE Exam Preparation March 22 & 27, 2018 Presented by Wendy Graham RD CDE Mentor OBJECTIVES Describe targets for blood glucose in pregnancy Discuss the risks to baby if blood glucose
More informationDiabetes Review. October 31, Dr. Don Eby Tracy Gaunt Dwayne Cottel
Diabetes Review October 31, 2012 Dr. Don Eby Tracy Gaunt Dwayne Cottel Diabetes Review Learning Objectives: Describe the anatomy and physiology of the pancreas Describe the effects of hormones on the maintenance
More informationLocal Anesthesia for Dental Hygienists Session III. Altered Consciousness and Diabetes Michael E. O Brien, DDS and Frank S.
Altered Consciousness in General Dr. Michael E. O Brien Dr. Frank S. Drongowski Definitions Confusion - a mental state marked by disturbances in comprehension, understanding, and resulting in bewilderment
More informationPhysical Activity/Exercise Prescription with Diabetes
Physical Activity/Exercise Prescription with Diabetes B R AD H I NTERMEYER C E P A C SM S A NFORD H E ALTH C A RDIAC R E H AB A N D D I ABE TES E XE RCISE The adoption and maintenance of physical activity
More informationDiabetes in Pregnancy
Diabetes in Pregnancy Ebony Boyce Carter, MD, MPH Division of Maternal Fetal Medicine Washington University School of Medicine Disclosures I have no financial disclosures to report. Objectives Review the
More informationDiabetic Emergencies: Ketoacidosis and the Hyperglycemic Hyperosmolar State. Adam Bursua, Pharm.D., BCPS
Diabetic Emergencies: Ketoacidosis and the Hyperglycemic Hyperosmolar State Adam Bursua, Pharm.D., BCPS Objectives Describe the epidemiology of diabetic ketoacidosis (DKA) and the hyperglycemic hyperosmolar
More informationDiabetes Mellitus, Type 1
Continuing Education (CEU) course for healthcare professionals. View the course online at wildirismedicaleducation.com for accreditation/approval information, course availability and other details, and
More informationDiabetes Mellitus, Type 1 (or Insulin-Dependent Diabetes Mellitus)
Diabetes Mellitus, Type 1 (or Insulin-Dependent Diabetes Mellitus) Pronunciations: (di"ah-be'teez MEL-ih-tus ) Diabetes Mellitus is a chronic condition characterized either by lack of insulin secretion
More informationMedical Nutrition Therapy for Diabetes Mellitus. Raziyeh Shenavar MSc. of Nutrition
Medical Nutrition Therapy for Diabetes Mellitus Raziyeh Shenavar MSc. of Nutrition Diabetes Mellitus A group of diseases characterized by high blood glucose concentrations resulting from defects in insulin
More informationSLEEP IN THE FACE OF CANCER AND DIABETES
SLEEP IN THE FACE OF CANCER AND DIABETES Joseph Anderson, CCSH, RPSGT, RST, RPFT, CRT-NPS Certified Clinical Sleep Health Educator Supervisor, Integrated Sleep Disorders Center & Tele-Sleep Coordinator
More informationDiabetes: Definition Pathophysiology Treatment Goals. By Scott Magee, MD, FACE
Diabetes: Definition Pathophysiology Treatment Goals By Scott Magee, MD, FACE Disclosures No disclosures to report Definition of Diabetes Mellitus Diabetes Mellitus comprises a group of disorders characterized
More informationMANAGEMENT OF TYPE 1 DIABETES MELLITUS
MANAGEMENT OF TYPE 1 DIABETES MELLITUS INVESTIGATIONS AND TREATMENT MANSI NAIK VII SEMESTER INVESTIGATIONS FASTING BLOOD SUGAR PLASMA GLUCOSE HEMOGLOBIN A 1c SYMPTOMS OF TYPE 1 DIABETES MELLITUS Polyuria
More informationCombining Complex Pathophysiologic Concepts: Diabetes Mellitus
Chapter 18 Combining Complex Pathophysiologic Concepts: Diabetes Mellitus KEY TERMS dawn phenomenon diabetes mellitus endocrine pancreas exocrine pancreas hyperglycemia hyperketonemia hypoglycemia insulin
More informationDOWNLOAD OR READ : TYPE I JUVENILE DIABETES PDF EBOOK EPUB MOBI
