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Diabetes-Part 2
- 1. 1 Similar but different ONE VERSUS TWO
- 2. 2 DISEASE COMPARISON VS TYPE 1 DM TYPE 2 DM Onset Rapid Onset Slow RapidSlow Weight Under Over Weight Over Under Antibodties Prese nt Not Present Antibodties Not Present Prese nt
- 3. 3 How else are type one and type two diabetes different?
- 5. 5 Who is at risk? TYPE 2 RISK FACTORS
- 7. 7 How are type one and type two diabetes similar?
- 9. 9 DIABETES DIAGNOSIS HbA1C Greater than or equal to 6.5% Fasting Plasma Glucose Greater than or equal to 126 mg/dL Oral Glucose Tolerance Test 2-hour plasma glucose greater than or equal to 200 mg/dL Random Plasma Glucose Greater than or equal to 200 mg/dL Criteria 01 Criteria 03 Criteria 02 Criteria 04
- 10. 10 What are the criteria for diagnosing prediabetes?
- 11. 11 PREDIABETES DIAGNOSIS HbA1C Greater than or equal to 5.5-6.4% Fasting Plasma Glucose Greater than or equal to 100-125 mg/dL Oral Glucose Tolerance Test 2-hour plasma glucose greater than or equal to 140-199 mg/dL Criteria 01 Criteria 03 Criteria 02
- 12. 12 GLYCEMIC TARGETS Inpatient Critically IllOutpatient Pregnant HbA1C ≤6.5% FPG < 110 mg/dL 2-hr PPG < 140 mg/dL Premeal < 140 mg/dL ≤120 mg/dL Random < 180 mg/dL < 140-180 mg/dL
- 13. 13 The highway to type 2 diabetes PATHOPHYSIOLOGICAL ALTERATIONS
- 14. 14 PATHOPHYSIOLOGY ALTERATION INCREASED APPETITE GLP-1 receptor agonist, Amylin mimetics INCREASED GLUCAGON SECRETION GLP-1 receptor agonist, Amylin mimetics, DPP- IV Inhibitors DECREASE INSULIN SECRETION Sulfonylureas, meglitinides, GLP-1 receptor agonist, DPP-IV Inhibitors IMPAIRED INCRETIN EFFECT GLP-1 receptor agonist, DPP-IV Inhibitors, possibly bile acid sequestrants DECREASED AMYLIN SECRETION Amylin mimetics CARBOHYDRATE ABSORPTION Alpha-glucosidase inhibitors INCREASED RATE OF GASTRIC EMPTYING GLP-1-receptor agonist, amylin mimetics INCREASED INSULIN RESISTANCE Weight loss, exercise, biguanides, thiazolidinediones, D2 dopamine-receptor agonists INCREASED HEPATIC GLUCOSE PRODUCTION Weight loss, exercise, biguanides, thiazolidinediones, insulin