Lec1 - Understanding Diabetes Mellitus

• • 51% increase of diabetes across the world
  • 15% increase in europe
  • 96% increase in middle east and north africa
  • 143% increase in africa
  • this can be due to different levels of access to healthcare, poorer detection rates, lack of education, diet etc

  
• Prevalence of Diabetes in the UK:

  • 90% have type 2
  • 8% have type 1
  • 2% have rarer types
  • > 4.8 million have diabetes, so 1 in 14
  • estimates 5 million by 2025
• Why is Diabetes a concern in Cardiovascular Health?

  • The presence of diabetes doubles mortality risk regardless of cardiovascular disease (CVD) presence
  • Diabetes is a significant precursor for CVD development
  • 32% of patients attending CPR are living with diabetes and only 41% meet the Chief Medical Officer’s (CMO’s) recommended activity levels (NACR, 2017)
• Classification of Diabetes:

  • 6 main classifications (WHO 2019):
  • Type 1 Diabetes (T1DM)
  • Type 2 Diabetes (T2DM)
  • Hybrid forms of diabetes (MODY)
  • Other specific types
  • Unclassified diabetes
  • Hyperglycaemia first detected in pregnancy
• T2DM risk factors:

  • obesity = 80 to 85% increased risk
  • physical inactivity = 30 to 40% increased risk
  • diet high intake of saturated fatty acids
  • social deprivation
  • family history = both parents 75% increased risk
  • ethnicity = increase if asian 6%, 4 % african/afro-carribean
  • age: older increases risk
  • sex: men increased risk
  • other
• Diagnosing DM:

  • need a venous blood sample
  • random blood glucose levels (2hrs post meal):
  • normal level: < 11 mmols
  • diabetes level: > 11 mmols
  • fasting blood glucose levels:
  • normal level: < 7 mmols
  • diabetes level: > 7 mmols
  • HbA1c levels:
  • normal level: < 42 mmols/mol
  • diabetes level: > 48 mmols/mol
• Glut 4s

  
• Cardiac rehab for those with T1DM

  
• Cardiac rehab for those with T2DM

  
• Freestyle libre:

  
• Freestyle libre:
• Freestyle Libre

  
• Different types of exercise/sport on blood glucose response
• Different types of exercise/sport on blood glucose response