Tip:
Highlight text to annotate it
X
type 1 in general is a condition where
the body does not make enough insulin
and that's the primary mechanism that causes diabetes
and most of the time it happens to be an autoimmune disorder. Type two
diabetes
on the other hand is usually
a disease where there is a combination of factors playing a role
including something that we call insulin resistance where the body's not sensitive
to
its own insulin as well as
impairment in insulin production
and perhaps other things
that go along so it is a not as clean of
a disease in a way in terms of the mechanistics of it thats
there is more things that have to go wrong in type 2 diabetes I think in
general to
for people to develop type two diabetes yet is it it is the most common
type of diabetes. The more overweight people are or more obese people are
more likely is that they become and diabetic and that and
so we have plenty of data showing evidence that
obesity seems to be a predecessor to
Diabetes, type 2 diabetes Now having said that that probably doesn't apply to
everyone
because there's people who as type 2 diabetics that
are really not that overweight or not overweight at all. I think people inherit
the predisposition
to our immune diseases and some people are predisposed to them some people are
actually sort of protected from them so
relatives of people with type 1 diabetes
are more likely to develop type 1 diabetes
and the likelihood anywhere from
you know to 2 to 5 percent somewhere in that range
if you have a first degree relative. And for type
two diabetes it's stronger.
we know that if you have a have
close relative a first degree relative with type 2 diabetes the chance that you're going to
have diabetes are very high
we don't know exactly how but but we know that
people who have and low levels of
inflammation will and
will develop some
of the conditions that predispose people for type 2 diabetes
and at the cellular level at the body level at the physiology level
it changes their hormone production
through different mechanisms
it changes the
the predisposition to complications from diabetes as well
so it is a very important player
in the etiology and pathophysiology of
for type 2 diabetes
We have plenty of evidence and I think the CDC has a very nice
record
of the epidemiology of obesity
in the United States for the last twenty thirty years or so
and and it clearly shows that
obesity rates have skyrocketed and at the same time just behind that
diabetes, type two diabetes rates have increased
and by the way even type 1 diabetes type 1 diabetes rates have increased and
and there is
we don't exactly why but there is ways to
tie that to to obesity as well
just like asthma and other autoimmune diseases that
we're seeing now people with obesity sometimes all it takes is people
to gain
10 pounds in the wrong place you gain
May 10 pounds in the intra-abdominal area and you're susceptible to
to diabetes and obesity that may
through your set
off of a cascade of events where
people start making, becoming so insulin insensitive in response to that they
start making too much insulin
and for some tissues that insulin is not enough for some is too much
and in response to that then the metabolism changes and
the macro nutrient metabolism changes and
energy expenditure changes and
and appetite changes and and that may trigger
people to eat more in response to somebody's
changes and that that eating more than makes them more overweight then that
in turn makes that whole process in worse and becomes a vicious cycle
but in the type diabetic who we more commonly
can diagnosis in the pre diabetic stage
then I think it is very important that they change their lifestyle
and that they become more active that they change their eating habits
that they eat healthier stuff
and that's a tough one because we I don't think nobody really knows
what what is best diet out there so in general I think we just as people with
to eat
less, reduce portion sizes to to be moderate with the intake of
carbohydrates
and to to get more active
an exercise and just just kinda common sense type of things
we actually here at UAB are testing one of these
therapies, it happens to be a device as you know there's
been a lot we have learned about the effects of gastric bypass surgery
and bariatric surgery in general for treatment of obesity and weight
for weight loss and effects that it has on diabetes
and so there is a company that has developed
a device that can be
placed in endoscopically into the stomach
and first part the the small bowel
a and it's basically it's very a simple device
very clever it's a little bit of a liner
that does not allow food
to get in touch with the or absorb for the first few
first portion of the small bowel and
and it basically mics functionally what gastric bypass surgery does
and it works really well that were where
participated in a multi-center study the first one in the US
and were seeing we're actually enrolling quite well we're seeing very nice results
now it's a blinded study so I can't tell you for sure
but in general people are doing well
right now we have most people with diabetes whether it's type one or type two
can have very normal lives
in terms of life span and
and free for the most part of complications, now there are still a few things that we
got to work on that
and and that implies that they have to
get treated aggressively intensively and and follow directions and all that
stuff
but if they do that that I think they can lead very normal
long lives like anybody else