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Diabetes - Coggle Diagram
Diabetes
Physical examination for diabetes
and further investigations
weight assessment
Symptoms of diabetes
polyuria
Polydipsia
blurry vision
fatigue
others
blood pressure
ophthalmoscopy
insulin injection sites checkup
feet assessment
heart examination
Thyroid examination
other refferals
Risk factors of diabetes
which have many types
presence of autoanibodies
Family history
viral infection
obesity
sedentary lifestyle
Age
gestation
Hypertension
Complications of diabetes
and treating the psychosocial aspect
diabetic neuropathy
peripheral artery disease
cerebrovascular disease
diabetic retinopathy
diabetic nephropathy
cardiovascular system complications
Types of diabetes
affecting the biochemical aspect
Type 2 diabetes
Insulin resistance
secretory defect
Both
Type 1 diabetes
immune mediated
Idiopathic
LADA (type 1.5)
Gestational diabetes
Monogenic diabetes
Maturity onset diabetes of young
permanent neonatal diabetes
Transient
Permenent
Mitochondrial diabetes
Secondary diabetes
Type 3 diabetes
Management of diabetes
and for emergency cases
life style modifications
oral hypoglycemic medications
insulin
others
Investigations for diabetes
to diagnose and give the proper treatment
routine studies
BMP like Renal functions and Electrolytes
•Liver chemistries
•Lipid panel
•Spot urinary albumin-to-creatinine ratio
additional studies
Urinalysis
•Antibody testing
•C-peptide
•ECG
•Radiology
hyperglycemia tests
Random blood glucose
•Fasting plasma glucose
•Oral glucose tolerance test (OGTT)
Hemoglobin A1C
Psychosocial impact of diabetes
to reduce the prevalance of diabetes
depression
Anxiety
social isolation
Physiology of the pancreas
endocrine function
secretion of hormones directly into the blood
islets of langerhans
Alpha cells
Glucagon
released when blood glucose is low
Delta cells
Somatostatin
inhibit insulin and glucagon secretion
Beta cells
Insulin
released when blood glucose is high
large number of GLUT2 transporters in beta cell and rate of glucose influx is proportional to blood glucose
Glucose is phosphorylated to glucose-6-phosphate by glucokinase
(rate limiting step)
Glucose-6-phosphate is susequently oxidzed to form ATP, which inhibits the ATP - sensitive K+ channels of the beta cells
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Glucose uptake by insulin
insulin bind to its receptor
signal transduction cascade
translocation and fusion of GLUT4 containing vesicle with plasma membrane
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Amylin
Satiety hormone and slow gastric emptying
PP cells
Pancreatic polypeptide
G cells
Gastrin
Epsilon cells
Ghrelin
Hunger hormone
exocrine function
stimulated by chyme in the duodenum for digestion
abnormalities might happen
Biochemistry of diabetes
and immunologial aspects
insulin normal functions
insulin effect on carbohydrate metabolism
increase rate of transport of glucose
increase rate of glycolysis
increase rate of glycogen synthesis
decrease rate of glycogen breakdown
decrease glycogenolysis and gluconeogenesis
activate pentose phosphate pathway
insulin effect on fat metabolism
decrease rate of lypolysis
increase fatty acid and triacylglycerol synthesis
increase rate of VLDL formation
increase uptake of triglyceride
decrease rate of fatty acid oxidation
increase rate of cholesterol synthesis
insulin effect on protein metabolism
increase rate of transport of some amino acids
increase rate of protein synthesis
decrease rate of protein degredation
decrease rate of uria formation
insulin is an anabolic hormone
Glucagon do the opposite
immunology of diabetes
thus it is important to perform PE
Type 1 diabetes
Autoantibodies
islet cell autoantibodies
insulin autoantibodies
Autoantibodies targeting the 65-KDa isoform of GAD
Autoantibodies targeting the phosphatase - related IA-2 molecule
Zinc transporter autoantibodies (ZnT8)
Type 2 diabetes
adipose tissue inflammatory macrophages (M1)
TNF-alpha
IL-1beta
IL-6
Epidemiology of diabetes
and return the function back to normal
very common in the UAE
Emergency management
to prevent complications