Diabetes mellitus +lifestyle .pdf

Diabetes Miletus Type1- Type 2- life style and DM Tipe I Diabetes Mellitus- Type II Diabetes mellitus- Life style and Diabetic By Dr. Abdulmalik Aloriney Assistant Professor & Consultant of Diabetes and Family Medicine Chairman of Family Medicine Department Diabetes Miletus Type1- Type 2- life st...

Diabetes Miletus Type1- Type 2- life style and DM Tipe I Diabetes Mellitus- Type II Diabetes mellitus- Life style and Diabetic By Dr. Abdulmalik Aloriney Assistant Professor & Consultant of Diabetes and Family Medicine Chairman of Family Medicine Department Diabetes Miletus Type1- Type 2- life style and DM By Dr. Abdulmalik Aloriney Assistant Professor & Consultant of Diabetes and Family Medicine Chairman of Family Medicine Department Dear students, Here are some learning resources that I need you to look at regarding my Diabetes lectures . I hope that you’ve learned well from my lectures, I have tried at the best to my ability to let you understand this important topic. I hope these lectures were your turning point that you ever since become an advocate in the field of Diabetes. I count on you to consider Diabetes as a learning priority. It is not about the exam, it is about changing our lives, our community and our world. Best wishes, Dr. Abdulmalik Aloriney Objectives: ➢ To define what is Diabetes. ➢To know the magnitude of this disease in term of prevalence, cost and complication occurrence. (no need to memorize numbers) ➢To recognize the basic pathophysiology of the disease type 1 and type 2 Diabetes and their complications ➢To recognize the clinical presentation of type 1 and type 2 DM and to identify the differences between them. ➢To know in general how and when to screen for type 2 DM ➢To know how to diagnose Type 2 DM. ➢To know the outlines of DM care and management ➢To know the outlines regarding healthy life style in term of diet, exercise and sleep. Note: these objectives are regarding only the 3 lectures about Diabetes that I have given, you should learn the objectives related to other Diabetes lectures given in this block by other professors. Teaching activities related to Diabetes in Endo block ➢Type 1 DM ➢Type 2 DM ➢Life style and DM ➢Pathology of complications of DM ➢Complications of DM ➢Pharmacological management of T1DM ➢Pharmacological management of T2DM PBL + Clinical session Diabetes in numbers • Prevalence of DM in Saudi Arabia is one of the highest in the world!! • Big variations noticed in national studies but all of them indicate high prevalence. • The World Health Organization (WHO) has reported that Saudi Arabia ranks the second highest in the Middle East, and is seventh in the world for the rate of diabetes. It is estimated that around 7 million of the population are diabetic and almost around 3 million have prediabetes. Diabetes in numbers • In USA, DM care costs 245 billion in 2012, 41% increase from 2007 • 21% of the cost for visits and medications, the remaining is for the complication management. • DM patient treatment cost is 3.2 times the normal individual. ❑In Saudi Arabia, one study published in 2013 mentioned that DM patient treatment cost is 10 times the normal individual. https://www.khanacademy.org/science/health-andmedicine/endocrine-system-diseases/diabetes/a/what-is-diabetesmellitus Go to Khan academy and read the article ( What is Diabetes) to learn a clear and basic information about Diabetes. No need to watch the videos but if you do to learn more that would be great!! What is Diabetes? • Group of disorders characterized by an inability of body to regulate its blood glucose level. Type 1 DM: complete lack of insulin Type 2 DM: insulin resistance, can end in loss of insulin secretion Type 2 DM Type 1 DM Type 1 DM Symptoms Type 2 DM Complications • High glucose > chronic inflammation > Arteries’ walls > atherosclerosis > fibrous plaque > decrease flow > rupture. (Macrovascular) • Damage to small vessels. (Microvascular) • Infections • Decrease Immunity DIABETES MANAGEMENT Started before the disease happening!! Prevention • Primary prevention: By healthy life style. • Secondary Prevention: Screening. • Tertiary prevention: Prevention of complications by: healthy life style and disease management (follow up, monitoring of complication, controlling comorbidities and pharmacological treatment. Primary prevention Secondary Prevention: Screening • General screening for adults with type 2, you need to know what this table is about. (read it carefully) • This table and the other 2 coming are published in the American Diabetes Association 2017 guidelines Screening • Only know that obese children need to be checked for type 2 Diabetes Screening • Only know what is the test used for screening in pregnancy and when to do it. Diagnosis: Screening tests: Tertiary prevention: prevention of complications • Achieved by: ➢ Keeping BS at the target. ➢Avoid hypoglycemia ➢ Controlling and preventing comorbidities. ➢ Life style modification. ➢ Screening for Complications for early management and prevention. ➢Patient education and advise ➢ Pharmacological treatment Keeping BS at the target. Hypoglycaemia Controlling and preventing comorbidities. No need to know the details of this picture, just to know that Blood Pressure and lipids must be kept under control for DM patients Life style modification. Screening for Complications for early management and prevention. We need to do every year to following examinations to screen for complications: ✓ Diabetic foot examination, checking for neuropathy, peripheral vascular disease, ulcers or infections at least once a year. ✓ Retina examination by ophthalmologists ✓ Blood and urine test to evaluate for nephropathy Patient education and advise Patients should have educations sessions about foot care, exercise, diet arrangements and insulin use. ➢Pharmacological treatment General description of DM medications mechanism of action No need to memorize this slide, just to know that there is step wise management in Diabetes No need to memorize this slide, just to know that there is step wise management in Diabetes Life style and Diabetes Life style and Diabetes • Healthy life style could prevent type 2 Diabetes. • Healthy life style strongly recommended for diabetic patients. • Healthy life style is the same for diabetic and non diabetic people. Life style.. ➢ Weight control. BMI < 25 Diet and exercise ➢Controlled by diet: Amount ( calories ) Type ( balanced amounts ) (type of fat) ( carbs ) ( proteins ) Time: 3 meals and 3 snacks, important to have breakfast!! Counting calories intake is just to control weight but that doesn’t mean calories only has a direct impact on blood glucose. Some types of food are rich in calories but less carbohydrates so it doesn’t increase blood glucose much, while other types are rich in carbohydrates content while it has no much calories. The calorie content and the carbohydrates contents not the only determinant wither this food is healthy or not. Food labels Carbs Carb limits Exercise Life style smoking and alcohol Sleep