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Session
by Dr Omar Hasan Kasule Sr. for 4th year medical students on
December 31, 2013
Comparison of two types of diabetes
Type 1 (insulin dependent)
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Type 2 (non insulin dependent)
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Age
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<30 yr
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>30 yr
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Weight
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Lean
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Overweight
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Heredity
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Genetic susceptibility
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Genetic determination
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Metabolic syndrome
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Na
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Associated (HT, CVA, MI, obesity, lipids etc)
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Pathogenesis
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Auto immune, ? environment
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Not auto immune, Insulin resistance
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Other factors
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Environment
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Early malnutrition
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Insulin
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Deficiency
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Partial deficiency
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Complications
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Ketoacidosis
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Hyperosmolar state
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Biochemical
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C-peptide eventually disappears
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C-peptide persists
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Clinical presentation
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Asymptomatic:
usually discovered on routine screening
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Symptoms:
thirst, polyuria, weight loss,?
polyphagia,
Arterial /macrovasculsr complications problems
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HT
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MI
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Gangrene
Microvascular complications
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diabetic
retinopathy
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cataract
Diabetic nephropathy
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Albuminuria
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renal failure
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anemia
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UTI
Diabetic neuropathy
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sensory
polyneuropathy
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acute painful
neuropathy
Autonomic neuropathy
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tachycardia due
to vagal neuropathy
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postural
hypotension due to loss of sympathetic tone
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bladder
dysfunction
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male erectile
dysfunction
Ischemic
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Neuropathic
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Symptoms
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Claudication, pain at rest
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Usually painless, may be painful
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Appearance
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Redness, skin changes
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No skin changes, toes clawed
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Palpation
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Cold, pulseless
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Warm. Strong pulse
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Ulceration
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Painless on heels and toes
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Painless on plantar aspect
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