Australian Catholic University: T2DM Vodcast Presentation

This document presents a student's Vodcast assignment focusing on Type 2 Diabetes Mellitus (T2DM). The assignment details a patient case study of a 65-year-old female diagnosed with T2DM, including her medical history, lifestyle, and current medication (Metformin). The Vodcast explains the pathophysiology of T2DM, emphasizing insulin resistance and the role of beta cells. It further discusses the complications of hyperglycemia such as neuropathy and myocardial infarction. The student also covers the treatment with Metformin and its mechanism of action, and highlights the association between adiposity and insulin resistance. The significance of HbA1c in T2DM management is also explained. The assignment references several studies to support the information provided.

NAME:
INSTITUTION:
STUDENT ID
DATE:
VODCAST

Details of my patient
 Name: Julie McRoberts
 Gender: Female
 Age: 65 years old
 Disease: Type 2 diabetes mellitus
 Healthy weight range: overweight
 Exercise: walks with a friend every morning
 Occupation: student
 Living status: lives on her own since she is widowed
 Medical history: Father died of diabetes mellitus
 Pregnant: NA
 Smoker: NO
 Alcohol intake: Glass of wine on social occasions
 Medications: Metformin

Introduction
 Type 2 diabetes mellitus according to WHO, is a condition in which fails to use insulin.
 Insulin is a hormone produced by the pancreas and it converts excess glucose to
glycogen.
 It is as a result of obesity and physical inactivity.
 Previously, it was common among adults but recently, it is affecting children as well.
 Patients suffering from T2DM experience frequent urination, weight loss and increased
thirst.

Pathophysiolo
gy of T2DM
 Normally, the body would respond to
hyperglycemia by producing insulin. It is
produced by beta cells of the pancreas. Insulin
then gets attached to the cell surface and sends a
signal for the cells to increase uptake of glucose
for metabolism. The level of glucose is then
restored back to normal.
 In T2DM,the beta cells after producing excessive
insulin during initial episodes of hyperglycemia
are insensitive and cannot synthesize more
insulin. As a result, the level of blood glucose
remains high(Zaccardi, Webb, Yates, & Davies,
2015).
 Furthermore, the available insulin attaches on the
cell receptors but do not send signals to the cells
to increase uptake of insulin.
 This two factors contributes to hyperglycemia as
it can be seen in McRoberts.
https://www.123rf.com/photo_70761391_stock-
vector-the-absorption-of-glucose-by-the-cell-type-
2-diabetes-increase-and-decrease-blood-sugar-
insulin-info.html

Complications of Hyperglycemia-
neuropathy , myocardial infarctions.
 Glucose is essential for cellular metabolism.
 However, Excessive glucose in the body is toxic causing damage to
nerves. This results to poor coordination of nerves in the body, a
condition described as neuropathy(Malone, 2016).
 Furthermore, excessive glucose damage nerves of the heart and
blood vessels that are responsible for contraction of muscles of the
heart and this condition is known is myocardial infarction(Takhirova &
Akbarov, 2016).
 If hyperglycemia is not controlled, My client McRoberts is at risk of the
two complications.

Treatment-Metformin
 T2DM can be managed by metformin. It works by stimulating cellular metabolism to
use excess glucose in blood. This is through inhibiting mitochondrial complex 1 that
stop synthesis of mitochondrial ATP. Eventually, there is elevated cytoplasmic ADP:
ATP and the AMP:ATP ratios. The changes in the ration activates AMP-activated protein
kinase that is responsible for increasing cellular metabolism(Kravchuk & Galagudza,
2013).
https://www.stada.com.vn/
product/483/metformin-stada-

ASSOCIATION BETWEEN ADIPOSITY
AND INSULIN RESISTANCE.
 Several studies argue that adiposity/overweight is a risk factor of
type 2 diabetes particularly insulin resistance. The reason behind this
is the synthesis of retinol binding protein 4 that leads to insulin
resistance among the different body cells.

Significance of HbA1c in T2DM
management
 HbA1c is a combination of hemoglobin and glucose.
 It is able to provide an estimate of blood glucose between 8 and 12 weeks(McEwan,
Foos, & Lamotte, 2015).
 High levels are diagnostic for potential T2DM complications and calls for urgent
actions. This makes it easier to manage T2DM in my client McRoberts.

References
Kravchuk, E. N., & Galagudza, M. M. (2013). Metformin in patients with ischemic heart disease
and type 2 diabetes mellitus: mechanism of action and clinical efficiency. Diabetes mellitus,
16(1), 5. doi:10.14341/2072-0351-3590
Malone, J. I. (2016). Diabetic Central Neuropathy: CNS Damage Related to Hyperglycemia.
Diabetes, 65(2), 355-357. doi:10.2337/dbi15-0034
McEwan, P., Foos, V., & Lamotte, M. (2015). The Impact of Baseline Hba1c and Hba1c
Trajectories on Time to Therapy Escalation In Type 2 Diabetes Mellitus. Value in Health, 18(7),
A698. doi:10.1016/j.jval.2015.09.2605
Takhirova, F., & Akbarov, Z. (2016). Calculator for myocardial infarction risk in patients with
type 2 diabetes mellitus. Endocrine Abstracts. doi:10.1530/endoabs.41.ep537
Zaccardi, F., Webb, D. R., Yates, T., & Davies, M. J. (2015). Pathophysiology of type 1 and type 2
diabetes mellitus: a 90-year perspective. Postgraduate Medical Journal, 92(1084), 63-69.
doi:10.1136/postgradmedj-2015-133281