DOWNLOAD OR READ : TYPE I JUVENILE DIABETES PDF EBOOK EPUB MOBI Page 1 Page 2 type i juvenile diabetes type i juvenile diabetes pdf type i juvenile diabetes Diabetes means your blood glucose, or blood
More informationFor more information about how to cite these materials visit
Author(s): Arno Kumagai, M.D., 2009 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Noncommercial Share Alike 3.0 License: http://creativecommons.org/licenses/by-nc-sa/3.0/
More informationDiabetic Ketoacidosis
Diabetic Ketoacidosis Definition: Diabetic Ketoacidosis is one of the most serious acute complications of diabetes. It s more common in young patients with type 1 diabetes mellitus. It s usually characterized
More informationDiabetes mellitus. Diabetes mellitus - 1. Diabetes mellitus Lecture from pathological physiology
Diabetes mellitus Lecture from pathological physiology Oliver Rácz, 2007-2018 Šafárik University, Košice, Slovakia In cooperation with F. Ništiar, (immunology) A. Chmelárová, (biochemistry) D. Kuzmová,
More informationDiabetes in the Young Athlete
Head Team Physician: Bridgewater State University New Bedford Bay Sox Fairhaven high School Diabetes in the Young Athlete Chad Beattie, MD Primary Care Sports Medicine Hawthorn Medical Associates Department
More informationOVERVIEW OF PEDIATRIC DIABETES Alan B. Cortez, M.D. Pediatric Endocrinology Chief, Department of Pediatrics Kaiser-Permanente, Orange County
OVERVIEW OF PEDIATRIC DIABETES 2011 Alan B. Cortez, M.D. Pediatric Endocrinology Chief, Department of Pediatrics Kaiser-Permanente, Orange County Outline of Pediatric Diabetes Presentation Types of Pediatric
More informationNCC Pediatrics Continuity Clinic Curriculum: Diabetes Faculty Guide
NCC Pediatrics Continuity Clinic Curriculum: Diabetes Faculty Guide Goals & Objectives: To learn outpatient and sick-day management for Type I Diabetes: Understand the different insulin preparations; initiation
More informationPathology of endocrine pancreas. By: Shifaa Alqa qa
Pathology of endocrine pancreas By: Shifaa Alqa qa major cell types: Beta ----- insulin Alpha ----- glucagon Delta ----- somatostatin PP (pancreatic polypeptide) cells ------ VIP DIABETES MELLITUS Normal
More informationV. N. Karazin Kharkiv National University Department of internal medicine Golubkina E.O., ass. of prof., Shanina I. V., ass. of prof.
V. N. Karazin Kharkiv National University Department of internal medicine Golubkina E.O., ass. of prof., Shanina I. V., ass. of prof., Macharinskaya O.S., ass. of prof; Supervisor: prof. Yabluchanskiy
More informationHypoglycemia, Sick Days/DKA and Hospitalization
Hypoglycemia, Sick Days/DKA and Hospitalization General survival skills for your client with diabetes at home and in Hospital Diabetes Canada guidelines for your client with diabetes while they are in
More informationBiochemistry. ENDOCRINE Block Practical Sessions. Editing file M E D I C I N E
HbA NH 2 H 2 O 2 KClO 3 Cl 2 O 7 PO 4 CH2O NAOH KMnO 4 M E D I C I N E KING SAUD UNIVERSITY Co 2 COOH MgCl 2 H 2 O Biochemistry ENDOCRINE Block Practical Sessions Important Doctors slides Extra Information
More informationPROBLEMS WITH REGULATION AND METABOLISM. Objectives A & P 8/11/2011
PROBLEMS WITH REGULATION AND METABOLISM Lemone and Burke Chapters 18-20 Objectives Review A & P Recall age related changes Identify diagnostic tests Describe etiology, pathophysiology, clinical manifestation,
More informationCase- history. Lab results
Neda Rasouli, M.D. Associate Professor of Medicine Division of Endocrinology, UC Denver VA_ Eastern Colorado Health Care System Case- history 46 y/o AA male with BMI 37 presented in Oct 2001 with polyuria,
More informationWhy do we care? 20.8 million people. 70% of people with diabetes will die of cardiovascular disease. What is Diabetes?
