Diabetes Mellitus -Pharmacotherapy 1 Exam 1

Glucose Control Physiology

Glucose Homeostasis

• The body maintains a narrow range of blood glucose levels (70-140 mg/dL) through a complex regulatory system involving the pancreas, liver, and other organs.

Hormonal Regulation

• Insulin:
  • Produced by pancreatic beta cells
  • Lowers blood glucose levels by:
    • Increasing glucose uptake in muscles and adipose tissue
    • Inhibiting glucose production in the liver
• Glucagon:
  • Produced by pancreatic alpha cells
  • Raises blood glucose levels by:
    • Stimulating glycogenolysis in the liver
    • Inhibiting glucose uptake in muscles and adipose tissue
• Other hormones:
  • Cortisol, growth hormone, and thyroid hormone also play roles in glucose regulation

Glucose Uptake and Storage

• Glycogen synthesis:
  • Glucose is converted to glycogen in the liver and muscles
  • Insulin promotes glycogen synthesis
• Glycogenolysis:
  • Glycogen is broken down to glucose in the liver
  • Glucagon stimulates glycogenolysis
• Gluconeogenesis:
  • Glucose is synthesized from non-carbohydrate sources (e.g., amino acids, lactate) in the liver and kidneys
  • Stimulated by glucagon and cortisol

Feedback Mechanisms

• Negative feedback loops:
  • High blood glucose levels stimulate insulin release, which reduces glucose levels
  • Low blood glucose levels stimulate glucagon release, which increases glucose levels
• Short-loop and long-loop feedback mechanisms:
  • Short-loop: local feedback within the pancreas
  • Long-loop: feedback via the bloodstream and other organs

Glucose Control Physiology

Glucose Homeostasis

• The body maintains blood glucose levels between 70-140 mg/dL through a complex regulatory system involving the pancreas, liver, and other organs.

Hormonal Regulation

• Insulin:
  • Produced by pancreatic beta cells
  • Lowers blood glucose levels by increasing glucose uptake in muscles and adipose tissue
  • Inhibits glucose production in the liver
• Glucagon:
  • Produced by pancreatic alpha cells
  • Raises blood glucose levels by stimulating glycogenolysis in the liver
  • Inhibits glucose uptake in muscles and adipose tissue
• Other hormones:
  • Cortisol, growth hormone, and thyroid hormone also play roles in glucose regulation

Glucose Uptake and Storage

• Glycogen synthesis:
  • Glucose is converted to glycogen in the liver and muscles
  • Insulin promotes glycogen synthesis
• Glycogenolysis:
  • Glycogen is broken down to glucose in the liver
  • Glucagon stimulates glycogenolysis
• Gluconeogenesis:
  • Glucose is synthesized from non-carbohydrate sources (e.g., amino acids, lactate) in the liver and kidneys
  • Stimulated by glucagon and cortisol

Feedback Mechanisms

• Negative feedback loops:
  • High blood glucose levels stimulate insulin release, which reduces glucose levels
  • Low blood glucose levels stimulate glucagon release, which increases glucose levels
• Short-loop and long-loop feedback mechanisms:
  • Short-loop: local feedback within the pancreas
  • Long-loop: feedback via the bloodstream and other organs

Definition and Types

• Diabetes: a group of metabolic disorders characterized by high blood sugar levels
• Type 1 Diabetes: autoimmune disease, body attacks and destroys insulin-producing beta cells in the pancreas
• Type 2 Diabetes: insulin resistance, body's cells become resistant to insulin, leading to high blood sugar
• Gestational Diabetes: develops during pregnancy, usually in the second or third trimester
• LADA (Latent Autoimmune Diabetes in Adults): autoimmune form of type 2 diabetes
• MODY (Maturity-Onset Diabetes of the Young): rare, genetic form of diabetes

Causes and Risk Factors

• Type 1 Diabetes: caused by genetics and autoimmune response
• Type 2 Diabetes: caused by obesity, physical inactivity, family history, certain medications, age, and ethnicity
• Obesity increases the risk of developing type 2 diabetes
• Physical inactivity is a significant risk factor for type 2 diabetes
• Family history can contribute to the development of type 2 diabetes
• Certain medications can increase the risk of type 2 diabetes
• Age increases the risk of type 2 diabetes after 45
• Ethnicity is a risk factor, with African Americans, Hispanics, American Indians, and Asians at higher risk

Symptoms

• Common symptoms of diabetes include increased thirst and hunger, frequent urination, fatigue, blurry vision, and cuts or bruises that are slow to heal
• Less common symptoms include numbness or tingling in hands and feet, recurring skin, gum, or bladder infections, and flu-like symptoms in type 1 diabetes

Diagnosis

• Fasting Plasma Glucose (FPG) test: measures blood sugar levels after an overnight fast
• Oral Glucose Tolerance Test (OGTT): measures blood sugar levels after consuming a sugary drink
• Hemoglobin A1c (HbA1c) test: measures average blood sugar levels over the past 2-3 months

Treatment and Management

• Lifestyle changes: healthy diet, regular physical activity, and weight loss (if overweight or obese) can help manage diabetes
• Insulin therapy is necessary for type 1 diabetes and some type 2 cases
• Oral medications such as metformin and sulfonylureas can be used to manage diabetes
• Regular blood sugar checks, HbA1c tests, and foot exams are necessary for monitoring diabetes

Definition and Types

• Diabetes is a group of metabolic disorders characterized by high blood sugar levels (hyperglycemia)
• There are two main types of diabetes: Type 1 Diabetes (T1D) and Type 2 Diabetes (T2D)

Type 1 Diabetes (T1D)

• Autoimmune disease in which the body doesn't produce insulin, usually develops in childhood or adolescence
• Characterized by genetic predisposition and environmental factors such as viral infections

