2015 Anatomical Chart Company Catalog

New edition — 44 new and updated charts!

Brand-new chart! What is Diabetes? UNDERSTANDING DIABETES Types of Diabetes

Type 1DiabetesMellitus (T1DM) Peoplewith T1DM do not produce insulin because their immune system (the body’s system for fighting infection)attacksanddestroys the insulin-producingbetacells in thepancreas, leaving littleorno insulin.Without insulin, sugarbuildsup in theblood instead ofbeing transferred to the cells. The cause of T1DM is not known but it is thought to be a combination of genetic and environmental factors (exposure to certain viruses).T1DM accounts for about 5% ofdiagnoseddiabetes in theUnited States. It can appear at any age, butdevelopsmost often in children andyoung adults. Type 2DiabetesMellitus (T2DM) iswhen thepancreasdoesnotproduce enough insulin, or the body cannotuse insulin properly (a condition called insulin resistance).T2DM is themost common formofdiabetesandgeneticsand environmental triggers mayplayapart in itsdevelopment.The following factorsplayan important role in causing highblood sugarand insulin resistance in individualsgeneticallyprone to type 2diabetes: • Beta cells in thepancreas slowly stopproducing insulin. • Alpha cells in thepancreasproduce toomuchofahormone calledglucagon that stimulates the liver tomake sugarwhich thebody can’tuse and it’s released into theblood. • The liver fails to store sugar as an energy source. • Thekidney overproducesglucose and INCREASES absorption ofglucose into theblood. • Low insulin levels cause the fat cells tobreakdown and release “free fatty acids” (FFAs).FFAs cause the liver tomakemore sugar, destroy the insulinproducingbeta cells in thepancreas andblock themuscles fromusingglucose for energy. • Muscle cells areunable to absorb anduseglucose for energy.Unusedglucose stays in theblood, increasing sugar levels. • Eating releaseshormones that tell thepancreas toproduce/release insulin,prevent the liver frommaking sugar, slow thepassage of food thru the stomach and send the brain amessage to “feel full”. In T2DM, these hormones are impaired resulting inweight gain and reduced insulin levels. • As onegainsweight, appetite is increased causingmoreweightgain and adding to insulin resistance.

Diabetesmellitusordiabetes isagroupofdiseases thataffect thebody’s cellsability to convertanduse sugar (glucose) from food for energy. The result is toomuch sugar (glucose) in the blood.Hyperglycemia (high blood sugar) candamageorgans suchas the eyes,kidneys,nerves,heartandbloodvessels, increasing riskof stroke andheart attacks. Patients with hypertension, high cholesterol, heart disease, a family history of diabetes, those who are overweight orHispanic orAfricanAmerican should be screened for diabetes beginning at age 45. Early diagnosis can slow theprogression of thedisease and lessen the risk of long term complications. Blood tests areused todiagnosediabetes.Alldiabetesblood tests involvedrawingblood and sending it to a lab for analysis.Yourhealth careprovidermayperform the following to test fordiabetes: •A1C blood test shows the average blood glucose levels over the past 3months, and is reported as a percentage, the higher the percentage, the higher your blood glucose levels have been.AnA1C test of greater than 6.5% is considered abnormal. •Fastingplasmaglucose test measuresbloodglucoseafter fasting forat least8hours.Fastingglucose levels above 126mg/dLare considered abnormal. • 2-HourOralGlucose test measuresbloodglucose levelsbefore and 2hours afterdrinking a special sweet liquid. 2-hourpostmealglucose levelsgreater than 200mg/dLare considered abnormal.

Brain

WhatHappens inDiabetes

Pre-diabetes iswhen the blood sugar level is higher than normal, but is still low enoughnot tobe considereddiabetes.92millionAmericanshaveprediabeteswhich isdefined ashaving fasting blood sugars levels of 100-125mg/dL, 2-hourpost meal blood sugars levels of 140-199mg/dL or anA1C of 5.7-6.4%. People withprediabetesareathigh risk for somediabetes related complications,

Pancreas

especially heart disease. Weight loss and exercise can reverse prediabetes. 11% of patients with prediabetes convert to clinical diabetes eachyear. Gestationaldiabetes isacondition thatwomencangetwhen they are pregnant. The exact cause is unknown but it is believed that pregnancy hormones make your cells more resistant to insulin resulting inhighblood sugar.Gestationaldiabetesusually disappears after thebaby isborn,butwomenwhohavehad it are athigher risk ofdevelopingT2DM later.