What is Diabetes? Diabetes 101 Ginny Burns RN MEd CDE Diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action
More informationBlood Glucose Monitoring
Blood Glucose Monitoring What is Glucose? A simple sugar that enters the diet as part of sucrose, lactose, or maltose Part of a polysaccharide called dietary starch Most of the body s energy comes from
More informationPathogenesis of Diabetes Mellitus
Pathogenesis of Diabetes Mellitus Young-Bum Kim, Ph.D. Associate Professor of Medicine Harvard Medical School Definition of Diabetes Mellitus a group of metabolic diseases characterized by hyperglycemia
More informationGestational Diabetes Mellitus Dr. Fawaz Amin Saad
Gestational Diabetes Mellitus Dr. Fawaz Amin Saad Senior Consultant OB/GYN, Al-Hayat Medical Center, Doha, Qatar DISCLOSURE OF CONFLICT OF INTEREST I am a full-time Employee at Al-Hayat Medical Center.
More information11 year-old female with altered mental status in the setting of diabetic ketoacidosis
11 year-old female with altered mental status in the setting of diabetic ketoacidosis Katie O Sullivan, M.D. Fellow Adult/Pediatric Endocrinology University of Chicago Thursday, January 23 rd, 2014 Chief
More informationDiabetes. HED\ED:NS-BL 037-3rd
Diabetes HED\ED:NS-BL 037-3rd Diabetes Diabetes mellitus is an epidemic disease and based on a recent study published on 2011, the estimated number of affected people is 366 million worldwide and the number
More informationCare of patients with endocrine system disorders
King Saud University College of Nursing Medical Surgical Department Application of Adult Health Nursing Skills ( NUR 317 ) Care of patients with endocrine system disorders Prepared by Mrs: Alwah M. Alkathiri
More informationIndividualizing Type 2 Diabetes Management. Cynthia Gerstenlauer, ANP-BC, GCNS-BC, CDE, CCD
Individualizing Type 2 Diabetes Management Cynthia Gerstenlauer, ANP-BC, GCNS-BC, CDE, CCD Harsh Statistics 30.3 million (9.4% of population) in US had DM in 2015 The percent of population with DM increases
More informationBIOS222 Pathology and Clinical Science 2 & 3
BIOS222 Pathology and Clinical Science 2 & 3 Session 16 Endocrine system disorders 3 Bioscience Department www.endeavour.edu.au Session Learning Outcomes At the end of the session, you should be able to:
More informationDiabetes Mellitus Case Study
COLORADO STATE UNIVERSITY Diabetes Mellitus Case Study Medical Nutrition Therapy By: Emily Lancaster 9/28/2012 [Type the abstract of the document here. The abstract is typically a short summary of the
More informationTHE CURRENT APPROACH TO T1D IN CHILDREN
THE CURRENT APPROACH TO T1D IN CHILDREN Dina Panagiotopoulos, MD, FRCPC Associate Professor, Department of Pediatrics University of British Columbia Endocrinologist, BC Children s Hospital CFRI & CDA Clinician
More informationThe University of Arizona Pediatric Residency Program. Primary Goals for Rotation. Endocrinology
The University of Arizona Pediatric Residency Program Primary Goals for Rotation Endocrinology 1. GOAL: Understand the role of the pediatrician in preventing endocrine dysfunction, and in counseling and
More informationAfter attending the lecture and reading these study notes, you will be able to:
Diabetes Mellitus Diabetes Mellitus Dr. Robyn Houlden Division of Endocrinology Queen's University Learning Objectives After attending the lecture and reading these study notes, you will be able to: State
More informationDr. Dafalla Ahmed Babiker Jazan University
Dr. Dafalla Ahmed Babiker Jazan University objectives Overview Definition of dehydration Causes of dehydration Types of dehydration Diagnosis, signs and symptoms Management of dehydration Complications
More informationChapter 37: Exercise Prescription in Patients with Diabetes
Chapter 37: Exercise Prescription in Patients with Diabetes American College of Sports Medicine. (2010). ACSM's resource manual for guidelines for exercise testing and prescription (6th ed.). New York:
More informationPediatric Diabetic Ketoacidosis (DKA) General Pediatrics Admission Order Set
Admitting MRP: Pediatrics: Dr. / Dr. on call to cover until 08:00 am Service: Medicine Team 1 Medicine Team 2 Medical subspecialty Diagnosis: Diabetic Ketoacidosis (DKA) Estimated length of stay Less than
More informationThe Endocrine System. Lipid-Soluble Hormones. Bio217 Sp14 Unit 5. Bio217: Pathophysiology Class Notes Professor Linda Falkow