Type 2 Diabetes (T2D)

• Body becomes resistant to insulin, and/or doesn't produce enough insulin, usually develops in adulthood
• Risk factors: obesity, physical inactivity, family history, age (risk increases after 45), ethnicity, history of gestational diabetes or delivering a baby over 9 lbs

Symptoms

• Common symptoms: increased thirst and urination, fatigue, blurred vision, slow healing of cuts and wounds, frequent infections
• May not exhibit symptoms in early stages

Complications

• Acute complications: diabetic ketoacidosis (DKA), hypoglycemia (low blood sugar)
• Chronic complications: cardiovascular disease, nephropathy (kidney damage), retinopathy (eye damage), neuropathy (nerve damage), foot ulcers and amputations

Diagnosis

• Diagnostic tests: fasting plasma glucose (FPG) test, oral glucose tolerance test (OGTT), hemoglobin A1c (HbA1c) test

Treatment and Management

• T1D: insulin therapy (injections or pump), blood glucose monitoring, healthy diet and exercise
• T2D: lifestyle changes (diet, exercise, weight loss), oral medications (e.g., metformin), insulin therapy (if necessary), blood glucose monitoring

Prevention

• Maintain a healthy weight to prevent developing Type 2 Diabetes
• Engage in regular physical activity to reduce the risk of developing Type 2 Diabetes
• Eat a balanced diet to reduce the risk of developing Type 2 Diabetes
• Limit sugary drinks and saturated fats to reduce the risk of developing Type 2 Diabetes
• Manage stress to reduce the risk of developing Type 2 Diabetes
• Get regular check-ups to prevent complications

Definition and Types

• Diabetes is a group of metabolic disorders characterized by high blood sugar levels (hyperglycemia)
• Three main types of diabetes: Type 1, Type 2, and Gestational Diabetes

Type 1 Diabetes

• Autoimmune disease where the body doesn't produce enough insulin, a hormone that regulates blood sugar levels
• Exact causes unknown, but genetic and environmental factors contribute to its development
• Symptoms may develop rapidly, sometimes over a few weeks

Type 2 Diabetes

• Metabolic disorder where the body becomes resistant to insulin, leading to high blood sugar levels
• Risk factors: obesity, physical inactivity, family history, age (45+ years), ethnicity, history of gestational diabetes
• Symptoms may be mild or absent, and the condition may be diagnosed through routine blood tests

Gestational Diabetes

• Develops during pregnancy, usually in the second or third trimester
• Risk factors: obesity, family history, age (35+ years), history of gestational diabetes in previous pregnancies

Symptoms

• Common symptoms: increased thirst and urination, fatigue, blurred vision, slow healing of cuts and wounds, frequent infections, tingling or numbness in hands and feet

Complications

• Untreated or poorly managed diabetes can lead to: microvascular complications (nephropathy, retinopathy, neuropathy) and macrovascular complications (cardiovascular disease, peripheral artery disease)

Management and Treatment

• Lifestyle changes: healthy diet, regular exercise, weight loss, stress management
• Medications: insulin, oral medications (metformin, sulfonylureas, etc.)
• Insulin therapy: for Type 1 diabetes and some Type 2 diabetes cases
• Monitoring: regular blood glucose testing, HbA1c tests to monitor blood sugar control

Definition and Types of Diabetes

• Diabetes is a group of metabolic disorders characterized by high blood sugar levels
• Two main types of diabetes:
  • Type 1 Diabetes: autoimmune disease where the body attacks and destroys insulin-producing beta cells in the pancreas
  • Type 2 Diabetes: insulin resistance, where the body becomes less responsive to insulin, leading to high blood sugar levels

Causes and Risk Factors

• Type 1 Diabetes: caused by genetic predisposition and environmental triggers such as viruses
• Type 2 Diabetes: caused by obesity, physical inactivity, family history, age (>45), and history of gestational diabetes

Symptoms of Diabetes

• Increased thirst and urination due to high blood sugar levels
• Fatigue from inadequate insulin production or insulin resistance
• Blurred vision caused by high blood sugar levels affecting the lens of the eye
• Slow healing of cuts and wounds due to damaged blood vessels and nerves
• Frequent infections due to weakened immune system
• Tingling or numbness in hands and feet due to nerve damage

Complications of Diabetes

• Macrovascular complications: heart disease, stroke, peripheral artery disease
  • Heart disease: high blood sugar levels damage blood vessels and increase risk of heart disease
  • Stroke: high blood sugar levels increase risk of stroke
  • Peripheral artery disease: narrowed or blocked blood vessels in legs increase risk of foot ulcers
• Microvascular complications: retinopathy, nephropathy, neuropathy
  • Retinopathy: high blood sugar levels damage blood vessels in the eye, leading to blindness
  • Nephropathy: high blood sugar levels damage kidneys, leading to kidney failure
  • Neuropathy: high blood sugar levels damage nerves, leading to pain, numbness, and tingling

Diagnosis of Diabetes

• Fasting Plasma Glucose (FPG) test: measures blood sugar levels after an overnight fast
• Oral Glucose Tolerance Test (OGTT): measures blood sugar levels after consuming a sugary drink
• Hemoglobin A1c (HbA1c) test: measures average blood sugar levels over the past 2-3 months

Treatment and Management of Diabetes

• Lifestyle changes: healthy diet, regular exercise, weight loss to improve insulin sensitivity
• Medications: oral medications (e.g., metformin) to improve insulin sensitivity, insulin therapy to replace insulin
• Self-monitoring: regular blood glucose monitoring, tracking carbohydrate intake and physical activity to adjust treatment plan

Glucose Control Physiology

• The body maintains a narrow range of blood glucose levels (70-140 mg/dL) through a complex regulatory system involving the pancreas, liver, and other organs.

