C) MARCO CONCEPTUAL SOBRE EL PROCEDIMIENTO DE MEDIACIÓN AMBIENTAL
6.12 Desarrollo del “Programa de Encuentros de Comunicación sobre el Anillo Ferroviario de
6.12.2 La Agenda de Actos Participativos (AAP)
Written by: Catharine Paddock PhD
Part of Article Retrieved from: http://www.medicalnewstoday.com/articles/222766.php
Type 2 diabetes is in the process of being redefined as an autoimmune disease rather than just a metabolic disorder, said an author of a new study published in Nature Medicine this week, the findings of which may lead to new diabetes treatments that target the immune system instead of trying to control blood sugar.
As part of the study the researchers showed that an antibody called anti-CD20, which targets and eliminates mature B cells in the immune system, stopped diabetes type 2 developing in lab mice prone to develop the disease, and restored their blood sugar level to normal.
Anti-CD20, available in the US under the trade names Rituxan and MabThera, is already approved as a treatment for some autoimmune diseases and blood cancers in humans, but more research is needed to see if it will work against diabetes in humans.
The researchers believe that insulin resistance, the hallmark of type 2 diabetes (unlike type 1 diabetes where it is the insulin-producing cells that are destroyed), is the result of B cells and other immune cells attacking the body's own tissues.
Co-first author Daniel Winer, now an endocrine pathologist at the University Health Network of the University of Toronto in Ontario, Canada, started working on the study as a postdoctoral scholar at Stanford University School of Medicine in California, USA. He told the press that: "We are in the process of redefining one of the most common diseases in America as an autoimmune disease, rather than a purely metabolic disease."
"This work will change the way people think about obesity, and will likely impact medicine for years to come as physicians begin to switch their focus to immune-modulating treatments for type-2 diabetes," he added.
The discovery brings type 2 diabetes, until now considered to be more of a metabolic disease, closer to type 1 diabetes, where the immune systems attacks and destroys the insulin-producing cells in the pancreas.
Type 2 diabetes occurs when the tissues of the body gradually become more and more resistant to insulin, the hormone that mops up dietary glucose and transports it to cells to convert into energy.
We don't know what causes the tissues to become resistant to insulin in type 2 diabetes, but we know it is linked to obesity and often runs in families.
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Type 2 Diabetes Article Analysis Questions
1. According to the article, what was type 2 diabetes considered as?
2. What does new research show that type 2 diabetes could be considered as?
3. Explain how the study showed this link.
4. Why is this research finding important?
5. Explain what happens in type 1 and type 2 diabetes.
6. What is type 2 diabetes still linked to?
Use the following website to answer questions 7 & 8:
http://www.mayoclinic.org/diseases-conditions/diabetes/basics/causes/CON20033091
7. What are the causes of Type 1 and Type 2 Diabetes?
Type 1 - Type 2 –
8. What are the symptoms of Type 1 and Type 2 Diabetes?
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CASE STUDY 1
PART ONE
Patient Information:
Patient name: Claire Age: 40
Current symptoms: Frequent urination,
increased thirst, extreme fatigue
Blood pressure: 120/75 Pulse: 75
Weight: 170 lbs. Height: 5’5”
BMI: _____ BMI Classification: ______ PART TWO
Claire’s Responses and Patient History: Family History
Mom – Multiple Sclerosis, Psoriasis Dad – Diabetes
Medications None Patient Responses
1. Do you have any other symptoms?
No, I don’t think so.
2. Do you have pain when urinating?
No.
3. How much water are you consuming daily? About 15 eight ounce
glasses.
4. How many times a day are you urinating? 20. At night? 3.
5. Does your urine have a distinct smell? Yes.
6. Have you noticed that your breath smells different? Not sure. Physician Orders the Following Tests
Glucose Blood Test (fasting) Urinalysis
A1C Blood Test
Oral Glucose Tolerance Test
CASE STUDY 2
PART ONE
Patient Information:
Patient name: Karen Age: 35
Current symptoms: Frequent urination,
fatigue
Blood pressure: 130/85 Pulse: 69
Weight: 160 lbs. Height: 5’9”
BMI: _____ BMI Classification: ______ PART TWO
Karen’s Responses and Patient History: Family History
Mom – Interstitial Cystitis Dad – Diabetes
Medications None Patient Responses
1. Do you have any other symptoms?
No, I don’t think so.
2. Do you have pain when urinating?
Yes.
3. How much water are you consuming
daily? About 8 eight ounce glasses. 4. How many times a day are you
urinating? 15. At night? 2. 5. Does your urine have a distinct
smell? Yes.
6. Have you noticed that your breath smells different? Not sure.
Physician Orders the Following Tests Glucose Blood Test (fasting) Urinalysis
A1C Blood Test
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CASE STUDY 1 & 2 COMPARATIVE ANALYSIS
1. Before moving on to Part 3, circle or highlight differences between the case studies. 2. Could these slight differences lead to two different diagnoses? Why?
3. Do you expect differences in test results? If so explain.
4. What was the most important difference between the two case studies?
CASE STUDY 1: PART THREE
Claire’s Test Results:
URINALYSIS
TEST RESULT NORMAL RANGE
Glucose Positive (present) Negative (not present)
Protein 5 0 – 30
Leukocyte Screen Negative Negative
Hemoglobin Screen Negative Negative
White Blood Cells 0 0 - 9
Red Blood Cells 0 0 - 4
Granular Casts 0 0
Hyaline Casts 0 0
Specific Gravity 1.015 1.003 – 1.035
Creatinine 69 27 - 260
OGTT
TEST RESULT LOW/HIGH
Glucose (fasting) 215 HIGH
Glucose (2 hours after consuming 75 grams of glucose dissolved in water)
300 HIGH
FBGT
TEST RESULT LOW/HIGH
Glucose (fasting) 200 HIGH
A1C
TEST RESULT LOW/HIGH
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CASE STUDY 2: PART THREE
Karen’s Test Results:
URINALYSIS
TEST RESULT NORMAL RANGE
Glucose Negative Negative (not present)
Protein 5 0 – 30
Leukocyte Screen Positive Negative
Hemoglobin Screen Negative Negative
White Blood Cells 20 0 - 9
Red Blood Cells 3 0 - 4
Granular Casts 0 0
Hyaline Casts 0 0
Specific Gravity 1.020 1.003 – 1.035
Creatinine 130 27 - 260
OGTT
TEST RESULT LOW/HIGH
Glucose (fasting) 90
Glucose (2 hours after consuming 75 grams of glucose dissolved in water)
100
FBGT
TEST RESULT LOW/HIGH
Glucose (fasting) 90
A1C
TEST RESULT LOW/HIGH
A1C 6.0
5. Circle or highlight differences in test results.
6. What is the probable diagnosis for case study 2? (Use the following websites to help you: https://labtestsonline.org/ and http://www.nhlbi.nih.gov/)
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