Lung

1 2

Food isbrokendown intoglucose.Glucose is a form of sugar in theblood and is the main source of energy for thebody. Glucoseneeds thehelp of ahormone called insulin to enter the cells. Ahormone is a chemical substancemade inonepartof thebodywhich travels to otherpartsof thebody tohelp cells andorgansdo their jobs. Insulin ismadeby special cells in

Heart

Symptoms ofDiabetes

Patients with type 1 diabetes usually report rapidly developing symptoms.With type 2 diabetes, symptoms usually develop gradually andmaynot appearuntilmanyyears after the onset of thedisease. •Weight loss evenwhen eatingproperly •Frequenturination

3

Liver

thepancreas calledbeta cells. Insulinmakes itpossible for glucose toenter the cells.The insulinopensadoor in the cell thatallowsglucose toenter. Indiabetes,yourpancreas doesn'tmake enough insulin, oryour cellsdon’t respond properly to the insulin produced,ora combination ofboth. Without thehelp of insulin, glucosebuildsup inyourblood

•Excessive thirst •Extremehunger •Fatigue

Kidney

4

Pancreas

•Blurredvision •Dry, itchy skin •More infections thanusual

Large intestine

Diabeticbeta cells Duringpre-diabetes,up to 80% of beta cell function is lost, insulin levelsdrop,glucose levels rise while fasting and after eating.

Normalbeta cells secrete insulinwhichdrives glucose intomuscle, liver and fat cellsmaintainingblood sugar levels in thenormal range

•Numbness in feet and/orhands • Slow-healing cuts or sores •No symptoms

5

Small intestine

causingyourblood sugar levels to rise.

Risk factors

Insulin

Type 2Diabetes andPrediabetes •Overweight or obesity •Physical inactivity/lack of exercise •Familyhistory ofdiabetes

Insulin frompancreas attaches to cell

Insulin cannot attach to cell

Glucose from food

•Certain racial and ethnicgroups (African Americans,Hispanic/LatinoAmericans,Asian Americans,Pacific Islanders,NativeAmericans andAlaskaNatives) •Older age –but onset is increasingdramatically among children,adolescentsandyoungeradults •History ofgestationaldiabetes ordelivery of ababyweighing 9pounds ormore atbirth •Highbloodpressure, lowHDL (good) cholesterol and/orhigh triglyceride levels •Polycysticovary syndrome Type 1Diabetes •Parent or siblingwhohasT1DM •Environmental factors (exposure toavirusor toxin) •Race –T1DM ismore common inwhites than in other races •Geography - certain countries, such asFinland and Sweden,havehigher rates ofT1DM Diabetes inYouth

Cell "door" is opened allowingglucose (sugar) to enter the cell

Glucosemoves into theblood

Celldoor is closed, glucose isnot able to enter andmoves into theblood

Glucose converted to energy

Energy-deprived cell

Insulin attaches to cell and opens a "door" allowing glucose to enter

Redblood cells

Increasedblood sugar (glucose) level

Diabetes isoneof themost common chronicdiseases in children and adolescents.About 1 in 400 people younger than 20 years have type 1 or type 2 diabetes.Although type 1 diabetes ismore prevalentamongchildrennationwide, type2diabetes isbecomingmore common inU.S.kidsand teens,especially if theyareoverweight.There is noknownway toprevent type1diabetes,but, expertsagree thathealthy eatingandanactive lifestyle canhelp toprevent type2diabetes inyouth. DiabetesManagement Peoplewith type 1 diabetes require insulin tomanage their diabetes. Insulinpensand insulinpumpsare safe, effectiveandaccurateways to take insulin.Treatment for type 1diabetes is a lifelong commitment to blood sugarmonitoring, taking insulin, healthy eating, exercise and regularvisits toyourhealth careprovider. Type 2Diabetesmaybe treatedwith avarietyofdifferent anti-diabetic medications determined by blood sugar levels and symptoms. Patientsmay also be prescribedmedicine to control cholesterol and bloodpressure. Peoplewithdiabetes canprevent ordelayproblems by keeping blood sugar levels as close tonormal aspossible,keepingbloodpressure and cholesterol under control and by getting regular medical care. Although diabetes is a common disease, every individual needs personalized care.Consultingwithadiabeteshealthcare teamwillhelp you tomaintain the correct balance betweenmedication, blood sugar monitoring,diet, and exercise.

NormalBodyCell

DiabeticBodyCell

Insulin acts as a “key” to open adoor in the cell that lets glucose enter,where itwillbe converted to energy.

Cellsdevelop a resistance to insulin, the insulindoesnotwork correctly ornot enough insulin ismadeby thepancreas.Cellsdonot get the fuel theyneed for energy and sugarbuildsup in theblood.

5 Tips for Successful Diabetes Self-Management

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2

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5

Knowyourmetabolic targets:blood sugar levels (A1C),bloodpressure, and cholesterol.

Practice living ahealthy lifestyle: exercise, lose weight ifoverweight, and makehealthy food choices.

Takeyourmedication asprescribed.

Followup frequently withhealth careproviders who areknowledgeable aboutdiabetes.

Stop smoking.

Developed in consultationwith JeffUngerMD,ABFM,FACE. © 2015

A.

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