dr. auriela szekelyobezitatea si diabetul zaharat în sindromul prader willi english

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Dr. Székely Aurelia

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  • 8/8/2019 Dr. Auriela SzekelyObezitatea si diabetul zaharat n Sindromul Prader Willi english

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    Dr. Szkely Aurelia

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    Obesity

    yIs a defining characteristic of PraderWilli Syndrome (PWS)

    y

    An important clue for the suspicion ofdiagnoses

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    Obesity

    y Body weight exceeds ideal weight by 20%

    y BMI - weight (kg) / height 2 (m2)y Normal: 19-25

    y Overweight: 25-30

    y ObesityI: 30-35

    y ObesityII: 35-40

    y Severe obesity (morbid): 40

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    Venus of Willendorf

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    Rubens The Three Graces

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    Picasso The Young Ladies of Avignon

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    Twiggy

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    Oana

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    Complicationsy Cardio-pulmonary deficiencies

    y Diabetes mellitus type II

    y Thrombophlebitis

    y Chronic Edema

    y

    Hernias

    y Eczema

    yArthrosis

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    In PWSy The essence of care for patients with PWS = fight against

    obesity

    y The main cause of obesity in PWS = hyperphagia

    y Adjusting the sensation of hunger - the hypothalamusy Feedbacks :

    Blood glucose

    Fats

    Leptin

    Cholecystokinin PYY

    Serotonin

    Endorphins

    etc..

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    In PWSy Decreases the sensitivity of the hypothalamus to

    regulating substances

    In obesity

    y I

    t is

    a deficit of leptin and melanocortin

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    Other mechanisms of obesity in PWS

    yMuscle hypotonia

    yPsychological structure

    yA possible hypothyroidism orhypogonadism

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    Treatment with growth hormone

    yHelps to normalize weight

    y Increases muscle mass

    yReduces the risk of diabetes

    y I

    ncreas

    es

    immunores

    is

    tance

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    In the fight for normal weight participate

    yThe patient

    yThe family

    yThe medical component

    yT

    hes

    ocial component

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    Obesity is realized only by excessivefood intake.

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    Energetic imbalance...... from positive has to be changed to negative by:

    1. Lifestyle

    2. Diety Doctor

    y Nutritionist

    y Support groups

    y

    Documentation provided by patient organizations

    3. Monitoring access to food

    4. Physical activity

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    Physical activity

    y Free physical activities - 1 hour per day, 5-6 times a

    week, regularly:y Walk

    y Bicycle

    y Swimming

    y

    Gamesy In specialized institutions

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    Speed of weight loss

    y 0,5 0,6 kg per week

    y 1 2 kg per month

    Preventing obesity, weight loss of obese patientswith PWS ensure a better quality of life and

    prevents complications.

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    Diabetes mellitus type IIy Is not the consequence of PWS

    y It is the complication of obesity in PWS

    Signs of developing diabetes mellitus

    yWeakening

    y

    Polydips

    iay Polyuria

    y Low energy

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    Diagnosis of diabetes mellitus

    y Hyperglycemia

    y Glycosuria

    Altered metabolism of lipids and proteins.

    Result: degenerative damage of large and smallarteries.

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    Complications

    y Ischemic cardiomyopathy

    yAtherosclerosis

    y Obliterative arteriopathy

    y Nephropathy

    y Retinopathy

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    Causes of decompensations

    y Not respecting the diet

    y Discontinuation of medicationy Excessive physical effort

    y Exhaustion, psychical stress

    y Surgeryy Infections

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    Treatment of diabetes mellitusy Diet planned by the DOCTOR

    y Number of Kcal

    yMeal composition

    y Schedule of the meals

    y Exercise

    y Body hygiene

    y Wounds

    y Teeth

    y Foot hygiene

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    Treatment of diabetes mellitus

    yMedications

    y To be initiated only in hospitalsy Antidiabetic tablets

    y Insulin Injections

    y Lifelong duration

    y Hydro-mineral therapy

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    Conclusion

    With early diagnosis, by uniting all forces andresources that are available to care for people with

    PWS, morbid obesity can be prevented, can bereduced and this way diabetes mellitus and its

    complications can be avoided.

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    I wish you success in this fight!