DiabetesDiabetes

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. 

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Blood sugar is normally controlled by a hormone called insulin that is secretedby the pancreas

Diabetes is a metabolic disorder of abnormally high blood sugar levels (hyperglycemia)

What is insulin?What is insulin?

A protein that reduces blood A protein that reduces blood glucose (sugar) levelsglucose (sugar) levels

Why?Why? Have you ever felt a “sugar rush” Have you ever felt a “sugar rush”

after eating something really sweet?after eating something really sweet? Insulin is produced by the pancreas Insulin is produced by the pancreas

to remove some of this excess sugar to remove some of this excess sugar from the bloodfrom the blood

Diabetes happens when insulin Diabetes happens when insulin isn’t made or doesn’t workisn’t made or doesn’t work

FOODFOOD

BloodstreamBloodstream

GlucoseGlucoseLevelsLevels

INSULIN

GlucoseGlucoseLevelsLevels

History of DiabetesHistory of Diabetes

First known reference: First known reference:

Egyptian papyrus, 1550 BCEgyptian papyrus, 1550 BC

Diabetes named by the Diabetes named by the Greek physician Greek physician Aretaeus between 30 Aretaeus between 30 and 90 ADand 90 AD

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How did they recognize the How did they recognize the disease back in those primitive disease back in those primitive

times?times?

Frequent Frequent urinationurination

ExcessiveExcessivethirstthirst

SweetSweeturineurine

History of the DiseaseHistory of the Disease

Avicenna, a famous Arab Avicenna, a famous Arab physician, described the physician, described the complications of the disease and complications of the disease and how it progressedhow it progressed

French physician Bouchardat French physician Bouchardat recognized the importance of recognized the importance of calorie intake in the 1870scalorie intake in the 1870s

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History of the DiseaseHistory of the DiseasePaul Langerhans identified the importance of the Paul Langerhans identified the importance of the pancreas in the early 19pancreas in the early 19thth century and discovered a century and discovered a group of cells that would later be known to produce group of cells that would later be known to produce insulininsulin

““Isle of Langerhans”Isle of Langerhans”

Historical Research on DogsHistorical Research on DogsThe hormone insulin drives blood glucose into tissues.The hormone insulin drives blood glucose into tissues.

Frederick Banting discovered insulin in dogs in the Frederick Banting discovered insulin in dogs in the 1920s and won the Nobel Prize.1920s and won the Nobel Prize.

Molecular Molecular structure of structure of

insulininsulin

Quick ReviewQuick Review

1. What are diabetes symptoms that 1. What are diabetes symptoms that everyone could recognize?everyone could recognize?

2. What is insulin? Where does it come 2. What is insulin? Where does it come from? What does it do?from? What does it do?

Mental Break 1

• Who is this?

Hint: movie starHint: movie star

Mental Break 1

• How about this?

Hint: first African Hint: first African American in American in major-league major-league baseballbaseball

Mental Break 1

• And finally, who is this?

Hint: Denver Hint: Denver Bronco Bronco quarterbackquarterback

WHAT DO THEY WHAT DO THEY ALL HAVE IN ALL HAVE IN COMMON?COMMON?

They All Have DiabetesThey All Have Diabetes

Did you think it was just Did you think it was just grandparents who got grandparents who got

diabetes?diabetes?

From 2002 to 2005:From 2002 to 2005:

Prescriptions of Prescriptions of diabetes medications diabetes medications

for for kidskids increased increased 100%100%

Points to PonderPoints to Ponder 8% of the population has some form of 8% of the population has some form of

diabetesdiabetes

Total economic cost of diabetes in the United Total economic cost of diabetes in the United States in 2007 was estimated at $174 billionStates in 2007 was estimated at $174 billion

The number of cases increased by 13.5% The number of cases increased by 13.5% between 2005 and 2007 AND IS STILL between 2005 and 2007 AND IS STILL INCREASING TODAY.INCREASING TODAY.

Why do you suppose incidence is Why do you suppose incidence is increasing?increasing?

Diabetes Is a Lifestyle Diabetes Is a Lifestyle DiseaseDisease

Type 1 DiabetesType 1 Diabetes

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Usually in children. Hereditary lack of insulin.

Type 2 DiabetesType 2 Diabetes

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Late onset. Caused by obesity, lack of exercise

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Why High Blood Sugar Is Why High Blood Sugar Is BadBad

If left uncontrolled, excess blood sugar binds to If left uncontrolled, excess blood sugar binds to blood vessel proteins, making vessels thicker and blood vessel proteins, making vessels thicker and less elastic. Can lead to:less elastic. Can lead to:

Heart attack/Stroke – the risk of each is 2 to 4 Heart attack/Stroke – the risk of each is 2 to 4 times higher in people with diabetestimes higher in people with diabetes

High Blood Pressure – 73% of diabetics have high High Blood Pressure – 73% of diabetics have high blood pressureblood pressure

Blindness – diabetes is the leading cause of Blindness – diabetes is the leading cause of blindness in adults 20-74 years of ageblindness in adults 20-74 years of age

Why diabetes is badWhy diabetes is bad

Ever Have a DoctorEver Have a Doctor Look at Your Eyes? Look at Your Eyes?

Early Stage of Diabetic Early Stage of Diabetic BlindnessBlindness

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Diabetes is also the leading Diabetes is also the leading cause of kidney failurecause of kidney failure

Diabetic ComaDiabetic ComaA diabetic can become unconscious for two reasons:A diabetic can become unconscious for two reasons:

1. Not enough blood glucose (as in insulin overdose): brain can’t 1. Not enough blood glucose (as in insulin overdose): brain can’t function without the energy.function without the energy.

