Professor / Consultant Physician & Endocrinologist, College of Medicine, University of Lagos (CMUL), Chief Clinical Coordinator, NSIA-LUTH Cancer Centre.
Most oral agents used in the treatment of diabetes function either by encouraging production of Insulin or by enhancing its action on peripheral organs and tissues. A grasp of the nature and mode of action of this important peptide hormone is fundamental to our understanding of the aetiology and treatment of type 2 diabetes. In this final session of the Diabesity Masterclass, Dr Fasanmade discusses the central role and significance of Insulin in the management of type 2 diabetic patients. He considers important indications, advantages and potential pitfalls of new generation (oral) DPP-4 and SGLT2 inhibitors vis-s-vis treatment regimens based on “older”, established antidiabetic agents such as Metformin, Sulphonylureas and Thiazolidinedione’s (Glitazones). The session traces the care pathway of the typical patient and presents helpful evidence to support the use of various treatments in optimising care in elderly patients with co-morbid chronic conditions and co-existing cardiovascular disease.
This session focuses on criteria, tools and thresholds for making a diagnosis of diabetes in adult patients. It highlights important differences between type 1 and type 2 diabetes and examines the increasingly blurred distinctions between these conditions. The session considers intermediate variations, such as MODY and LADA and examines aetiological differences in comparison with the more established forms of the disease. The so-called “type 3 diabetes” provides an early introduction to the concept of insulin resistance and lays the foundation for the subsequent session on Alzheimer’s disease and mental health.
This session examines the combination of metabolic abnormalities arising from insulin resistance and adipose tissue dysregulation. It discusses the concept of “Diabesity” and evidence-based modalities for the treatment of type 2 diabetes in ageing and overweight patients. The session identifies risk factors contributing to the presentation of Metabolic Syndrome X and explores the condition’s causal relationship with coronary heart disease in general.