CONCEPT OF NON-COMMUNICABLE DISEASES

6 out of 10

How many out of 10 deaths are brought by non-communicable diseases (NCDs)?

Ischaemic heart disease

What is the leading NCD among the top 10 causes of mortality?

Neoplasms (Cancer), Cerebrovascular diseases (Stroke), Diabetes Mellitus, Hypertension, Genitourinary system diseases.

List 5 major examples of NCDs (other than heart disease).

What are Non-Communicable Diseases (NCDs)?

• They are Chronic (long-duration) diseases.

• Characterized by low progression of illness, but long-lasting manifestations.

• Also known as "Lifestyle-Related Diseases”

• Non-modifiable Factors: Family history, age, etc.

• Modifiable Factors: Lifestyle practices, etc.

The probable causes of NCDs are exposure to risk factors. What are the two types of risk factors?

Lifestyle, Hereditary, Environmental

What are the three main categories of causes for Non-Communicable Diseases (NCDs)?

1. Smoking Tobacco

2. Alcohol Abuse

3. Unhealthy Diet

4. High-fat consumption

5. Excessive salt/sugar intake

6. Physical Inactivity (Sedentary Lifestyle)

What are 6 modifiable lifestyle risk factors for NCDs?

Hereditary

• Genetic factors passed from parents to children.

• They are non-modifiable in nature.

Diabetes Mellitus

A group of disorders characterized by abnormalities in carbohydrate, protein, and fat metabolism, typically involving high blood sugar (hyperglycemia) due to insulin resistance or insufficient insulin production.

What causes the metabolic dysfunction in Diabetes Mellitus?

Problems arise when substances (like insulin) that allow cells to process macromolecules (carbs, fats, proteins) are not released properly, causing the body to resist these nutrients.

Define Metabolism in the context of energy production.

The process your body uses to get or make/convert energy from the food you eat.

Catabolism

The process of breaking down food into smaller substances.

Anabolism

The process of producing energy (or building up) from the food you eat, typically through mitochondria.

Why must glucose be directed to the cells after digestion?

For metabolism: to undergo anabolism and provide energy to the body.

Metabolic Disorder

A collective term for a group of syndromes that disrupt the normal metabolic processes in the body.

An 8-hour fasting blood glucose level of 126 mg/dL or higher.

What is the diagnostic criteria for Diabetes Mellitus via blood sampling?

Type 1 Diabetes (IDDM - Insulin Dependent)
Type 2 Diabetes (NIDDM - Non-Insulin Dependent)

What are the two main types of Diabetes Mellitus?

Insulin Deficient

What is the primary characteristic of Type 1 Diabetes (IDDM)?

The pancreas has impaired insulin production, requiring patients to inject insulin to utilize glucose.

Insulin Insufficient

What is the primary characteristic of Type 2 Diabetes (NIDDM)?
The body does not use insulin properly (insulin resistance), and it is often managed without immediate insulin dependence.

• Genetic/Familial

• Juvenile onset (appears early in life)

• Environmental factors

• Viruses and chemical toxins

How is Type 1 Diabetes (IDDM) acquired/onset?

• Family history

• Overweight/Obesity

• Sedentary lifestyle

• Hypertension (high blood pressure)

What are the main risk factors for acquiring Type 2 Diabetes (NIDDM)?

Because their pancreas has impaired production of insulin (Insulin Deficient).

Why do IDDM patients need insulin injections?

Diabetes, hypertension, and kidney diseases can affect one another.

How is Type 2 Diabetes (NIDDM) linked to other diseases?

History of gestational diabetes or delivering a baby weighing >9 lbs.

What history puts a patient at risk for Type 2 Diabetes?

HDL (good cholesterol) < 35 mg/dL (< 0.90 mmol/L) and Triglycerides > 250 mg/dL (> 2.82 mmol/L).

What are the characteristic laboratory values for Type 2 Diabetes (lipids)?

A combination of lifestyle changes (diet/exercise), oral hypoglycemic medications (e.g., Metformin), and sometimes insulin shots to maintain normal blood glucose.

What is the treatment for Type 2 Diabetes?

HDL (High Density Lipoprotein), LDL (Low Density Lipoprotein), VLDL (Very Low Density Lipoprotein)

What are the 3 kinds of cholesterol?

VLDL (Very Low Density Lipoprotein)

Which type of cholesterol is the "worst form" that can become plaque?

Glucose

Acts as a source of energy needed for everyday activities and cellular function.

Insulin

A hormone that promotes the utilization of glucose by cells. It allows glucose to move out of the bloodstream and into the cells.

