Physiology and Consequences of Type 2 Diabetes Mellitus
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Added on 2023/03/24
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This presentation provides an overview of the physiology and consequences of Type 2 Diabetes Mellitus. It discusses insulin resistance, hyperglycemia, and the use of Metformin for management. It also explores the role of HbA1c in long-term control of blood glucose levels.
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Vodcast -Type 2 Diabetes
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Client Information Name– John Smith Gender– Male Age– 68 Sufferer condition– Type 2 Diabetes mellitus Is he within a healthy weight range– Overweight Do he exercise–take small morning walk Occupation– Retired bank manager Living status– Lives with his son and daughter in law. Family Medical History– John's mother was also patient of diabetes type 2. Is he a smoker- No
Contd...... Alcohol intake– One beer on alternate days. Medicines he is prescribed with- Metformin
Question 1: Physiology for blood glucose control in John Smith In type 2 diabetes John's body produce less amount of insulin from beta cells of pancreatic islets. It also leads to impaired insulin action in the tissues of liver, muscles and fat and create a condition known as insulin resistance. In this condition various cells of muscles, liver and fat cells are not able to respond for the insulin even if they are present in large amount. The main reason for inadequate insulin production is insulin resistance and this occurs due to condition of overweight and lack of physical activities.
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Comparison with a non- diabetic person •Inanon-diabeticorhealthyperson,insulinisbeing synthesized in specific quantities and the whole process takes place in beta cells present in the pancreas. •It is being released in two ways. The first phase maximizes the blood sugar levels. •The second phase is quite sustained in which there is a slow response. •The interaction of the molecules of insulin with the structure of the cell membranes improves the intracellular metabolism.
Question 2: Consequences of hyperglycaemia in John Smith High level of blood glucose level leads to several consequences. In John's case he was dealing with retinopathy. Due to increase in blood glucose level the blood vessels tends to get damaged. The vessels surrounding John's eyes got highly damaged and start leaking protein and fat that form a layer around eyes which interfere with normal vision.
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Angina Pectoris •Insulinresistanceis considered as a process in which the body is unable to appropriatelyusethe insulin it makes. It acts as a reason for type 2 diabetes. •Duetodiabetesmellitus type2,Johnmightbe havinghigheramountof thosesubstancesinhis blood which are responsible for causing clots.
Continued… Further, presence of diabetes may have also caused damage to the nerves of his heart and the blood vessels. Due to high levels of glucose in the blood, the walls of the arteries become susceptible to development of atheroma. This may have led to insufficient flow of blood to heart muscle leading to angina.
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Question 3: Use of Metformin by John Smith for management of type 2 diabetes mellitus It is known that in John, the sensitivity of cells for insulin is low. Metformin is administered by John in order to increase the sensitivity of various body tissue for insulin. It also help in lowering down the production of glucose in liver.
Continued… It can also help John by decreasing the absorption of glucose in the small intestine. And it is the best available medicine for the management of diabetes among overweight people.
Action of Metformin
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Question 4: (A)Pathophysiology for insulin resistance due to increased abdominal adiposity There is a core relation between the insulin resistance and increase in abdominal adiposity. This mainly occur because of the change in the functions that are performed by adipose tissue.
Continued… This malfunctioning in the adipose result in the increased release of fatty acids and results in abnormalities in adipokine secretion. The main reason for this improper functioning is dysfunction of visceral adipose tissue which become magnified for the release of free fatty acids.
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Question 4: (B)Use of HbA1c for the long term control and management of blood glucose level The term HbA1c is also known as glycated haemoglobin. This occurs when haemoglobin combines with glucose present in the blood. Through this test clinicians and doctors are able to get information regarding average blood sugar level in body for a period of time.
Continued… When sugar is processed in body then glucose present in blood stream attached to haemoglobin i.e. the amount of glucose that combines with this protein refers to the total amount of sugar that is present in our blood stream. And due to the reason RBC's survive for 8-12 weeks in human body thus measuring HbA1c gives result for that particular duration.
References Hardy, O. T., Czech, M. P. and Corveraa, S., 2012. What causes the insulin resistance underlying obesity?.U.S. National Library of Medicines. 19(2). Pp. 81-87. Khardori, R., 2017. Type 2 Diabetes Mellitus.Med scape Rojas, L. B. A. and Gomes, M. B., 2013. Metformin: an old but still the best treatment for type 2 diabetes.Diabetology & Metabolic Syndrome. Nentwich, M. M. and Ulbig, M. W., 2015. Diabetic retinopathy - ocular complications of diabetes mellitus.World Journal of Diabetes. 6(3). Pp. 489–499. Florkowski, C. 2013. HbA1c as a Diagnostic Test for Diabetes Mellitus – Reviewing the Evidence. The clinical Biochemist Reviews.
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Annotated Bibliography 1.Hardy, O. T., Czech, M. P. and Corveraa, S., 2012. What causes the insulin resistance underlying obesity?.U.S. National Library of Medicines. 19(2). Pp. 81-87. I used this journal to learn about pathophysiology of insulin resistance due to increase in abdominal adiposity. 2.Khardori, R., 2017. Type 2 Diabetes Mellitus.Med scape. I used this article to gain knowledge regarding insulin synthesis and its resistance in human body. 3.Rojas, L. B. A. and Gomes, M. B., 2013. Metformin: an old but still the best treatment for type 2 diabetes.Diabetology & Metabolic Syndrome. I have been through this article in order to examine the use and effects of Metformin in diabetes type 2.
Contd...... 4.Nentwich, M. M. and Ulbig, M. W., 2015. Diabetic retinopathy - ocular complications of diabetes mellitus.World Journal of Diabetes.6(3). Pp. 489–499. Ihavegonethroughthisarticletogetproperunderstanding regarding effect of retinopathy on the person having high level of Type 2 diabetes mellitus. 5.Florkowski, C. 2013. HbA1c as a Diagnostic Test for Diabetes Mellitus – Reviewing the Evidence. The clinical Biochemist Reviews. I used this article for gathering appropriate information regarding use of HbA1c test for the proper management of type 2 diabetes mellitus.