Hormonal Regulation

• Insulin:
  • Produced by pancreatic beta cells
  • Lowers blood glucose levels by increasing glucose uptake in muscles and adipose tissue and inhibiting glucose production in the liver
• Glucagon:
  • Produced by pancreatic alpha cells
  • Raises blood glucose levels by stimulating glycogenolysis in the liver and inhibiting glucose uptake in muscles and adipose tissue
• Other hormones:
  • Cortisol, growth hormone, and thyroid hormone also play roles in glucose regulation

Glucose Uptake and Storage

• Glycogen synthesis:
  • Glucose is converted to glycogen in the liver and muscles
  • Insulin promotes glycogen synthesis
• Glycogenolysis:
  • Glycogen is broken down to glucose in the liver
  • Glucagon stimulates glycogenolysis
• Gluconeogenesis:
  • Glucose is synthesized from non-carbohydrate sources (e.g., amino acids, lactate) in the liver and kidneys
  • Stimulated by glucagon and cortisol

Feedback Mechanisms

• Negative feedback loops:
  • High blood glucose levels stimulate insulin release, which reduces glucose levels
  • Low blood glucose levels stimulate glucagon release, which increases glucose levels
• Short-loop and long-loop feedback mechanisms:
  • Short-loop: local feedback within the pancreas
  • Long-loop: feedback via the bloodstream and other organs

Diabetes

• Definition: a group of metabolic disorders characterized by high blood sugar levels
• Types:
  • Type 1 Diabetes: autoimmune disease, body attacks and destroys insulin-producing beta cells in the pancreas
  • Type 2 Diabetes: insulin resistance, body becomes less responsive to insulin, leading to high blood sugar levels
  • Gestational Diabetes: develops during pregnancy, usually in the second or third trimester
  • LADA (Latent Autoimmune Diabetes in Adults): autoimmune form of type 2 diabetes
  • MODY (Maturity-Onset Diabetes of the Young): rare, genetic form of diabetes

Causes and Risk Factors

• Type 1 Diabetes:
  • Genetics
  • Autoimmune response
• Type 2 Diabetes:
  • Obesity
  • Physical inactivity
  • Family history
  • Certain medications
  • Age (risk increases after 45)
  • Ethnicity (African Americans, Hispanics, American Indians, and Asians are at higher risk)

Symptoms

• Common symptoms:
  • Increased thirst and urination
  • Fatigue
  • Blurry vision
  • Cuts or bruises that are slow to heal
• Less common symptoms:
  • Numbness or tingling in hands and feet
  • Recurring skin, gum, or bladder infections
  • Flu-like symptoms (in type 1 diabetes)

Diagnosis

• Fasting Plasma Glucose (FPG) test: measures blood sugar levels after an overnight fast
• Oral Glucose Tolerance Test (OGTT): measures blood sugar levels after consuming a sugary drink
• Hemoglobin A1c (HbA1c) test: measures average blood sugar levels over the past 2-3 months

Treatment and Management

• Lifestyle changes:
  • Healthy diet
  • Regular physical activity
  • Weight loss (if overweight or obese)
• Medications:
  • Insulin therapy (type 1 diabetes, some type 2 cases)
  • Oral medications (metformin, sulfonylureas, etc.)
• Monitoring: regular blood sugar checks, HbA1c tests, and foot exams

Glucose Control Physiology

• The body maintains a narrow range of blood glucose levels (70-140 mg/dL) through a complex regulatory system involving the pancreas, liver, and other organs.

Hormonal Regulation

• Insulin:
  • Produced by pancreatic beta cells
  • Lowers blood glucose levels by increasing glucose uptake in muscles and adipose tissue and inhibiting glucose production in the liver
• Glucagon:
  • Produced by pancreatic alpha cells
  • Raises blood glucose levels by stimulating glycogenolysis in the liver and inhibiting glucose uptake in muscles and adipose tissue
• Other hormones:
  • Cortisol, growth hormone, and thyroid hormone also play roles in glucose regulation

Glucose Uptake and Storage

• Glycogen synthesis:
  • Glucose is converted to glycogen in the liver and muscles
  • Insulin promotes glycogen synthesis
• Glycogenolysis:
  • Glycogen is broken down to glucose in the liver
  • Glucagon stimulates glycogenolysis
• Gluconeogenesis:
  • Glucose is synthesized from non-carbohydrate sources (e.g., amino acids, lactate) in the liver and kidneys
  • Stimulated by glucagon and cortisol

Feedback Mechanisms

• Negative feedback loops:
  • High blood glucose levels stimulate insulin release, which reduces glucose levels
  • Low blood glucose levels stimulate glucagon release, which increases glucose levels
• Short-loop and long-loop feedback mechanisms:
  • Short-loop: local feedback within the pancreas
  • Long-loop: feedback via the bloodstream and other organs

Diabetes

• Definition: a group of metabolic disorders characterized by high blood sugar levels
• Types:
  • Type 1 Diabetes: autoimmune disease, body attacks and destroys insulin-producing beta cells in the pancreas
  • Type 2 Diabetes: insulin resistance, body becomes less responsive to insulin, leading to high blood sugar levels
  • Gestational Diabetes: develops during pregnancy, usually in the second or third trimester
  • LADA (Latent Autoimmune Diabetes in Adults): autoimmune form of type 2 diabetes
  • MODY (Maturity-Onset Diabetes of the Young): rare, genetic form of diabetes

Causes and Risk Factors

• Type 1 Diabetes:
  • Genetics
  • Autoimmune response
• Type 2 Diabetes:
  • Obesity
  • Physical inactivity
  • Family history
  • Certain medications
  • Age (risk increases after 45)
  • Ethnicity (African Americans, Hispanics, American Indians, and Asians are at higher risk)

