This presentation provides a brief overview of Type II Diabetes Mellitus, including its consequences, insulin synthesis and release, Metformin management, insulin resistance, and more. It also includes information about Jack Anderson, a 65-year-old patient with Type II diabetes mellitus.
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TYPE II DIABETES MELLITUS -a brief presentation
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PATIENT’S SUMMARY Name: Jack Anderson Age: 65 years old Issue: Type II diabetes mellitus Weight: Overweight with a BMI of 37 Job: Works a senior manager of a local supermarket Family: Lives with his wife and two college-going children Drinking habit: Alcoholic in nature, drinks 4-5 glasses of alcohol per day Medicines used: Takes Metformin on a regular basis but blood sugar level is not being managed. Family History: His father and Uncle had diabetes and died due to the complications of it. Hello! I am Jack Anderson, 65 years old and my concern is regarding type II diabetes mellitus!
INSULIN SYNTHESIS, RELEASE AND BINDING TO TARGET TISSUE FOR JACK Beta cells of pancrea s produc es Insulin After getting released into the blood stream, it is transport ed into the target cells Insulin gets bind to the receptor of the target cell membrane and then it sends signal to the glucose channels Glucose channels open into the cell reducing the levels of blood sugar Insulin binding in case of JackI n d ia betic p atie n ts i n s u li n rece p t o rs b ec o m e resista n t t o t h e i n s u li n T h e g l u c o se tra n s p o rte d i n t o t h ecells g et re d u ce d B l o o d g l u c o s e l e v e l i n c r e a s e s
CONSEQUENCES OF LONG-TERM POORLY CONTROLLED HYPERGLYCAEMIA Neuropathy is common complication of diabetes that causes nerve damage. Jack consumes alcohol and it increases the risk of developing neuropathy. Since his blood glucose level is poorly managed, osmotic stress can cause atrophy in his nerve cell that leads to neuropathy (Yabe, Seino, Fukushima & Seino, 2015). Myocardial infarction for Jack •This occur when coronary arteries are narrowed by atherosclerosis. •It can lead to the death of heart muscle. •According to literatures, diabetes increase the risk of myocardial infarction due to higher incidence of cardiovascular disease. •Jack’s poorly managed blood sugar level causes hyperglycaemia and it leads to myocardial infarction. •Also, BMI is another reason of Myocardial infarction according to literature and high BMI of Jack increases the risk of it.
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METFORMIN MANAGEMENT FOR JACK Jack is consuming Metformin as a part of his treatment. This is effective because it increases the sensitivity of muscles and thus blood sugar level is reduced from the blood easily. Jack intakes Metformin after meal and as a result it reduces spike in blood sugar level (Weir, Abrahamowicz, Beauchamp & Eurich, 2018). Metformin : Mechanism of action It enables muscle cell to remove glucose by increasing its sensitivity. Liver produces glucose, breaking down the glycogen and metformin reduces the amount of glucose. Metformin delays the sugar absorption from the intestine after taking meals and results in reduced blood sugar level.
INSULIN RESISTANCE AND ABDOMINAL ADIPOSITY Excess body fat enhances the availability of free fatty acids. It increases glucose production, inhibits glucose utilization, and insulin secretion. Adeponectin is a peptide increases the sensitivity of peripheral cells to insulin and for type II diabetes patients, level of peptide is low (Marcadenti, Fuchs, Moreira, Gus & Fuchs, 2017). HBA1C AND ITS USE ON JACK HbA1c or Haemoglobin A1c is found in red blood cells and it is formed when glucose is attached to haemoglobin. The concentration of HbA1c depends on the blood glucose levels. It provides an average blood sugar level over 8-12 weeks. For patients like Jack it is a better indicator long term management than one off blood sugar measurements. Measure of regular exercise and healthy diet is important for Jack.
WORKS CITED Czech, M. P. (2017). Insulin action and resistance in obesity and type 2 diabetes.Nature medicine,23(7), 804. Retrieved fromhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC648953/ Marcadenti, A., Fuchs, F. D., Moreira, L. B., Gus, M., & Fuchs, S. C. (2017). Adiposity phenotypes are associated with type-2 diabetes: LAP index, body adiposity index, and neck circumference.Atherosclerosis,266, 145-150. Retrieved fromhttps://www.sciencedirect.com/science/article/pii/S0021915017312935 Weir, D. L., Abrahamowicz, M., Beauchamp, M. E., & Eurich, D. T. (2018). Acute vs cumulative benefits of metformin use in patients with type 2 diabetes and heart failure.Diabetes, Obesity and Metabolism,20(11), 2653-2660. Retrieved fromhttps://onlinelibrary.wiley.com/doi/pdf/10.1111/dom.13448 Yabe, D., Seino, Y., Fukushima, M., & Seino, S. (2015).βcell dysfunction versus insulin resistance in the pathogenesis of type 2 diabetes in East Asians.Current diabetes reports,15(6), 36. Retrieved fromhttps:// link.springer.com/article/10.1007/s11892-015-0602-9