W1: Diabetes Mellitus
Goals:
• Describe the prevalence and incidence of diabetes globally.
• Describe the disease etiology (how does diabetes develop?)
• Recall the major risk factors for the development of diabetes.
• Explain prevention opportunities
Prevalence, incidence and mortality
Diabetes related mortality
Overall life-expectancy of a diabetes patient is reduced by 4-6 years
Diabetes caused 4.2 million deaths in 2019
Associated with 11.3% of all global deaths
Etiology
Type 1 diabetes: auto-immune disease. No production of insulin. Usually develops
in childhood and patients require lifelong insulin injections.
Type 2 diabetes: metabolic disorder characterized by hyperglycemia and altered
lipid metabolism. Usually develops in adulthood and is associated with a
unhealthy lifestyle; it is the major form of diabetes.
Gestational diabetes: state of hyperglycaemia developing during pregnancy.
, Microvascular = smaller vessels
Macrovascular = lager vessels
How do we diagnose diabetes?
- Measure glucose levels in urine ( but this is not very precise)
- Measure glucose
- Oral glucose tolerance test (glycemic response to 75g glucose)
- Hba1c, reflects glycemic control over past 6 weeks
o Hb = haemoglobin
o A1c = glucose molecule
Pre-diabetes
Fasting plasma glucose (FPG) level 5,6 – 7,0
mM
OR 2 hour post 75 glucose 7,8 – 11,1 mM
OR Hba1c 5,7 – 6,4% (39-47 mmol/mol)
Glucose regulation after a meal:
Stages and risk factors in development of
type 2 diabetes
Insulin resistance = The muscle and the liver
and the adipose tissue are a little bit insensitive
Goals:
• Describe the prevalence and incidence of diabetes globally.
• Describe the disease etiology (how does diabetes develop?)
• Recall the major risk factors for the development of diabetes.
• Explain prevention opportunities
Prevalence, incidence and mortality
Diabetes related mortality
Overall life-expectancy of a diabetes patient is reduced by 4-6 years
Diabetes caused 4.2 million deaths in 2019
Associated with 11.3% of all global deaths
Etiology
Type 1 diabetes: auto-immune disease. No production of insulin. Usually develops
in childhood and patients require lifelong insulin injections.
Type 2 diabetes: metabolic disorder characterized by hyperglycemia and altered
lipid metabolism. Usually develops in adulthood and is associated with a
unhealthy lifestyle; it is the major form of diabetes.
Gestational diabetes: state of hyperglycaemia developing during pregnancy.
, Microvascular = smaller vessels
Macrovascular = lager vessels
How do we diagnose diabetes?
- Measure glucose levels in urine ( but this is not very precise)
- Measure glucose
- Oral glucose tolerance test (glycemic response to 75g glucose)
- Hba1c, reflects glycemic control over past 6 weeks
o Hb = haemoglobin
o A1c = glucose molecule
Pre-diabetes
Fasting plasma glucose (FPG) level 5,6 – 7,0
mM
OR 2 hour post 75 glucose 7,8 – 11,1 mM
OR Hba1c 5,7 – 6,4% (39-47 mmol/mol)
Glucose regulation after a meal:
Stages and risk factors in development of
type 2 diabetes
Insulin resistance = The muscle and the liver
and the adipose tissue are a little bit insensitive