Symptoms

• Common symptoms:
  • Increased thirst and urination
  • Fatigue
  • Blurry vision
  • Cuts or bruises that are slow to heal
• Less common symptoms:
  • Numbness or tingling in hands and feet
  • Recurring skin, gum, or bladder infections
  • Flu-like symptoms (in type 1 diabetes)

Diagnosis

• Fasting Plasma Glucose (FPG) test: measures blood sugar levels after an overnight fast
• Oral Glucose Tolerance Test (OGTT): measures blood sugar levels after consuming a sugary drink
• Hemoglobin A1c (HbA1c) test: measures average blood sugar levels over the past 2-3 months

Treatment and Management

• Lifestyle changes:
  • Healthy diet
  • Regular physical activity
  • Weight loss (if overweight or obese)
• Medications:
  • Insulin therapy (type 1 diabetes, some type 2 cases)
  • Oral medications (metformin, sulfonylureas, etc.)
• Monitoring: regular blood sugar checks, HbA1c tests, and foot exams

Diabetes Management Goals

Glycemic Control

• Target HbA1c level: < 7% (53 mmol/mol) for most adults
• Fasting plasma glucose target: 80-130 mg/dL (4.4-7.2 mmol/L)
• 2-hour postprandial glucose target: < 180 mg/dL (10 mmol/L)

Blood Pressure Control

• Target blood pressure: < 140/90 mmHg for most adults
• Target blood pressure for those with kidney disease or higher cardiovascular risk: < 130/80 mmHg

Lipid Control

• Target LDL cholesterol level: < 100 mg/dL (2.6 mmol/L)
• Target HDL cholesterol levels: > 40 mg/dL (1.0 mmol/L) for men, > 50 mg/dL (1.3 mmol/L) for women
• Target triglycerides level: < 150 mg/dL (1.7 mmol/L)

Lifestyle Management

• Maintain a healthy weight: BMI 18.5-24.9
• Engage in regular physical activity: at least 150 minutes/week
• Eat a balanced diet: focus on whole, unprocessed foods
• Manage stress: use relaxation techniques like meditation, deep breathing

Individualized Goals

• Set personalized targets with a healthcare provider based on age, health status, and other factors
• Regularly monitor and adjust goals as needed

Glucose Control Physiology

• The body maintains a narrow range of blood glucose levels (70-140 mg/dL) through a complex regulatory system involving the pancreas, liver, and other organs.

Hormonal Regulation

• Insulin:
  • Produced by pancreatic beta cells
  • Lowers blood glucose levels by increasing glucose uptake in muscles and adipose tissue and inhibiting glucose production in the liver
• Glucagon:
  • Produced by pancreatic alpha cells
  • Raises blood glucose levels by stimulating glycogenolysis in the liver and inhibiting glucose uptake in muscles and adipose tissue
• Other hormones:
  • Cortisol, growth hormone, and thyroid hormone also play roles in glucose regulation

Glucose Uptake and Storage

• Glycogen synthesis:
  • Glucose is converted to glycogen in the liver and muscles
  • Insulin promotes glycogen synthesis
• Glycogenolysis:
  • Glycogen is broken down to glucose in the liver
  • Glucagon stimulates glycogenolysis
• Gluconeogenesis:
  • Glucose is synthesized from non-carbohydrate sources (e.g., amino acids, lactate) in the liver and kidneys
  • Stimulated by glucagon and cortisol

Feedback Mechanisms

• Negative feedback loops:
  • High blood glucose levels stimulate insulin release, which reduces glucose levels
  • Low blood glucose levels stimulate glucagon release, which increases glucose levels
• Short-loop and long-loop feedback mechanisms:
  • Short-loop: local feedback within the pancreas
  • Long-loop: feedback via the bloodstream and other organs

Diabetes

Definition and Types

• Diabetes: a group of metabolic disorders characterized by high blood sugar levels
• Types:
  • Type 1 Diabetes: autoimmune disease, body attacks and destroys insulin-producing beta cells in the pancreas
  • Type 2 Diabetes: insulin resistance, body becomes less responsive to insulin, leading to high blood sugar levels
  • Gestational Diabetes: develops during pregnancy, usually in the second or third trimester
  • LADA (Latent Autoimmune Diabetes in Adults): autoimmune form of type 2 diabetes
  • MODY (Maturity-Onset Diabetes of the Young): rare, genetic form of diabetes

Causes and Risk Factors

• Type 1 Diabetes:
  • Genetics
  • Autoimmune response
• Type 2 Diabetes:
  • Obesity
  • Physical inactivity
  • Family history
  • Certain medications
  • Age (risk increases after 45)
  • Ethnicity (African Americans, Hispanics, American Indians, and Asians are at higher risk)

Symptoms

• Common symptoms:
  • Increased thirst and urination
  • Fatigue
  • Blurry vision
  • Cuts or bruises that are slow to heal
• Less common symptoms:
  • Numbness or tingling in hands and feet
  • Recurring skin, gum, or bladder infections
  • Flu-like symptoms (in type 1 diabetes)

Diagnosis

• Fasting Plasma Glucose (FPG) test: measures blood sugar levels after an overnight fast
• Oral Glucose Tolerance Test (OGTT): measures blood sugar levels after consuming a sugary drink
• Hemoglobin A1c (HbA1c) test: measures average blood sugar levels over the past 2-3 months

Treatment and Management

• Lifestyle changes:
  • Healthy diet
  • Regular physical activity
  • Weight loss (if overweight or obese)
• Medications:
  • Insulin therapy (type 1 diabetes, some type 2 cases)
  • Oral medications (metformin, sulfonylureas, etc.)
• Monitoring: regular blood sugar checks, HbA1c tests, and foot exams

Glucose Homeostasis

• The body maintains a narrow range of blood glucose levels (70-140 mg/dL) through a complex regulatory system involving the pancreas, liver, and other organs.