What occurs during Type 2 Diabetes regarding insulin?

Insulin resistance occurs, meaning the body cannot use insulin effectively, and the pancreas may not produce enough, preventing glucose from entering cells.

Hyperglycemia

• It is the high accumulation of glucose in the bloodstream, caused when glucose cannot enter the cells.

• No substance counteracts the increase, and blood may turn viscous (thick), hindering transport.

Beta cells located in the islets of Langerhans

Which cells in the pancreas are responsible for producing insulin?

They cannot produce sufficient insulin, leading to impaired blood sugar management.

What happens when cells surrounding the blood capillaries in the pancreas become dysfunctional?

Alpha cells

In the pancreas, this produces glucagon, which enables the utilization of sugar in the liver and manages its increase.

Viscous (thick)

In Type 2 Diabetes, high blood sugar leads to blood becoming ______, making it hard to transport.

• Insulin: Increases (to store glucose).

• Glucagon: Decreases (to stop liver glucose production).

What happens to insulin and glucagon levels after eating a high-carb meal?

• Insulin: Lowers blood sugar (after eating).

• Glucagon: Raises blood sugar (when hungry).

• They work in opposition to maintain homeostasis.

What is the fundamental difference between the functions of Insulin and Glucagon?

Gestational Diabetes Mellitus (GDM)

A type of diabetes mellitus characterized by high blood glucose levels, first found during pregnancy.

It is generally caused by pregnancy hormones reducing insulin effectiveness and usually goes away after childbirth

How do pregnancy hormones cause Gestational Diabetes?

Pregnancy hormones can alter the activity of the pancreas, leading to insulin resistance (insulin not working effectively).

Increased risk of developing Type 2 Diabetes later in life.

What is the long-term risk for a mother who has experienced Gestational Diabetes?

High blood glucose in the mother passes to the baby, causing the baby to bear more weight (higher birth weight/macrosomia).

How does Maternal Gestational Diabetes affect the fetus?

Why is there not enough insulin in Gestational Diabetes?

Increased circulation demands (maternal + fetal/placental) increase the workload on the body, making existing insulin ineffective.

Maternal Circulation during pregnancy

The circulation within the mother’s body, including her placenta.

Fetal Circulation during pregnancy

The circulation within the developing fetus, including the umbilical cord, placenta, and fetal blood vessels.

Increased workload for maternal/fetal circulation, leading to high glucose demands.

What causes inadequate insulin coverage in Gestational Diabetes?

Annual doctor visits to monitor for type 2 diabetes.

What is the recommended long-term follow-up for a mother with gestational diabetes to ensure prevention?

False. They are separate systems; the placenta acts as a membrane for exchange.

True or False: Maternal and fetal blood mix directly within the placenta.

Polyuria, Polydipsia, Polyphagia

What are the four "Classic Signs" of Diabetes Mellitus?

Polyuria

Excessive urination (often due to osmotic diuresis from high blood sugar).

Polydipsia

Excessive thirst (due to dehydration from polyuria).

Polyphagia

Excessive hunger (cells are starving, as glucose cannot enter them).

Fasting Blood Sugar (FBS) Test

• Time: 8 hours of fasting (last meal is dinner previous night).

• Results:

  • Normal: <100 mg/dL

  • Prediabetes: 100-125 mg/dL

• Diabetes: >=126 mg/dL

Oral Glucose Tolerance Test (OGTT)

• Procedure: 75 grams of glucose dissolved in water; blood tested 2 hours later.

• Medical Advice: No food/drinks 8-12 hours prior.

• Results:

  • Normal: <140 mg/dL

  • Prediabetes: 141-199 mg/dL

  • Diabetes: >=200 mg/dL

Random/Casual Blood Sugar Test

• Usage: Most utilized daily method.

• Procedure: Finger prick with a lancet, blood placed on a test strip, analyzed by a Glucometer.

• Medical Advice: Fasting is still required.

• Normal Range: 70-125 mg/dL

Log books (for recording daily results from a glucometer).

How can a patient track daily blood sugar levels?

1. Maintain healthy weight/prevent obesity.

2. Encourage proper nutrition.

3. Promote regular physical activity/exercise.

4. Smoking cessation & avoid secondhand smoke.

What are the 4 key areas for the prevention and control of Diabetes Mellitus?

Cardiovascular Diseases

A group of disorders affecting the heart and blood vessels, characterized by a dysfunction of the heart and blood vessels.

Arteries

Carries oxygenated (oxygen-rich) blood from the heart to the systems/circulation.

Veins

Carries deoxygenated (oxygen-poor) blood back to the heart from the body/systems.

