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Fatima was brought confused

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Mind Map on Fatima was brought confused, created by Maryam Alowais on 26/02/2020.
Maryam Alowais
Mind Map by Maryam Alowais, updated more than 1 year ago More Less
Alya Almualla
Created by Alya Almualla about 5 years ago
Maryam Alowais
Copied by Maryam Alowais about 4 years ago
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Resource summary

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

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