Hormonal Regulation

• Insulin:
  • Produced by pancreatic beta cells
  • Lowers blood glucose levels by:
    • Increasing glucose uptake in muscles and adipose tissue
    • Inhibiting glucose production in the liver
• Glucagon:
  • Produced by pancreatic alpha cells
  • Raises blood glucose levels by:
    • Stimulating glycogenolysis in the liver
    • Inhibiting glucose uptake in muscles and adipose tissue
• Other hormones:
  • Cortisol, growth hormone, and thyroid hormone also play roles in glucose regulation

Glucose Uptake and Storage

• Glycogen synthesis:
  • Glucose is converted to glycogen in the liver and muscles
  • Insulin promotes glycogen synthesis
• Glycogenolysis:
  • Glycogen is broken down to glucose in the liver
  • Glucagon stimulates glycogenolysis
• Gluconeogenesis:
  • Glucose is synthesized from non-carbohydrate sources (e.g., amino acids, lactate) in the liver and kidneys
  • Stimulated by glucagon and cortisol

Feedback Mechanisms

• Negative feedback loops:
  • High blood glucose levels stimulate insulin release, which reduces glucose levels
  • Low blood glucose levels stimulate glucagon release, which increases glucose levels
• Short-loop and long-loop feedback mechanisms:
  • Short-loop: local feedback within the pancreas
  • Long-loop: feedback via the bloodstream and other organs

Diabetes Definition and Types

• Diabetes: a group of metabolic disorders characterized by high blood sugar levels
• Types:
  • Type 1 Diabetes: autoimmune disease, body attacks and destroys insulin-producing beta cells in the pancreas
  • Type 2 Diabetes: insulin resistance, body's cells become resistant to insulin, leading to high blood sugar
  • Gestational Diabetes: develops during pregnancy, usually in the second or third trimester

Causes and Risk Factors

• Type 1 Diabetes:
  • Genetic predisposition
  • Autoimmune response
• Type 2 Diabetes:
  • Obesity
  • Physical inactivity
  • Family history
  • Certain medications
  • Age (risk increases after 45)
  • Ethnicity (African Americans, Hispanics, American Indians, and Asians are at higher risk)

Symptoms

• Common symptoms:
  • Increased thirst and hunger
  • Frequent urination
  • Fatigue
  • Blurry vision
  • Cuts or bruises that are slow to heal
• Less common symptoms:
  • Numbness or tingling in hands and feet
  • Recurring skin, gum, or bladder infections
  • Flu-like symptoms (in type 1 diabetes)

Diagnosis

• Fasting Plasma Glucose (FPG) test: measures blood sugar levels after an overnight fast
• Oral Glucose Tolerance Test (OGTT): measures blood sugar levels after consuming a sugary drink
• Hemoglobin A1c (HbA1c) test: measures average blood sugar levels over the past 2-3 months

Glucose Control Physiology

• The body maintains a narrow range of blood glucose levels (70-140 mg/dL) through a complex regulatory system involving the pancreas, liver, and other organs.

Hormonal Regulation

• Insulin: produced by pancreatic beta cells, lowers blood glucose levels by increasing glucose uptake in muscles and adipose tissue, and inhibiting glucose production in the liver.
• Glucagon: produced by pancreatic alpha cells, raises blood glucose levels by stimulating glycogenolysis in the liver and inhibiting glucose uptake in muscles and adipose tissue.
• Other hormones: cortisol, growth hormone, and thyroid hormone also play roles in glucose regulation.

Glucose Uptake and Storage

• Glycogen synthesis: glucose is converted to glycogen in the liver and muscles, and insulin promotes glycogen synthesis.
• Glycogenolysis: glycogen is broken down to glucose in the liver, and glucagon stimulates glycogenolysis.
• Gluconeogenesis: glucose is synthesized from non-carbohydrate sources (e.g., amino acids, lactate) in the liver and kidneys, and is stimulated by glucagon and cortisol.

Feedback Mechanisms

• Negative feedback loops: high blood glucose levels stimulate insulin release, which reduces glucose levels, and low blood glucose levels stimulate glucagon release, which increases glucose levels.
• Short-loop and long-loop feedback mechanisms: short-loop feedback occurs locally within the pancreas, and long-loop feedback involves the bloodstream and other organs.

Diabetes

• Definition: a group of metabolic disorders characterized by high blood sugar levels.
• Types:
• Type 1 Diabetes: autoimmune disease, body attacks and destroys insulin-producing beta cells in the pancreas.
• Type 2 Diabetes: insulin resistance, body becomes less responsive to insulin, leading to high blood sugar levels.
• Gestational Diabetes: develops during pregnancy, usually in the second or third trimester.

Causes and Risk Factors

• Type 1 Diabetes: genetics, autoimmune response.
• Type 2 Diabetes: obesity, physical inactivity, family history, age (>45), history of gestational diabetes.

Symptoms

• Increased thirst and urination
• Fatigue
• Blurred vision
• Slow healing of cuts and wounds
• Frequent infections
• Tingling or numbness in hands and feet

Diagnosis

• Fasting Plasma Glucose (FPG): measures blood sugar levels after an overnight fast.
• Oral Glucose Tolerance Test (OGTT): measures blood sugar levels after consuming a sugary drink.
• Hemoglobin A1c (HbA1c): measures average blood sugar levels over the past 2-3 months.

Treatment and Management

• Lifestyle changes: healthy diet, regular exercise, weight loss.
• Medications: oral medications (e.g., metformin), insulin therapy.
• Self-monitoring: regular blood glucose monitoring, tracking carbohydrate intake and physical activity.

