ACU BIOL122 Assignment 2: Vodcast on Type 2 Diabetes Mellitus

This Vodcast assignment focuses on a 65-year-old female patient with Type 2 Diabetes Mellitus. It details the patient's medical history, symptoms, and the underlying pathophysiology of the disease, including the synthesis and binding of insulin in both normal and diabetic individuals. The presentation explores clinical manifestations like hyperglycemia, neuropathy, and myocardial infarction, and discusses the pharmacological management using Metformin. Furthermore, the Vodcast highlights the importance of patient education, emphasizing the link between abdominal adiposity and insulin resistance, and the use of HbA1c for monitoring. The assignment references key studies and research to support the information presented, providing a comprehensive overview of Type 2 Diabetes Mellitus and its management.

NAME:
INSTITUTION:
TUTOR:
DATE:
VODCAST
TYPE II DIABETES MELLITUS

Patient/clients details
 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

Type 2 diabetes mellitus
 Long term metabolic disorder characterized by high blood glucose, insulin resistance
and lack of insulin.
signs and symptoms
 Increased thirst
 Frequent urination
 Unexplained weight loss.

synthesis and binding of insulin
in normal and diabetic individual
 In a normal individual, insulin, a hormone produced by beta cells of the pancreas
regulates the amount of glucose in blood.
 When the level of glucose in blood is high, the pancreas synthesize insulin which
moves the glucose into cells. This achieved by insulin binding on receptors on cells
then instructing them to take up more glucose from blood and use it as a source of
energy (Zaccardi, Webb, Yates, & Davies, 2015).
 In an individual with T2DM like Julie McRoberts ,the beta cells after producing high
amounts of insulin with increasing glucose in blood become insensitive to high
amounts of glucose. They therefore fail to synthesize insulin creating a shortage of
insulin and this means high glucose in blood. Furthermore, the insulin binds on the
receptors in tissues but it doesn’t send the signal to the cells to pick up more glucose.
 This two factors contribute to high glucose in blood.

clinical manifestations of hyperglycemia(Neuropathy
and myocardial infarction
 Hyperglycemia is a condition describing excessive glucose in the
body.
 Excessive glucose according to studies, is toxic thus it damages
nerves interfering with their ability to transmit signals leading to
neuropathy (DeFronzo et al., 2015).
 This condition can happen in my patient since he has excessive
glucose in blood.

 Since the patient has high blood glucose, he is at risk of myocardial infarction.
 Studies note that high blood glucose in blood if not properly managed, damages
nerves that control both the heart and the blood vessels leading to a condition known
as myocardial infarction (Zaccardi, Webb, Yates, & Davies, 2015).

Management of type 2 diabetes-
metformin
 Metformin is an appropriate drug for my client.
 It activates AMP-activated protein kinase that
increase glucose metabolism and this reduce the
amount of glucose in blood (Rena, Hardie, &
Pearson).
 This is achieved through inhibition of mitochondrial
complex 1 which in return prevent production of
mitochondrial ATP. These changes leads to
increased cytoplasmic ADP:ATP as well as the
AMP:ATP ratios (Song, 2016).

Patient education.
 A person with increased abdominal adiposity is at high risk of insulin resistance.
 Studies note that adiposity leads to production of a protein known as retinol-binding
protein 4 (RBP4) and this protein is known to initiate insulin resistance (Keenan et al.,
2015).
 The client should therefore be educated on importance of physical excessive to reduce
adiposity.

HbA1c
 Glycated hemoglobin (HbA1c) provides the average glucose in plasma for a period of
between 8 and 12 weeks. It is the most preferred since it can be done at anytime and
doesn’t need any preparation like fasting (Vijayakumar, Nelson, Hanson, Knowler, &
Sinha, 2016).
 Since it can provide an average measure of glucose between 8 and 12 weeks, it
makes it easy to manage my client who is suffering from type 2 diabetes.

References
DeFronzo, R. A., Ferrannini, E., Groop, L., Henry, R. R., Herman, W. H., Holst, J. J., … Weiss, R. (2015).
Type 2 diabetes mellitus. Nature Reviews Disease Primers, 15019. doi:10.1038/nrdp.2015.19
Keenan, M. J., Zhou, J., Hegsted, M., Pelkman, C., Durham, H. A., Coulon, D. B., & Martin, R. J. (2015).
Role of Resistant Starch in Improving Gut Health, Adiposity, and Insulin Resistance. Advances in
Nutrition, 6(2), 198-205. doi:10.3945/an.114.007419
Rena, G., Hardie, D. G., & Pearson, E. R. (2017). The mechanisms of action of metformin.
Diabetologia, 60(9), 1577-1585. doi:10.1007/s00125-017-4342-z
Song, R. (2016). Mechanism of Metformin: A Tale of Two Sites. Diabetes Care, 39(2), 187-189.
doi:10.2337/dci15-0013
Vijayakumar, P., Nelson, R. G., Hanson, R. L., Knowler, W. C., & Sinha, M. (2016). HbA1cand the
Prediction of Type 2 Diabetes in Children and Adults. Diabetes Care, 40(1), 16-21. doi:10.2337/dc16-
1358
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