Bio217: Pathophysiology Class Notes Professor Linda Falkow Mechanisms of Hormonal Regulation Unit V: Endocrine System Disorders Chapter 17 Chap. 17: Mechanisms of Hormonal Regulation Chap. 18: Alterations
More informationdiabetes in adults Metabolic complications of
Metabolic complications of diabetes in adults Dimitri MARGETIS MD ICU St ANTOINE PARIS Definition Diabetic acidoketosis Serious complication in type I diabetes : Hyperglycemia Metabolic acidosis Acidic
More informationManagement of Pregestational and Gestational Diabetes Mellitus
Background and Prevalence Management of Pregestational and Gestational Diabetes Mellitus Pregestational Diabetes - 8 million women in the US are affected, complicating 1% of all pregnancies. Type II is
More informationDiabetes: Across the Lifespan Friday, October 17, Obesity, Insulin Resistance and Type 2 Diabetes Cardiovascular Risks in Children.
Diabetes: Across the Lifespan Friday, October 17, 2014 Obesity, Insulin Resistance and Type 2 Diabetes Cardiovascular Risks in Children. Don P. Wilson, M.D., FNLA Diplomate, Am Brd of Clinical Lipidology
More informationDiseases of the endocrine pancreas
Diseases of the endocrine pancreas Lecture outline Diabetes mellitus Pancreatic neuroendocrine tumors Diabetes mellitus, introduction Hyperglycemia due to defects in insulin secretion, insulin action,
More informationEmergency Medical Training Services Emergency Medical Technician Paramedic Program Outlines Outline Topic: Endocrine Revised: 11/2013
Emergency Medical Training Services Emergency Medical Technician Paramedic Program Outlines Outline Topic: Endocrine Revised: 11/2013 Endocrine system includes 8 major glands. 1. Pituitary (master gland)
More informationProvide preventive counseling to parents and patients with specific endocrine conditions about:
Endocrinology Description: The resident will become familiar with the diagnosis, management, and treatment of endocrine problems. The resident will evaluate patients with a multitude of endocrine problems,
More informationMedically Compromised Patients (Part II)
Medically Compromised Patients (Part II) Ra ed Salma BDS, MSc, JBOMFS, MFDRCSI Endocrine Disorders I. Diabetes Mellitus (DM) Definition (WHO): - Chronic disease due to absolute or relative lack of insulin
More informationHormonal Regulations Of Glucose Metabolism & DM
Hormonal Regulations Of Glucose Metabolism & DM What Hormones Regulate Metabolism? What Hormones Regulate Metabolism? Insulin Glucagon Thyroid hormones Cortisol Epinephrine Most regulation occurs in order
More informationNursing Care of the Resident with Diabetes Mellitus
Nursing Care of the Resident with Diabetes Mellitus Level III Definitions Diabetes is a disorder in which there is relative or absolute lack of insulin. Among other things, glucose (sugar) from food cannot
More informationChapter 17. Endocrine and Hematologic Emergencies
Chapter 17 Endocrine and Hematologic Emergencies Introduction (1 of 2) Endocrine system affects nearly every: Cell Organ Bodily function Endocrine disorders can have many signs and symptoms. Introduction
More informationCCRN/PCCN Review Course May 30, 2013
A & P Review CCRN/PCCN Review Course May 30, 2013 Endocrine Anterior pituitary Growth hormone: long bone growth Thyroid stimulating hormone: growth, thyroid secretion Adrenocorticotropic hormone: growth,
More informationHyperglycemia Procedure: Management and Treatment Adult Patients
Approved by: Chief Operating Officer; and Chief Medical Officer Hyperglycemia Procedure: Management and Treatment Corporate Policy & Procedures Manual Number: VII-B-465 Date Approved January 23, 2018 Date
More informationDistinguishing T1D vs. T2D in Childhood: a case report for discussion
Distinguishing T1D vs. T2D in Childhood: a case report for discussion Alba Morales, MD Associate Professor of Pediatrics Division of Pediatric Endocrinology and Diabetes Disclosure I have no financial
More informationManaging your Diabetes when you are Sick. Type 1 Diabetes Insulin Pump
Managing your Diabetes when you are Sick Type 1 Diabetes Insulin Pump Disclaimer This is general information developed by The Ottawa Hospital. It is not intended to replace the advice of a qualified health-care
More informationChildhood and Juvenile Diabetes. 2.0 Contact Hours. Presented by: CEU Professor.