Glucose Control Physiology

• Blood glucose levels are maintained between 70-140 mg/dL through a complex regulatory system involving the pancreas, liver, and other organs.

Hormonal Regulation

• Insulin:
  • Produced by pancreatic beta cells
  • Lowers blood glucose levels by increasing glucose uptake in muscles and adipose tissue and inhibiting glucose production in the liver
• Glucagon:
  • Produced by pancreatic alpha cells
  • Raises blood glucose levels by stimulating glycogenolysis in the liver and inhibiting glucose uptake in muscles and adipose tissue
• Other hormones:
  • Cortisol, growth hormone, and thyroid hormone also play roles in glucose regulation

Glucose Uptake and Storage

• Glycogen synthesis:
  • Glucose is converted to glycogen in the liver and muscles
  • Insulin promotes glycogen synthesis
• Glycogenolysis:
  • Glycogen is broken down to glucose in the liver
  • Glucagon stimulates glycogenolysis
• Gluconeogenesis:
  • Glucose is synthesized from non-carbohydrate sources (e.g., amino acids, lactate) in the liver and kidneys
  • Stimulated by glucagon and cortisol

Feedback Mechanisms

• Negative feedback loops:
  • High blood glucose levels stimulate insulin release, which reduces glucose levels
  • Low blood glucose levels stimulate glucagon release, which increases glucose levels
• Short-loop and long-loop feedback mechanisms:
  • Short-loop: local feedback within the pancreas
  • Long-loop: feedback via the bloodstream and other organs

Diabetes

• Definition: a group of metabolic disorders characterized by high blood sugar levels
• Types:
  • Type 1 Diabetes: autoimmune disease, body attacks and destroys insulin-producing beta cells in the pancreas
  • Type 2 Diabetes: insulin resistance, body's cells become resistant to insulin, leading to high blood sugar
  • Gestational Diabetes: develops during pregnancy, usually in the second or third trimester
  • LADA (Latent Autoimmune Diabetes in Adults): autoimmune form of type 2 diabetes
  • MODY (Maturity-Onset Diabetes of the Young): rare, genetic form of diabetes

Causes and Risk Factors

• Type 1 Diabetes:
  • Genetics
  • Autoimmune response
• Type 2 Diabetes:
  • Obesity
  • Physical inactivity
  • Family history
  • Certain medications
  • Age (risk increases after 45)
  • Ethnicity (African Americans, Hispanics, American Indians, and Asians are at higher risk)

Symptoms

• Common symptoms:
  • Increased thirst and hunger
  • Frequent urination
  • Fatigue
  • Blurry vision
  • Cuts or bruises that are slow to heal
• Less common symptoms:
  • Numbness or tingling in hands and feet
  • Recurring skin, gum, or bladder infections
  • Flu-like symptoms (in type 1 diabetes)

Diagnosis

• Fasting Plasma Glucose (FPG) test: measures blood sugar levels after an overnight fast
• Oral Glucose Tolerance Test (OGTT): measures blood sugar levels after consuming a sugary drink
• Hemoglobin A1c (HbA1c) test: measures average blood sugar levels over the past 2-3 months

Treatment and Management

• Lifestyle changes:
  • Healthy diet
  • Regular physical activity
  • Weight loss (if overweight or obese)
• Medications:
  • Insulin therapy (type 1 diabetes, some type 2 cases)
  • Oral medications (metformin, sulfonylureas, etc.)
• Monitoring: regular blood sugar checks, HbA1c tests, and foot exams

Glucose Control Physiology

• The body maintains a narrow range of blood glucose levels (70-140 mg/dL) through a complex regulatory system involving the pancreas, liver, and other organs.

Hormonal Regulation

• Insulin: produced by pancreatic beta cells, lowers blood glucose levels by:
  • Increasing glucose uptake in muscles and adipose tissue
  • Inhibiting glucose production in the liver
• Glucagon: produced by pancreatic alpha cells, raises blood glucose levels by:
  • Stimulating glycogenolysis in the liver
  • Inhibiting glucose uptake in muscles and adipose tissue
• Other hormones: cortisol, growth hormone, and thyroid hormone also play roles in glucose regulation.

Glucose Uptake and Storage

• Glycogen synthesis: glucose is converted to glycogen in the liver and muscles, promoted by insulin
• Glycogenolysis: glycogen is broken down to glucose in the liver, stimulated by glucagon
• Gluconeogenesis: glucose is synthesized from non-carbohydrate sources (e.g., amino acids, lactate) in the liver and kidneys, also stimulated by glucagon and cortisol.

Feedback Mechanisms

• Negative feedback loops: high blood glucose levels stimulate insulin release, which reduces glucose levels; low blood glucose levels stimulate glucagon release, which increases glucose levels
• Short-loop and long-loop feedback mechanisms: short-loop: local feedback within the pancreas; long-loop: feedback via the bloodstream and other organs.

