Types of diabetes

Diabetes OutreachAugust 2010

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Types of diabetes

Learning outcomes

> Define the types of diabetes.

> Define the risk factors for diabetes.

> Understand that type 1 and type 2 diabetes have different clinical presentations.

> Describe the basic management principles for type 2 diabetes.

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Glucose metabolism

> Food is broken down into glucose via the gastrointestinal tract.

> Glucose is absorbed into the blood stream.

> The pancreas produces insulin which allows the glucose to enter the cells of the body.

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How carbohydrate is used

BGL

carbohydrate

insulin

brain

muscle

pancreas

liver

GIT

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Classification of diabetes

> Type 1 – Autoimmune.

> Type 2 – Insulin resistance/deficiency.

> Gestational – Occurs during pregnancy.

> Secondary – Result of another disorder.

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Pre diabetes

> A condition in which BGLs are higher than normal but are not high enough for a diagnosis of diabetes.

> People have an increased risk for developing type 2 diabetes and have an increased cardiovascular risk.

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Features of type 1

Characteristics

> Little or no insulin produced due to destruction of beta cells.

Onset

> Rapid onset, ketonuria often present, there may be significant weight loss.

Treatment

> Requires intensive insulin therapy either by multiple injections or insulin pump.

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Features of type 2Characteristics

> Insufficient insulin and/or insulin resistance.

> Usually family history.

> Age, overweight, lifestyle factors.

Onset

> Gradual onset and may initially have no symptoms.

Treatment

> Initially may be managed with diet and exercise but will require oral tablets and/or insulin as diabetes progresses.

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Activity

Think about someone you know with diabetes.

Write down one or two comments about this person.

> How do you think they are coping?

> How do they feel about having diabetes?

> Are they ‘good’ self managers? Why?

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Risks for type 2 diabetes

> Age: >40 years

> Family history: 1st degree relative

> Weight: BMI >30

> Pregnancy: Babies >4kg/9lb or gestational diabetes

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Case study

Beth is 40 years old and is complaining to you that she feels tired all the time. She has always gone to the toilet once in the night, now she goes three times. She has also had vaginal thrush on 2 or 3 occasions in the last 6 months.

What do you think could be happening to Beth?

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Beth has been to her doctor and found out that she has diabetes.

She is a little overweight and has elevated cholesterol levels.

What type of diabetes does she have?

Why?

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Aims of management

> Restore the altered metabolism.

> Reduce the risk of complications.

> Reduce the progression of complications.

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References

> Diabetes Outreach (2009) Diabetes Manual

> Diabetes Outreach Website www.diabetesoutreach.org.au

> Harris P, Mann L, London J, Phillips P, and Webster C (2009/10) Diabetes management in general practice: Guidelines for type 2 diabetes. Diabetes Australia and Royal Australian College of General Practitioners, Canberra. www.racgp.org.au/guidelines

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