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Published byDomenic Ellis Modified over 9 years ago
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Collection of glands that secrete hormones directly into the bloodstream. › Adrenal glands, parathyroid glands, pancreas, pineal gland, pituitary gland, ovaries, testes, thymus gland, thyroid gland
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(Hormone.org, 2012)
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(Zelman, Tompary, Raymond, Holdaway, Mulvhill, 2010)
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TSH T3 T4 Disruption of hormones › Hyperthyroidism › Hypothyroidism (NIDDK, 2006)
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Exophthalmos Profuse perspiration Hand tremors Goiter Weight loss Nervousness/excitability Rapid pulse Polydipsia Diarrhea Insomnia Most common type: Grave’s Disease
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Most common type of hypothyroidism › Hashimoto’s Disease › The thyroid doesn’t make enough thyroid hormone › Symptoms: Fatigue, mental depression, feeling cold, weight gain, dry skin and hair, constipation, menstrual irregularities
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Most people have no symptoms 4 types: › Papillary – slow growing – easily treated – rarely fatal › Follicular – again slow growing – rarely fatal › Medullary – less common – more aggressive › Anaplastic – least common – most aggressive
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Adrenal Insufficiency › Adrenal glands cannot produce enough cortisol OR › Pituitary gland fails to produce enough adrenocorticotropin (ACTH) Symptoms: › Chronic, worsening fatigue › Muscle weakness › Loss of appetite › Weight loss › Nausea/vomiting › Diarrhea › Craving for salty foods › Low blood glucose › Headache
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Caused by prolonged exposure of the body’s tissues to high levels of the hormone cortisol. Relatively rare but risk factors: › Obesity › Type 2 diabetes › High blood pressure
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Signs & Symptoms: › Rounded face › Upper body obesity › Increased neck fat › Bruise easily / poor healing › Weakened bones › Fatigue › Increased thirst/urination › Irritability / anxiety / depression (NIDDK, 2006)
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Medication Radioactive Iodine Surgery Prevention??
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In diabetes, blood glucose builds up for several possible reasons… High Blood Glucose (Hyperglycemia) Too little insulin is made Liver releases too much glucose Cells can’t use insulin well American Diabetes Association
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Type 1 › Pancreas makes too little or no insulin Pre-diabetes Gestational Diabetes Type 2 › Cells do not use insulin well (insulin resistant) › Ability for pancreas to make insulin decreases over time
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Number of Americans with Diagnosed Diabetes, 1980-2009 www.cdc.gov
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Currently affects about 29.1 million Americans of all ages. › About 9.3% of the population (U.S.) › Estimated 8 million undiagnosed › Hispanics/Latinos – about 13% diagnosed › African Americans – about 13% diagnosed › Asian Americans – about 9% diagnosed (CDC, 2014)
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(Oregon.gov, 2006)
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Increased thirst Increased urination Blurry vision Fatigue Weight loss Nausea and vomiting More frequent infections
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A leading cause of blindness Leading cause of non-accident amputations Kidney disease Nerve damage (peripheral neuropathy) Heart attack / stroke
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Oral medication only 58% No medication 16% Insulin only 12% Insulin and oral medicatio n 14% Treatment of Diabetes National Diabetes Information Clearinghouse. National Diabetes Statistics, 2011. Available at: http://diabetes.niddk.nih.gov/dm/pubs/statistics/
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“The best time to plant a tree is 20 years ago. The second best time is now.” Chinese Proverb Good news with diabetes prevention › Small steps matter
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Active interventions (vs placebo) would: Cost-Effectiveness of Lifestyle Modification or Metformin: DPP Herman WH, et al for the Diabetes Prevention Program Research Group. Ann Intern Med. 2005:142:323-332. Intensive Lifestyle Metformin Delay onset of type 2 diabetes by 11.1 years3.4 years Reduce incidence of type 2 diabetes by 20%8% Increase life expectancy by 0.5 years0.2 years Cost per QALY$1,124$31,286 QALY = Quality Adjusted Life Years
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