Topic 1.0 Physiology and Pathophysiology of Diabetes

Topic 1.0 Physiology and Pathophysiology of Diabetes

1. Normal physiology of glucose metabolism (Online Lecture 1 hour) Assoc Professor Dr Gnanajothy Ponnudurai
2. Pathophysiology of diabetes mellitus (Online Lecture 1 hour) Dr Moe Thida Kway
3. Epidemiology and types of diabetes mellitus  (Online Lecture 1 hour) Prof Dato Dr Mafauzy Mohamed (Guest lecturer)
4. Diagnosis of diabetes mellitus and laboratory investigations for diabetes (Online Lecture 1 hour) Prof Dato Dr Mafauzy Mohamed (Guest lecturer)
5. Guided reading (3 hours)
6. Online MCQ quiz (1 hour)

Topic 1.1 Normal physiology of glucose metabolism

(Asynchronous online lecture - 1 hour)

Learning Outcomes

At the end of this lesson, you should be able to:

• Discuss the structure and function of key organs, such as the pancreas, liver, muscle, adipose tissue, and kidney
• Discuss the basic physiology of digestion, absorption and metabolism of glucose
• Discuss the relationship between blood glucose and insulin in healthy people including gluconeogenesis, glycogenolysis, lipolysis and ketogenesis
• Discuss normal insulin synthesis and secretion
• Understand the hormonal, metabolic and neural control of insulin production and secretion
• Discuss insulin action
• Discuss the role of insulin receptors
• Discuss the effect of insulin and counter-regulatory hormones on fuel homeostasis (carbohydrate, fat and protein)

Learning Materials

Topic 1.2 Pathophysiology of Diabetes Mellitus

(Asynchronous online lecture - 1 hour)

Learning Outcomes

At the end of this lesson, you should be able to:

• Discuss the natural history of diabetes, including primary and secondary failure of oral blood glucose-lowering agents
• Discuss the results of insulin deficiency and its effects on carbohydrate, lipid and protein metabolism
• Discuss how increased blood glucose levels lead to diabetes complications, including the polyol pathway, oxidative stress, glycation and protein kinase C
• Discuss the effect of defective insulin action or ‘insensitivity to insulin’ (also known as ‘insulin resistance’) in terms of genes, adiposity, gender, diet, exercise, hyperglycaemia, drugs and infection
• Discuss the characteristics of the metabolic syndrome and the importance of its being recognised and treated

Learning Materials

Topic 1.3  Epidemiology and types of Diabetes Mellitus

(Asynchronous online lecture - 1 hour)

Learning Outcomes

At the end of this lesson, you should be able to:

• Define diabetes mellitus
• Discuss the incidence and prevalence of diabetes in Malaysia and globally
• Differentiate between the disorders of glycaemia: impaired glucose tolerance and impaired fasting glucose, type 1 diabetes, type 2 diabetes, other specific types of diabetes (such as MODY, LADA, steroid-induced diabetes), gestational diabetes, diabetes that occurs secondary to other chronic diseases in childhood – such as cystic fibrosis, haemoglobinopathies
• Discuss the differences between type 1 diabetes and type 2 diabetes in terms of clinical presentation, patient characteristics, and pathogenesis
• Discuss the roles of genetic, environmental factors and immunology in the development of type 1 diabetes
• Discuss the role of genetic and environmental factors, obesity, insensitivity to insulin, and insulin deficiency in the development of type 2 diabetes
• Discuss the emerging trend of type 2 diabetes in young people
  

Learning Materials

Topic 1.4  Diagnosis of diabetes mellitus and laboratory investigations for diabetes 

(Asynchronous online lecture - 1 hour)

Learning Outcomes

At the end of this lesson, you should be able to:

• Discuss the screening for diabetes mellitus
• Discuss the clinical presentations for different types of diabetes
• Discuss the atypical presentation of diabetes symptoms
• Discuss the laboratory investigations used for different types of diabetes
• Discuss the diagnostic criteria for diabetes mellitus and different disorders of glycaemia
• Identify the laboratory investigations used to diagnose diabetes and their appropriate use (fasting blood glucose, post-meal blood glucose, oral glucose tolerance test)
• Discuss the appropriate use of the following tests: c-peptide, insulin antibodies, islet cell antibodies and GAD antibodies assays, as well as urinalysis (urine glucose and ketones) and HbA1c estimation
• Discuss factors that can affect the accuracy of laboratory investigations
  

Learning Materials

Physiology and pathophysiology of Diabetes Mellitus

(Guided Reading - 3 hours)

Learning Outcomes

At the end of this lesson, you should be able to:

• Determine and deduct the physiology and pathophysiology of diabetes mellitus and various disorders of glycaemia
• Interpret and justify the use of appropriate laboratory investigations to screen and diagnose diabetes mellitus and various disorders of

Learning Materials

Physiology and pathophysiology of Diabetes Mellitus

(Quiz - 1 hour)

Learning Activities