Diabetes

Objectives Be able to relate the history of Diabetes Identify the symptoms associated with Diabetes Difference between Type 1 and Type 2 Prevention and treatment in animals and humans. Explain why high blood glucose is a health hazard.

Blood sugar is normally controlled by a hormone called insulin that is secreted by the pancreas Diabetes is a metabolic disorder of abnormally high blood sugar levels (hyperglycemia)

What is insulin? A protein that reduces blood glucose (sugar) levels A protein that reduces blood glucose (sugar) levels Why? Why? Have you ever felt a “sugar rush” after eating something really sweet? Have you ever felt a “sugar rush” after eating something really sweet? Insulin is produced by the pancreas to remove some of this excess sugar from the blood Insulin is produced by the pancreas to remove some of this excess sugar from the blood Diabetes happens when insulin isn’t made or doesn’t work Diabetes happens when insulin isn’t made or doesn’t work FOOD Bloodstream GlucoseLevels INSULIN GlucoseLevels

History of Diabetes First known reference: Egyptian papyrus, 1550 BC Diabetes named by the Greek physician Aretaeus between 30 and 90 AD

How did they recognize the disease back in those primitive times? Frequenturination Excessivethirst Sweeturine

History of the Disease Avicenna, a famous Arab physician, described the complications of the disease and how it progressed French physician Bouchardat recognized the importance of calorie intake in the 1870s

History of the Disease Paul Langerhans identified the importance of the pancreas in the early 19 th century and discovered a group of cells that would later be known to produce insulin “Isle of Langerhans” “Isle of Langerhans”

Historical Research on Dogs The hormone insulin drives blood glucose into tissues. Frederick Banting discovered insulin in dogs in the 1920s and won the Nobel Prize. Molecular structure of insulin

Quick Review 1. What are diabetes symptoms that everyone could recognize? 2. What is insulin? Where does it come from? What does it do?

Mental Break 1 Who is this? Hint: movie star

Mental Break 1 How about this? Hint: first African American in major- league baseball

Mental Break 1 And finally, who is this? Hint: Denver Bronco quarterback WHAT DO THEY ALL HAVE IN COMMON?

They All Have Diabetes Did you think it was just grandparents who got diabetes?

From 2002 to 2005: Prescriptions of diabetes medications for kids increased 100%

Points to Ponder 8% of the population has some form of diabetes 8% of the population has some form of diabetes Total economic cost of diabetes in the United States in 2007 was estimated at $174 billion Total economic cost of diabetes in the United States in 2007 was estimated at $174 billion The number of cases increased by 13.5% between 2005 and 2007 AND IS STILL INCREASING TODAY. The number of cases increased by 13.5% between 2005 and 2007 AND IS STILL INCREASING TODAY. Why do you suppose incidence is increasing?

Diabetes Is a Lifestyle Disease

Type 1 Diabetes Usually in children. Hereditary lack of insulin.

Type 2 Diabetes Late onset. Caused by obesity, lack of exercise

Why High Blood Sugar Is Bad If left uncontrolled, excess blood sugar binds to blood vessel proteins, making vessels thicker and less elastic. Can lead to: If left uncontrolled, excess blood sugar binds to blood vessel proteins, making vessels thicker and less elastic. Can lead to: Heart attack/Stroke – the risk of each is 2 to 4 times higher in people with diabetes Heart attack/Stroke – the risk of each is 2 to 4 times higher in people with diabetes High Blood Pressure – 73% of diabetics have high blood pressure High Blood Pressure – 73% of diabetics have high blood pressure Blindness – diabetes is the leading cause of blindness in adults years of age Blindness – diabetes is the leading cause of blindness in adults years of age

Why diabetes is bad

Ever Have a Doctor Look at Your Eyes?

Early Stage of Diabetic Blindness

Diabetes is also the leading cause of kidney failure

Diabetic Coma A diabetic can become unconscious for two reasons: 1. Not enough blood glucose (as in insulin overdose): brain can’t function without the energy. 2. Too much blood glucose (as in forgetting to take your insulin): dehydration of nerve cells can cause them to stop working. Also, excess glucose causes cells to metabolize differently, breaking down fat and protein to produce harmful chemicals (“ketone bodies”)

Diabetic Coma (up to 15% of diabetics will have a coma episode) Problem: you see a diabetic in a coma. How do you know to give a candy bar or a shot of their insulin? What should you do? THINK-PAIR-SHARE Exercise: 1. Form a pair with another student and discuss your answers.

Diabetic Coma Answer: unless you can measure their blood glucose, you can’t tell which kind of coma it is. GET THEM TO AN EMERGENCY ROOM RIGHT AWAY! Delay or giving them the wrong treatment could kill them. could kill them.