Hypertension, Coronary Artery Disease, Cerebrovascular Disease (Stroke)

Name 3 common types of Cardiovascular Disease

Hypertension (“high blood”)

A Cardiovascular Disease that refers to the sustained elevation of blood pressure, damaging blood vessels.

Cerebrovascular Disease

A disease involving the blood vessels supplying the brain, often resulting in a stroke.

Due to a compensatory mechanism responding to the insufficiency of blood/oxygen received by the body.

Why does the heart work harder during hypertension?

Mean Arterial Pressure

It determines the average pressure of arteries in one (1) cardiac cycle.

• Systolic: >= 140 mmHg

• Diastolic: >= 90 mmHg

What are the diagnostic criteria for Hypertension (sustained)?

Systolic (Numerator)

Pressure when the heart is beating/contracting (maximum pressure).

Diastolic (Denominator)

Pressure in arteries between beats (minimum pressure/ventricles relaxed).

Diastolic Blood Pressure

Which blood pressure reading is given more emphasis when diagnosing hypertension?

• Diagnosis focus: Diastolic

• Best time to check: Morning (body relaxed)

• Systolic: Max pressure, contraction.

• Diastolic: Min pressure, relaxation.

• Diagnosis focus: ?

• Best time to check: ?

1. Primary (Essential/Idiopathic) Hypertension

2. Secondary Hypertension

What are the two main classifications of Hypertension?

Primary (Essential/Idiopathic) Hypertension

• High blood pressure with no single identifiable cause.

• Develops gradually over time.

• Most common classification.

• Possible Mechanism: Decreased release of blood in circulation.

Secondary Hypertension

• High blood pressure brought about by other underlying diseases.

• Affects kidneys, arteries, heart, or endocrine system.

• Primary: No specific, known cause (idiopathic).

• Secondary: Caused by a specific, known underlying condition.

Primary Hypertension vs. Secondary Hypertension: How do they differ in origin?

Coronary Artery Disease (CAD)

• Definition: A heart disease caused by impaired blood flow due to the blockage/narrowing of coronary arteries.

• Also known as: Ischemic Heart Disease.

• Impact: Reduces the heart's ability to send blood to the rest of the body.

• Role: Acts as a trigger for other cardiovascular diseases.

1. Ischemia

2. Infarction

3. Necrosis

What are the 3 chronological stages of Coronary Artery Disease?

The blockage and narrowing of major blood vessels (coronary arteries).

What causes the impaired blood flow in Ischemic Heart Disease?

Narrowing

Coronary Artery Disease (or Ischemic Heart Disease) causes impairment of blood flow, leading to the blockage and _______ of coronary arteries.

Ischemia

An insufficiency of blood flow to a specific organ or tissue, resulting in a shortage of oxygen and nutrients.

Infarction

Loss of function in an organ or tissue due to a lack of blood supply (e.g., Myocardial Infarction/Heart Attack in CAD).

Necrosis

The irreversible death of organs and tissue.

Occlusion

A block in the vessel, making it difficult for blood to pass.

Stenosis

A narrowing of the blood vessel diameter, making it difficult for blood to pass.

Plaque

Hardened fats that stay inside the blood vessel, causing blockages or narrowing.

Atherosclerosis

Buildup of plaque due to high cholesterol (VLDL).

Arteriosclerosis

General term for the narrowing and loss of elasticity of medium/large arteries (occurs with age).

Atherosclerosis

What is the underlying cause of Coronary Artery Disease (CAD)?

Coronary Artery Disease (CAD), which can lead to Myocardial Infarction (Heart Attack).

What is the result of atherosclerosis in coronary arteries?

1. Ischemia: Insufficient blood/oxygen.

2. Infarction: Loss of function due to low blood supply.

3. Necrosis: Irreversible tissue death.

Progression of Tissue Damage (Sequence)

Angina Pectoris; Dyspnea.

Heart attack warning signs: Pain in the left chest is known as __________, while shortness of breath is medically termed __________.

Chest (left side), Jaw, Neck, and Back

Which specific body areas might hurt during an impending heart attack?

Stroke (Cerebrovascular Disease)

A loss or alteration of bodily function caused by an insufficient supply of blood to parts of the brain.

Brain tissue dies due to lack of oxygen, causing the brain to lose command of the body

Paralysis

What is the main consequence and classification of stroke?

1. Thrombotic Stroke

2. Embolic Stroke

3. Hemorrhagic Stroke

What are the three main types of stroke?

Thrombotic

Artery is clogged/blocked by a clot (thrombus) formed within the brain.

Embolic

A clot travels from elsewhere in the body to the brain.