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17103609
Fatima was brought confused
Descrição
Mapa Mental sobre Fatima was brought confused, criado por Alya Almualla em 03-03-2019.
Mapa Mental por
Alya Almualla
, atualizado more than 1 year ago
Mais
Menos
Criado por
Alya Almualla
mais de 5 anos atrás
128
0
0
Resumo de Recurso
Fatima was brought confused
Due to
Diabetes
Affect the Pancreas
Normal structure
Elongated, tapered organ
Behind the stomach
Parts
Head "Right side"
Widest part
lies in the curve of the duodenum
Body "Tapered left side"
Tail "Near spleen"
2 types of glands
Exocrine
Secretes digestive enzymes
Endocrine
Islets of Langerhans
Secretes hormones into the bloodstream
Type of islets
Beta cells
Insulin and Amylin
Regulation of glucose
Role of other hormones
Carbohydrate, protein & fat metabolism in well fed state
Normal range of calories intake
Gluconeogenesis and Glycogenolysis
Alpha cells
Glucagon
Delta cells
Somatostatin
PP cells
Pancreatic polypeptide
Epsilon cells
Ghrelin
Blood supply
Head
Superior and inferior pancreaticoduodenal arteries
Branches of the gastroduodenal
Pancreatic branches of the splenic artery
Venous drainage
Head of the pancreas
Into the superior mesenteric branches of the hepatic portal vein
The rest
Pancreatic veins via the splenic vein
Types "Classification"
Type 1
Immune mediated
Insulin dependent diabetes mellitus
Juvenile onset diabetes
5–10% of diabetes
Cellular-mediated autoimmune destruction of beta cells
Strong association with HLA
Etiology
Genetic susceptibility
Autoimmunity
Evidence
Lymphocytic infiltration (Insulitis)
Other autoimmune diseases
Environmental factors
Virus infection
Islet cell injury
Molecular mimicry
Chemicals/Drugs
Pathogenesis
Autoantibodies
Glutamic Acid Decarboxylase
Insulin
Tyrosine phosphatases IA-2
Zink transporter 8
Idiopathic
Strongly inherited
Not associated with HLA
LADA (1.5)
Age (30-50)
Glutamic acid decarboxylase antibodies
Gestational
5-10% of pregnant women
Third trimester
Disappears after delivery
Greater risk of
Monogenic
MODY
15 forms
Age of 35
Autosomal dominant inheritance
Permanent Neonatal diabetes
Age of 6 months
Transient
Overexpression of genes
Permanent
Autosomal dominant mutations
Mitochondrial diabetes
Mutations in the mitochondrial DNA
Commonest mutation is m.3243A>G
Maternally inherited diabetes and deafness syndrome
Secondary
Pancreatic disease
Endocrinopathies
Drug induced
Insulin action
Genetics syndromes
Infections
Post transplantation
Type 2
Non-insulin dependent diabetes mellitus
Types
Insulin resistance
Secretory defect
Both
Adult onset diabetes
90-95% of diabetes
No autoimmune destruction of beta cells
Etiology
Genetic factors
Greater importance in type 2 in type 1
Genetic defects may affect
Beta Islet cells function
Peripheral resistance
Abnormal insulin secretion
Progressive age-related loss of beta Islet cells function
Amylin accumulation
Insulin resistance
Reduced number of receptors
Abnormally functioning receptors
Post-receptor defects
Environmental factors
Obesity
Physical inactivity
Psychosocial stress
Pathogenesis
Epidemiology
Diabetes people: 108 million in 1980 to 422 million in 2014
Half of all deaths > High blood glucose > Before 70
UAE
IDF: in 2017, 17.3% of UAE population (Age 20-79) > Type 2 diabetes
Over 1 million people living with diabetes in the UAE
Prevalence: 15th worldwide
Clinical manifestations
Hyperglycemia
Polyuria
Diabetes insipidus
Diuretics Caffeine Ethanol
Glucosuria
Polyphagia
Weight loss and muscle weakness
Diabetic ketoacidosis (Types 1)
Oxidation of the free FA
Polydipsia
Investigations
Blood test
Fasting plasma glucose test
Random plasma glucose test
Glucose challenge test
Oral glucose tolerance test
Special tests
C-peptide
GADA
IA-2alpha and IA-2beta
ICA
Other tests
Urine test
FBC
Urea and electrolytes
Liver function tests
Fasting lipid profile
ECG
Thyroid tests
Serum B12 and red cell folate
Coeliac auto-antibody screen
Glucometer
Management
Lifestyle modification
Diet
Physical activity
Oral hypoglycemics
Biguanides
Metformin
Decrease hepatic glucose production
Thiazolidinediones
Rosiglitazone / Pioglitazone
Improve peripheral insulin sensitivity
Alpha-glucosidase
Acarbose / Miglitol
Delay carbohydrate absorption
Sulfonylureas
Glimepiride / Glipizide / Glyburide / Gliclazide
Stimulate insulin secretion from pancreatic beta cells
Short-acting insulinotropic agents
Repaglinide / Nateglinide
Stimulate insulin secretion from pancreatic beta cells
Glucagon-like peptide receptor agonists
Exenatide / Liraglutide
Incretin mimetics
DPP-4 Inhibitors
Sitagliptin / Saxagliptin / Linagliptin
Inhibit the enzyme DPP-4
Pramlintide
Delays gastric emptying / Suppresses glucagon secretion / Decreases appetite
Sodium-glucose transporter 2 inhibitors
Canagliflozin / Dapagliflozin / Empagliflozin
Causes glycosuria and lowers glucose levels
Insulin therapy
Mechanism
Bind insulin receptor
Liver "Increase glycogen storage"
Muscle "Increase protein synthesis"
Fat "TG storage"
Cell membrane "Increase K uptake"
Adverse effects
Hypoglycemia
Lipodystrophy
Rare HSR
Weight gain
Pancreatic transplant
Managing the hypertension in diabtetes
ACEi
ARB
CCB
Diuretic
Complications
Microvascular
Retinopathy
Neuropathy
Diabetic foot disorders
Nephropathy
Macrovascular
CVD
Diabetic coma
Hyper/hypoglycemia
Psychosocial aspect
Adjustment disorder
Lowered self-esteem
Depression
Diet non-adherence
Psychological burden "Obesity"
Anexos de mídia
Pancreas (binary/octet-stream)
Vasculature Of The Pancreas Splenic Artery And Vein (binary/octet-stream)
Panc (binary/octet-stream)
Epid (binary/octet-stream)
Insu (binary/octet-stream)
Pathp (binary/octet-stream)
Amyl (binary/octet-stream)
Path2 (binary/octet-stream)
Gene (binary/octet-stream)
Insu (binary/octet-stream)
Other (binary/octet-stream)
Tred (binary/octet-stream)
Well (binary/octet-stream)
1 S2.0 B9780444626158000126 F12 05 9780444626158 (binary/octet-stream)
Cal (binary/octet-stream)
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