Mental Break 2 What will you eat for breakfast, lunch and dinner? Breakfast: Three fried-egg sandwiches loaded with cheese, lettuce, tomatoes, fried onions and mayonnaise. Two cups of coffee. One five-egg omelet. One bowl of grits. Three slices of French toast topped with powdered sugar. Three chocolate-chip pancakes. Lunch: One pound of enriched pasta. Two large ham and cheese sandwiches with mayo on white bread. Energy drinks packing 1,000 calories. Dinner: One pound of pasta. An entire pizza. More energy drinks. This is a lot of food! This is a correct diet for who?

Mental Break 2 Michael Phelps So, eating 12,000 calories a day is ok if you are Michael Phelps! It is important to match your diet with exercise

Type 2 Prevalence is rapidly increasing and it is also being found more often in younger people Prevalence is rapidly increasing and it is also being found more often in younger people Both of these observations are being linked to the obesity epidemic that has taken over the globe. Both of these observations are being linked to the obesity epidemic that has taken over the globe. Obesity has been found to cause increased insulin resistance which can result in diabetes Obesity has been found to cause increased insulin resistance which can result in diabetes

Type 2 Over 85% of diabetics have a Body Mass Index of over 25, which is classified as overweight Over 85% of diabetics have a Body Mass Index of over 25, which is classified as overweight Over 55% have a BMI of over 30, which is obese Over 55% have a BMI of over 30, which is obese

Treatment and Prevention of Type 2 A proper diet and good exercise habits can support weight loss and effectively limit the effects of the disease. A proper diet and good exercise habits can support weight loss and effectively limit the effects of the disease. Management of glucose levels Management of glucose levels is still required and often is still required and often insulin replacement therapy insulin replacement therapy is also needed. is also needed.

Treatment /Articles/ /insulin-in-treating- diabetes-ga-2-main_Full.jpg

Mental Break 3 What are the differences between Type 1 and Type 2 diabetes? What does body-mass index measure and why is it important? Which diabetes is most treatable with diet and exercise?

Diabetes in Animals Diabetes is a growing problem in both dogs and cats Diabetes is a growing problem in both dogs and cats Dogs are most often Dogs are most often found to have type 1 found to have type 1 diabetes, while cats diabetes, while cats can have a combination can have a combination

Symptoms Symptoms are similar to those in humans Symptoms are similar to those in humans Sudden weight loss or gain Sudden weight loss or gain Excessive drinking or urination Excessive drinking or urination Appetite is either excessive or absent Appetite is either excessive or absent Dogs are highly sensitive to eye problems such as blurred vision and cataracts Dogs are highly sensitive to eye problems such as blurred vision and cataracts In cats, the back legs become weak and their gait may become wobbly or stilted In cats, the back legs become weak and their gait may become wobbly or stilted Thinning of the skin can also occur Thinning of the skin can also occur Dehydration can finally lead to death Dehydration can finally lead to death

Treatment As with humans, diet and exercise. If that is not enough, must use an insulin injection program.

Diet A simple change of diet can go a long ways in helping to reduce the effects of diabetes. A simple change of diet can go a long ways in helping to reduce the effects of diabetes. A low-carbohydrate diet reduces the amount of insulin needed and stabilizes blood sugar levels in cats. A low-carbohydrate diet reduces the amount of insulin needed and stabilizes blood sugar levels in cats. A high-fiber, moderate-carb diet has been recommended for dogs. A high-fiber, moderate-carb diet has been recommended for dogs.

Ongoing Research Type 1 Treatment Type 1 Treatment Islet Cell Encapsulation – transplant of insulin-producing Islet cells encapsulated in permeable membrane to shield them from the immune system Islet Cell Encapsulation – transplant of insulin-producing Islet cells encapsulated in permeable membrane to shield them from the immune system Islet Cell Regeneration – Involves a protein that is responsible for the regeneration of Islet cells and other important hormones in the pancreas – in clinical trials Islet Cell Regeneration – Involves a protein that is responsible for the regeneration of Islet cells and other important hormones in the pancreas – in clinical trials Islet cell development from stem cells Islet cell development from stem cells

Ongoing Research Type 1 Treatment Type 1 Treatment Gene Therapy – an oral medication consisting of viral vectors containing the insulin gene is digested and delivered to the upper intestines where it is reproduced Gene Therapy – an oral medication consisting of viral vectors containing the insulin gene is digested and delivered to the upper intestines where it is reproduced Type 1 Prevention Type 1 Prevention Immunization – a biochemical mechanism is being researched that prevents the immune system from attacking beta (insulin-producing) cells Immunization – a biochemical mechanism is being researched that prevents the immune system from attacking beta (insulin-producing) cells

Ongoing Research Pancreatic beta cells Nanotechnology

Understanding Diabetes Knowing the symptoms associated with Diabetes Understanding the difference between Type 1 and Type 2 Prevention and treatment in animals and humans. Why is this important?

Any Questions?