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Diabetes type 1
Diabetes type 1?
Diabetes type 1 is characterized by an absolute deficiency of insulin caused by an autoimmune attack on the β cells of the pancreas. In type 1 diabetes, the islets of Langerhans become infiltrated with activated lymphocytes, leading to a condition called insulitis.
Prevalence of type 1 diabetes is 5%–10% and age of onset is <30 Years and speed of onset of type 1 diabetes is rapid as compare to type 2 diabetes and the pateints of type 1 diabetes are usually thin.
Genetics Family history uncommon
Associations. Other autoimmune diseases: Graves disease, Hashimoto thyroiditis, pernicious anemia,
Addison disease
Pathogenesis:Lack of insulin Pancreas devoid of β-islet cells Insulitis: T-cell cytokine destruction
(type IV hyper senstivity reaction) and autoantibodies against β-islet cells (>80%) and insulin (>50%) (type II HSR) Triggers for destruction—e.g., viruses
Clinical findings:Polyuria (osmotic diuresis from glucosuria), polydipsia(excessive thirst) (↑POSM), polyphagia(excessive hunger), weight loss Ketoacidosis (hyperglycemia, coma; production of ketone bodies); lactic acidosis from shock (losing sodium by osmotic diuresis from glucosuria)
Treatment: Insulin
Tag :
Diabetes Mellitus type 1,
Diabetes
Diabetes Mellitus:
Diabetes mellitus is not one disease, but rather is a heterogeneous group of multifactorial, polygenic syndromes characterized by an elevation of fasting blood glucose caused by a relative or absolute deficiency in insulin. Diabetes is the leading cause of adult blindness and amputation, and a major cause of renal failure, nerve damage, heart attacks, and strokes. Diabetes mellitus can be separated into two groups type 1 (formerly called insulin-dependent diabetes mellitus) and type 2 (formerly called noninsulin-dependent diabetes)
A. Epidemiology
1. Affects 5% to 7% of population in the United States
• Increased in Native Americans (35% of Pima Indians)
2. Leading cause in the United States for:
a. Legal blindness
b. Peripheral neuropathy
c. Chronic renal failure (CRF)
d. Below-the-knee amputation
3. Incidence increases with age.
Comparison Between Type 1 and Type 2 Diabetes Mellitus
Age Dependent Pharmacology.
Age Dependent Pharmacology:
A. PEDIATRIC PHARMACOLOGY
1. Newborns have a greater percentage of weight from body water and less body
fat than adults.
a. A water-soluble drug will have a higher Vd (relative to body size) in children
than in adults.
b. A lipid-soluble drug will have a lower Vd (relative to body size) in children
than
2. Pl
in adults.
asma protein binding is reduced for approximately the first year.
3. Metabolism, especially oxidation and glucuronidation, is also reduced.
4. Glomerular filtration rate (GFR) and renal tubular function are reduced in
newborns.
B. GERIATRIC PHARMACOLOGY:
1. The elderly generally have
a. A smaller overall body mass and less lean body mass
b. A higher percentage of body fat and less body water
i. A water soluble drug will have a lower Vd than in a person of average age.
ii. A lipid soluble drug will have a higher Vd.
c. Reduced plasma albumin, which will reduce the amount of bound drug in the
plasma
d. Reduced renal excretion
e. Reduced hepatic metabolism of some drugs, especially Phase I reactions.
f. Other nonpharmacokinetic changes
i. Central nervous system (CNS) drugs often produce confusion.
ii. Cardiovascular drugs often have greater effects in the elderly patient because
the homeostatic mechanisms (e.g., baroreceptor reflexes) are sluggish.
2. Special care must be taken when prescribing drugs for the elderly.
a. Overall, elderly patients require smaller dosages of most drugs than young
adults.
b. Compliance issues (e.g., cost, complex dosage regimens, childproof packaging
that is difficult to open) are common in the elderly.
c. Drug safety is of particular concern due to the fact that elderly patients tend to have
reduced drug metabolizing capability, take multiple drugs, and have comorbidities.
This increases the risk of problems due to drug-drug interactions and side effects
Tag :
Age dependent Pharmacology,
Pharmacodynamics
PHARMACODYNAMIC.
A. PHARMACODYNAMICS is a description of the properties of drug-receptor interactions
and can be thought of as what the drug does to the body.
Tag :
pharmacodynamic,