Diabetes

• A group of metabolic disorders characterized by high blood sugar levels
• Types:
  • Type 1 Diabetes: autoimmune disease, body attacks and destroys insulin-producing beta cells in the pancreas
  • Type 2 Diabetes: insulin resistance, body becomes less responsive to insulin, leading to high blood sugar levels
  • Gestational Diabetes: develops during pregnancy
  • LADA (Latent Autoimmune Diabetes in Adults): autoimmune form of type 2 diabetes
  • MODY (Maturity-Onset Diabetes of the Young): rare, genetic form of diabetes

Causes and Risk Factors

• Type 1 Diabetes: genetics, autoimmune response
• Type 2 Diabetes: obesity, physical inactivity, family history, age (>45), certain medications, ethnicity (African Americans, Hispanics, American Indians, and Asians)

Symptoms

• Common symptoms:
  • Increased thirst and urination
  • Fatigue
  • Blurry vision
  • Cuts or bruises that are slow to heal
  • Frequent infections
• Less common symptoms:
  • Numbness or tingling in hands and feet
  • Recurring skin, gum, or bladder infections
  • Flu-like symptoms (in type 1 diabetes)

Diagnosis

• Fasting Plasma Glucose (FPG) test: measures blood sugar levels after an overnight fast
• Oral Glucose Tolerance Test (OGTT): measures blood sugar levels after consuming a sugary drink
• Hemoglobin A1c (HbA1c) test: measures average blood sugar levels over the past 2-3 months

Treatment and Management

• Lifestyle changes: healthy diet, regular physical activity, weight loss
• Medications: insulin therapy, oral medications (e.g., metformin)
• Monitoring: regular blood glucose checks, HbA1c tests, and foot exams

Note: The above notes have been condensed and reorganized for easier study and review.

Glucose Control Physiology

• The body maintains a narrow range of blood glucose levels (70-140 mg/dL) through a complex regulatory system involving the pancreas, liver, and other organs.

Hormonal Regulation

• Insulin:
  • Produced by pancreatic beta cells
  • Lowers blood glucose levels by increasing glucose uptake in muscles and adipose tissue and inhibiting glucose production in the liver
• Glucagon:
  • Produced by pancreatic alpha cells
  • Raises blood glucose levels by stimulating glycogenolysis in the liver and inhibiting glucose uptake in muscles and adipose tissue
• Other hormones:
  • Cortisol, growth hormone, and thyroid hormone also play roles in glucose regulation

Glucose Uptake and Storage

• Glycogen synthesis:
  • Glucose is converted to glycogen in the liver and muscles
  • Insulin promotes glycogen synthesis
• Glycogenolysis:
  • Glycogen is broken down to glucose in the liver
  • Glucagon stimulates glycogenolysis
• Gluconeogenesis:
  • Glucose is synthesized from non-carbohydrate sources (e.g., amino acids, lactate) in the liver and kidneys
  • Stimulated by glucagon and cortisol

Feedback Mechanisms

• Negative feedback loops:
  • High blood glucose levels stimulate insulin release, which reduces glucose levels
  • Low blood glucose levels stimulate glucagon release, which increases glucose levels
• Short-loop and long-loop feedback mechanisms:
  • Short-loop: local feedback within the pancreas
  • Long-loop: feedback via the bloodstream and other organs

Diabetes Definition and Types

• Diabetes: a group of metabolic disorders characterized by high blood sugar levels
• Types:
  • Type 1 Diabetes: autoimmune disease, body attacks and destroys insulin-producing beta cells in the pancreas
  • Type 2 Diabetes: insulin resistance, body's cells become resistant to insulin, leading to high blood sugar
  • Gestational Diabetes: develops during pregnancy, usually in the second or third trimester
  • LADA (Latent Autoimmune Diabetes in Adults): autoimmune form of type 2 diabetes
  • MODY (Maturity-Onset Diabetes of the Young): rare, genetic form of diabetes

Causes and Risk Factors

• Type 1 Diabetes:
  • Genetics
  • Autoimmune response
• Type 2 Diabetes:
  • Obesity
  • Physical inactivity
  • Family history
  • Certain medications
  • Age (risk increases after 45)
  • Ethnicity (African Americans, Hispanics, American Indians, and Asians are at higher risk)

Symptoms

• Common symptoms:
  • Increased thirst and urination
  • Frequent urination
  • Fatigue
  • Blurry vision
  • Cuts or bruises that are slow to heal
• Less common symptoms:
  • Numbness or tingling in hands and feet
  • Recurring skin, gum, or bladder infections
  • Flu-like symptoms (in type 1 diabetes)

Diagnosis

• Fasting Plasma Glucose (FPG) test: measures blood sugar levels after an overnight fast
• Oral Glucose Tolerance Test (OGTT): measures blood sugar levels after consuming a sugary drink
• Hemoglobin A1c (HbA1c) test: measures average blood sugar levels over the past 2-3 months

Treatment and Management

• Lifestyle changes:
  • Healthy diet
  • Regular physical activity
  • Weight loss (if overweight or obese)
• Medications:
  • Insulin therapy (type 1 diabetes, some type 2 cases)
  • Oral medications (metformin, sulfonylureas, etc.)
• Monitoring: regular blood sugar checks, HbA1c tests, and foot exams

Glucose Control Physiology

• The body maintains a narrow range of blood glucose levels (70-140 mg/dL) through a complex regulatory system involving the pancreas, liver, and other organs.

Hormonal Regulation

• Insulin:
  • Produced by pancreatic beta cells
  • Lowers blood glucose levels by:
    • Increasing glucose uptake in muscles and adipose tissue
    • Inhibiting glucose production in the liver
• Glucagon:
  • Produced by pancreatic alpha cells
  • Raises blood glucose levels by:
    • Stimulating glycogenolysis in the liver
    • Inhibiting glucose uptake in muscles and adipose tissue
• Other hormones:
  • Cortisol, growth hormone, and thyroid hormone also play roles in glucose regulation

Glucose Uptake and Storage

• Glycogen synthesis:
  • Glucose is converted to glycogen in the liver and muscles
  • Insulin promotes glycogen synthesis
• Glycogenolysis:
  • Glycogen is broken down to glucose in the liver
  • Glucagon stimulates glycogenolysis
• Gluconeogenesis:
  • Glucose is synthesized from non-carbohydrate sources (e.g., amino acids, lactate) in the liver and kidneys
  • Stimulated by glucagon and cortisol

