Epidemiology and Pathophysiology and Obesity!!
Epidemiology and Pathophysiology Israel A. Hartman, MD
Epidemiology!and!Pathophysiology of!Type!2!Diabetes!and!Obesity!!
Israel!A.!Hartman,!MD,!FACE Clinical!Instructor!of!Internal!Medicine
UT!Southwestern Medical!Center Dallas,!Texas
Diabetes in the USA
? >26 million Americans with diabetes in 2011 ? About 10% have type 1 diabetes
? Many more with either IGT, IFG or both ? Many Americans today with the metabolic
syndrome at risk for diabetes
The epidemic continues...
CDC 2008; National Diabetes Fact Sheet and the National Diabetes Surveillance System;
1
Epidemiology and Pathophysiology Israel A. Hartman, MD
Actual and Projected Diagnosed Diabetes in the United States, 1990-2050
Number (millions)
Year
National!Diabetes!Surveillance!System.!Available!at:!. Narayan!KMV,!et!al.!Diabetes!Care.!2006;29:2114"2116.
County-level Estimates of Diagnosed Diabetes among Adults aged ! 20 years: United States 2009
diabetes
Age-adjusted percent
2
Epidemiology and Pathophysiology Israel A. Hartman, MD
Estimated lifetime risk of developing diabetes for individuals born in the United States in 2000
Narayan et al, JAMA, 2003
Type 2 Diabetes in Children and Adolescents
3
Epidemiology and Pathophysiology Israel A. Hartman, MD
Diagnostic!Blood!Tests
RPG
Random plasma glucose
Any time, irrespective of
meals
FPG
Fasting plasma glucose
Before breakfast (8-h fast)
OGTT
Oral glucose tolerance test
1 or 2 hours after drinking a medically
formulated glucose drink
HbA1c or A1C
Glycated hemoglobin Average of blood glucose over 2-3 months
Any time, irrespective of meals
!200 mg/dL plus signs/symptoms
!126 mg/dL
!200 mg/dL
!6.5%?
Diagnosis must be confirmed with a second glucose measurement on another day
New criterion (ADA, 2009)
No confirmation necessary
Increasing!Problem!of!Obesity! and!Diabetes!in!the!United!States
Obesity*
92% increase
Diabetes
20% increase
1998
2006
1998
2007
*BMI!"30!kg/m2.
Mokdad AH,!et!al.!JAMA.!1999;282:1519#1522;!Ogden!CL,!et!al.!NCHS!data!brief!no!1.!Hyattsville,!MD:!National! Center!for!Health!Statistics,!2007;!Mokdad AH,!et!al. Diabetes!Care.!2000;23:1278#1283;!CDC.!National!diabetes! fact!sheet.!Atlanta,!GA:!U.S.!Department!of!Health!and!Human!Services,!Centers!for!Disease!Control!and! Prevention,!2008.
4
Epidemiology and Pathophysiology Israel A. Hartman, MD
Type!2!Diabetes
Why!Is!It!Important?
Clinical!Impact!of!Diabetes!Mellitus
Heart disease and stroke
! Account for 65% of deaths
! 2- to 4-fold increase in cardiovascular disease death rates
Kidney disease ! Diabetes is leading
cause of ESRD ! Accounts for 44% of
cases
Diabetes
Blindness
! Diabetic retinopathy causes 12,000 to 24,000 new cases of blindness/year
! Serves as leading cause of new cases of blindness in adults 20-74 years of age
Amputations
! More than 60% of nontraumatic lower-limb amputations occurs in people with diabetes
! 10-fold increase in amputation rate
ESRD, end-stage renal disease. American Diabetes Association. . Accessed December 11, 2008
5
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- epidemiology and pathophysiology and obesity
- hypertension and myocardial infarction
- guidelines for management of acute myocardial infarction
- morbidity and mortality weekly report
- ischemia and infarction mit opencourseware
- pathophysiology of disease pdf download
- a critical appraisal of the evolution of st elevation
- national chronic kidney disease fact sheet 2017
- pathophysiology of human disease
Related searches
- me and vs and i
- me and or and i
- you and or and you
- tomorrow and tomorrow and tomorrow sparknotes
- definitions and synonyms and antonyms
- idioms and origins and meanings
- dvt pathophysiology and risk factors
- tomorrow and tomorrow and tomorrow kurt
- have and has and singular and plural
- science and technology and ethics
- tomorrow and tomorrow and tomorrow summary
- and i and me grammar