2. Too much blood glucose (as in forgetting to take your insulin): 2. Too much blood glucose (as in forgetting to take your insulin): dehydration of nerve cells can cause them to stop working. Also, dehydration of nerve cells can cause them to stop working. Also, excess glucose causes cells to metabolize differently, breaking excess glucose causes cells to metabolize differently, breaking down fat and protein to produce harmful chemicals (“ketone down fat and protein to produce harmful chemicals (“ketone bodies”)bodies”)

Diabetic ComaDiabetic Coma(up to 15% of diabetics will have a coma episode)(up to 15% of diabetics will have a coma episode)

Problem: you see a diabetic in a coma. How do you know to 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 give a candy bar or a shot of their insulin? What should you do?do?

THINK-PAIR-SHARE Exercise:THINK-PAIR-SHARE Exercise:

1. Form a pair with another student and discuss your answers.1. Form a pair with another student and discuss your answers.

Diabetic ComaDiabetic Coma

Answer: unless you can measure their blood glucose, Answer: unless you can measure their blood glucose, you can’t tell which kind of coma it is.you can’t tell which kind of coma it is.

GET THEM TO AN EMERGENCY ROOM RIGHT AWAY!GET THEM TO AN EMERGENCY ROOM RIGHT AWAY!Delay or giving them the wrong treatmentDelay or giving them the wrong treatment

could kill them.could kill them.

Mental Break 2What 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 2Type 2

Prevalence is rapidly increasing and it is also Prevalence is rapidly increasing and it is also being found more often in younger peoplebeing found more often in younger people

Both of these observations are being linked to Both of these observations are being linked to the obesity epidemic that has taken over the the obesity epidemic that has taken over the globe.globe.

Obesity has been found to cause increased Obesity has been found to cause increased insulin resistance which can result in diabetesinsulin resistance which can result in diabetes

Type 2Type 2

Over 85% of Over 85% of diabetics have a diabetics have a Body Mass Body Mass Index of over Index of over 25, which is 25, which is classified as classified as overweightoverweight

Over 55% have Over 55% have a BMI of over a BMI of over 30, which is 30, which is obeseobese

Treatment and Prevention of Treatment and Prevention of Type 2Type 2

A proper diet and good exercise habits can A proper diet and good exercise habits can support weight loss and effectively limit the support weight loss and effectively limit the effects of the disease.effects of the disease.

Management of glucose levels Management of glucose levels

is still required and often is still required and often

insulin replacement therapyinsulin replacement therapy

is also needed.is also needed.

Treatment Treatment

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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 AnimalsDiabetes in Animals

Diabetes is a growing problem in both dogs Diabetes is a growing problem in both dogs and catsand cats

Dogs are most often Dogs are most often

found to have type 1found to have type 1

diabetes, while cats diabetes, while cats

can have a combinationcan have a combination

SymptomsSymptoms Symptoms are similar to those in humansSymptoms are similar to those in humans

Sudden weight loss or gainSudden weight loss or gain Excessive drinking or urinationExcessive drinking or urination Appetite is either excessive or absentAppetite is either excessive or absent Dogs are highly sensitive to eye Dogs are highly sensitive to eye

problems such as blurred vision and problems such as blurred vision and cataractscataracts

In cats, the back legs become weak and In cats, the back legs become weak and their gait may become wobbly or stiltedtheir gait may become wobbly or stilted

Thinning of the skin can also occurThinning of the skin can also occur Dehydration can finally lead to deathDehydration can finally lead to death

TreatmentTreatmentAs with humans, diet and exercise. If that is not As with humans, diet and exercise. If that is not

enough, must use an insulin injection program.enough, must use an insulin injection program.

DietDiet

A simple change of diet can go a long ways A simple change of diet can go a long ways in helping to reduce the effects of diabetes.in helping to reduce the effects of diabetes.

A low-carbohydrate diet reduces the amount A low-carbohydrate diet reduces the amount of insulin needed and stabilizes blood sugar of insulin needed and stabilizes blood sugar levels in cats. levels in cats.

A high-fiber, moderate-carb diet has been A high-fiber, moderate-carb diet has been recommended for dogs.recommended for dogs.

Ongoing ResearchOngoing Research Type 1 TreatmentType 1 Treatment

Islet Cell Encapsulation – transplant of Islet Cell Encapsulation – transplant of insulin-producinginsulin-producing Islet cells encapsulated in permeable membrane to shield Islet cells encapsulated in permeable membrane to shield them from the immune systemthem from the immune system

Islet Cell Regeneration – Involves a protein that is Islet Cell Regeneration – Involves a protein that is responsible for the regeneration of Islet cells and other responsible for the regeneration of Islet cells and other important hormones in the pancreas – in clinical trialsimportant hormones in the pancreas – in clinical trials

Islet cell development from stem cells Islet cell development from stem cells

Ongoing ResearchOngoing Research Type 1 Treatment Type 1 Treatment

Gene Therapy – an oral medication consisting of viral Gene Therapy – an oral medication consisting of viral vectors containing the insulin gene is digested and vectors containing the insulin gene is digested and delivered to the upper intestines where it is reproduceddelivered to the upper intestines where it is reproduced

Type 1 PreventionType 1 Prevention

Immunization – a biochemical mechanism is being Immunization – a biochemical mechanism is being researched that prevents the immune system from researched that prevents the immune system from attacking beta (insulin-producing) cellsattacking beta (insulin-producing) cells

Ongoing ResearchOngoing Research

Pancreatic beta Pancreatic beta cellscells

NanotechnologyNanotechnology

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?Any Questions?