Feedback Mechanisms

• Negative feedback loops:
  • High blood glucose levels stimulate insulin release, which reduces glucose levels
  • Low blood glucose levels stimulate glucagon release, which increases glucose levels
• Short-loop and long-loop feedback mechanisms:
  • Short-loop: local feedback within the pancreas
  • Long-loop: feedback via the bloodstream and other organs

Diabetes Definition and Types

• Diabetes: a group of metabolic disorders characterized by high blood sugar levels
• Types:
  • Type 1 Diabetes: autoimmune disease, body attacks and destroys insulin-producing beta cells in the pancreas
  • Type 2 Diabetes: insulin resistance, body's cells become resistant to insulin, leading to high blood sugar
  • Gestational Diabetes: develops during pregnancy, usually in the second or third trimester
  • LADA (Latent Autoimmune Diabetes in Adults): autoimmune form of type 2 diabetes
  • MODY (Maturity-Onset Diabetes of the Young): rare, genetic form of diabetes

Diabetes Causes and Risk Factors

• Type 1 Diabetes: genetics, autoimmune response
• Type 2 Diabetes: obesity, physical inactivity, family history, age (risk increases after 45), ethnicity (African Americans, Hispanics, American Indians, and Asians are at higher risk)

Diabetes Symptoms

• Common symptoms:
  • Increased thirst and hunger
  • Frequent urination
  • Fatigue
  • Blurry vision
  • Cuts or bruises that are slow to heal
• Less common symptoms:
  • Numbness or tingling in hands and feet
  • Recurring skin, gum, or bladder infections
  • Flu-like symptoms (in type 1 diabetes)

Diabetes Diagnosis

• Fasting Plasma Glucose (FPG) test: measures blood sugar levels after an overnight fast
• Oral Glucose Tolerance Test (OGTT): measures blood sugar levels after consuming a sugary drink
• Hemoglobin A1c (HbA1c) test: measures average blood sugar levels over the past 2-3 months

Diabetes Treatment and Management

• Lifestyle changes:
  • Healthy diet
  • Regular physical activity
  • Weight loss (if overweight or obese)
• Medications:
  • Insulin therapy (type 1 diabetes, some type 2 cases)
  • Oral medications (metformin, sulfonylureas, etc.)
• Monitoring: regular blood sugar checks, HbA1c tests, and foot exams

Glucose Control Physiology

• The body maintains a narrow range of blood glucose levels (70-140 mg/dL) through a complex regulatory system involving the pancreas, liver, and other organs.

Hormonal Regulation

• Insulin:
  • Produced by pancreatic beta cells
  • Lowers blood glucose levels by:
    • Increasing glucose uptake in muscles and adipose tissue
    • Inhibiting glucose production in the liver
• Glucagon:
  • Produced by pancreatic alpha cells
  • Raises blood glucose levels by:
    • Stimulating glycogenolysis in the liver
    • Inhibiting glucose uptake in muscles and adipose tissue
• Other hormones:
  • Cortisol, growth hormone, and thyroid hormone also play roles in glucose regulation

Glucose Uptake and Storage

• Glycogen synthesis:
  • Glucose is converted to glycogen in the liver and muscles
  • Insulin promotes glycogen synthesis
• Glycogenolysis:
  • Glycogen is broken down to glucose in the liver
  • Glucagon stimulates glycogenolysis
• Gluconeogenesis:
  • Glucose is synthesized from non-carbohydrate sources (e.g., amino acids, lactate) in the liver and kidneys
  • Stimulated by glucagon and cortisol

Feedback Mechanisms

• Negative feedback loops:
  • High blood glucose levels stimulate insulin release, which reduces glucose levels
  • Low blood glucose levels stimulate glucagon release, which increases glucose levels
• Short-loop and long-loop feedback mechanisms:
  • Short-loop: local feedback within the pancreas
  • Long-loop: feedback via the bloodstream and other organs

Diabetes Definition and Types

• Diabetes: a group of metabolic disorders characterized by high blood sugar levels
• Types:
  • Type 1 Diabetes: autoimmune disease, body attacks and destroys insulin-producing beta cells in the pancreas
  • Type 2 Diabetes: insulin resistance, body's cells become resistant to insulin, leading to high blood sugar
  • Gestational Diabetes: develops during pregnancy, usually in the second or third trimester
  • LADA (Latent Autoimmune Diabetes in Adults): autoimmune form of type 2 diabetes
  • MODY (Maturity-Onset Diabetes of the Young): rare, genetic form of diabetes

Diabetes Causes and Risk Factors

• Type 1 Diabetes: genetics, autoimmune response
• Type 2 Diabetes: obesity, physical inactivity, family history, age (risk increases after 45), ethnicity (African Americans, Hispanics, American Indians, and Asians are at higher risk)

Diabetes Symptoms

• Common symptoms:
  • Increased thirst and hunger
  • Frequent urination
  • Fatigue
  • Blurry vision
  • Cuts or bruises that are slow to heal
• Less common symptoms:
  • Numbness or tingling in hands and feet
  • Recurring skin, gum, or bladder infections
  • Flu-like symptoms (in type 1 diabetes)

Diabetes Diagnosis

• Fasting Plasma Glucose (FPG) test: measures blood sugar levels after an overnight fast
• Oral Glucose Tolerance Test (OGTT): measures blood sugar levels after consuming a sugary drink
• Hemoglobin A1c (HbA1c) test: measures average blood sugar levels over the past 2-3 months

Diabetes Treatment and Management

• Lifestyle changes:
  • Healthy diet
  • Regular physical activity
  • Weight loss (if overweight or obese)
• Medications:
  • Insulin therapy (type 1 diabetes, some type 2 cases)
  • Oral medications (metformin, sulfonylureas, etc.)
• Monitoring: regular blood sugar checks, HbA1c tests, and foot exams