Childhood and Juvenile Diabetes 2.0 Contact Hours Presented by: CEU Professor www.ceuprofessoronline.com Copyright 2009 The Magellan Group, LLC. All Rights Reserved. Reproduction and distribution of these
More informationDiabetes, sugar. Greenville Veterinary Clinic LLC 409 E. Jamestown Rd. Greenville, PA (724)
Greenville Veterinary Clinic LLC 409 E. Jamestown Rd. Greenville, PA 16125 (724) 588-5260 Feline diabetes mellitus Diabetes, sugar AffectedAnimals: Most diabetic cats are older than 10 years of age when
More informationEndocrinology and the Athlete. Objectives
Endocrinology and the Athlete Paul Thornton, MD Medical Director Endocrinology Objectives Overview of type 1 diabetes Impact of type 1 diabetes on athletic performance Management of type 1 diabetes daily
More informationNutrition and Medicine, 2006 Tufts University School of Medicine Nutrition and Type 2 Diabetes: Learning Objectives
Nutrition and Medicine, 2006 Tufts University School of Medicine Nutrition and Type 2 Diabetes: Learning Objectives Margo N. Woods, D.Sc. 1. Discuss the increase in the incidence and prevalence of type
More informationGlucose Homeostasis. Liver. Glucose. Muscle, Fat. Pancreatic Islet. Glucose utilization. Glucose production, storage Insulin Glucagon
Glucose Homeostasis Liver Glucose Glucose utilization Glucose production, storage Insulin Glucagon Muscle, Fat Pancreatic Islet Classification of Diabetes Type 1 diabetes Type 2 diabetes Other types of
More informationI. General Considerations
1 2 3 I. General Considerations A. Type I ( Juvenile Onset or IDDM) IDDM results from autoimmune destruction of beta cells inability to secrete insulin --> ketone formation --> DKA 4 Diabetic Ketoacidosis
More informationObjectives. Why is blood glucose important? Hypoglycaemia. Hyperglycaemia. Acute Diabetes Emergencies (DKA,HONK)
Acute Diabetes Emergencies Ross Buchan, DSN North Glasgow September 2017 Objectives Why is blood glucose important? Hypoglycaemia Hyperglycaemia Acute Diabetes Emergencies (DKA,HONK) Importance of Blood
More informationLab Activity 21. Endocrine System Glucometer. Portland Community College BI 232
Lab Activity 21 Endocrine System Glucometer Portland Community College BI 232 2 Hormone Functions ACTH (adrenocorticotropic hormone) Regulates the activity of the cortex of the adrenal gland TSH (thyroid
More informationType 2 DM in Adolescents: Use of GLP-1 RA. Objectives. Scope of Problem: Obesity. Background. Pathophysiology of T2DM
Type 2 DM in Adolescents: Use of GLP-1 RA Objectives Identify patients in the pediatric population with T2DM that would potentially benefit from the use of GLP-1 RA Discuss changes in glycemic outcomes
More informationDKA : Diabetic Ketoacidosis & HHS: Hyperlgycemic Hyperosmolar Syndrome Protocol. Glycemic Task Force September 2014
DKA : Diabetic Ketoacidosis & HHS: Hyperlgycemic Hyperosmolar Syndrome Protocol Glycemic Task Force September 2014 Hyperglycemic Crises: Pathophysiology DKA HHS Hyperglycemia DKA HHS Umpierrez, In Shoemaker,
More informationWk 10. Management of Clients with Diabetes Mellitus
Wk 10. Management of Clients with Diabetes Mellitus 2. Acute complications of DM 1) Hyperglycemia and diabetic ketoacidosis Hyperglycemia: glycogenolysis gluconeogenesis 1) Etiology and Risk Factors Taking
More information