Transcript Got Insulin? Understanding and Managing Type 1 Diabetes

Got Insulin?
Understanding and
Managing Type 1 Diabetes Mellitus
Jason F. Lopez
Whitney M. Young Magnet High School, CPS
Ali Cinar, Ph.D.
Research Mentor – Illinois Institute of Technology
This material is based upon work supported by the National Science Foundation under
grant No. EEC-0502174. Any opinions, findings, and conclusions or recommendations
expressed in this material are those of the author(s) and do not necessarily reflect the
views of the National Science Foundation.
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Educational Module Overview
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Subject: Regular and honors biology.
Target audience: 9th grade high school students (activities
may be adapted for younger or older students).
Time requirement: 2-4 weeks depending on the number of
activities chosen and length of classes (educational module
was developed for 50 minute periods).
Pre and post assessment questionnaires, matrices, and scoring
rubrics.
10 total activities within the module—three of which can be
considered optional—complete with instructional objectives
and applications.
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Focus of Educational Module
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Content: (1) Type 1 Diabetes Mellitus; (2) Type 2
Diabetes Mellitus; (3) GlucoSim – online blood
glucose simulator; (4) Food Tables – online
nutritional guide; (5) carbohydrate digestion; (6) pH;
and (7) chemical regulation.
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Scientific Inquiry: An inductive, inquiry-based
teaching approach should be adhered to during the
implementation of the educational module. Scientific
inquiry will also be used to measure instructional
outcomes (i.e. student performance and knowledge).
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Focus of Educational Module
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Design: Activities in the educational module will
introduce students to the engineering design process –
how engineers solve problems.
 Students
will design an original laboratory investigation.
 Students will design an original treatment plan for a person
with Type 1 Diabetes Mellitus.
 Students will design a personal “wellness plan” depending
on their own individual eating and exercise habits.
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Focus of Educational Module
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Ethics: Professional ethics issues pertaining to the
involvement of science and/or engineering in
Diabetes Mellitus can be discussed throughout the
educational module as appropriate.
 Disposal
of potentially hazardous chemical and the
environment.
 Health and safety related issues.
 Pharmaceutical testing on laboratory animals.
 Cure vs. maintenance of Diabetes Mellitus.
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Educational Module Goals
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Students will appreciate how scientists from different
disciplines (i.e. biology and engineering) can combine their
knowledge to help solve real world problems.
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Students will continue to develop the skills that encompass
scientific inquiry (i.e. analyzing, measuring, observing,
inferring, etc.) and the nature of scientific discovery,
knowledge, and processes.
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Students will explain the purpose of carbohydrate digestion
and the role the pancreas plays in maintaining glucose
homeostasis via the secretion of the hormone insulin.
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Educational Module Goals
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Students will develop an understanding of Type 1 Diabetes
Mellitus as well as what is involved in managing the disease.
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Students will appreciate the importance that diet and exercise
have on establishing overall well-being, maintaining good
health, and reducing the chances of developing Type 2
Diabetes Mellitus.
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Students will use state-of-the-art computer software to design
a nutritional and exercise regimen for a person who has Type 1
Diabetes Mellitus requiring multiple daily injections of insulin.
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Illinois State Learning Standards Addressed
(Early High School)
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11.A.4a: Formulate hypotheses referencing prior research and knowledge.
11.A.4c: Collect, organize and analyze data accurately and precisely.
11.A.4e: Formulate alternative hypotheses to explain unexpected results.
11.B.4c: Develop working visualizations of the proposed solutions design (e.g.
blueprints, schematics, flowcharts, cad-cam, animations).
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11.B.4e: Develop and test a prototype or simulation of the solution design
using available materials, instruments, and technology.
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12.A.4a: Explain how genetic combinations produce visible effects and
variations among physical features and cellular functions of organisms.
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12.A.4b: Describe the structures and organizations of cells and tissues that
underlie basic life functions including nutrition, respiration, cellular transport,
biosynthesis, and reproduction.
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Illinois State Learning Standards Addressed
(Early High School)
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13.A.4b: Assess the validity of scientific data by analyzing the results, sample
set, sample size, similar previous experimentations, possible misrepresentation
of data presented and potential sources of error.
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13.A.4d: Explain how peer review helps to assure the accurate use of data and
improves the scientific process.
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13.B.4b: Analyze a particular occupation to identify decisions that may be
influenced by a knowledge of science.
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National Benchmarks for Science Literacy
(AAAS Project 2061; 1993)
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Chapter 8 (Health Technology), Section F, Number 7
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Biotechnology has contributed to health improvement in many
ways, but its cost and application have led to a variety of
controversial social and ethical issues.
Chapter 1 (The Scientific Enterprise), Section C, Numbers 4-5
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Although each [science] discipline provides a conceptual structure
for organizing and pursuing knowledge, many problems are studied
by scientists using information and skills from many disciplines.
(Excerpt)
Current ethics in science hold that research involving human
subjects may be conducted only with the informed consent of the
subjects, even if this constraint limits some kinds of potentially
important research or influences the results. (Excerpt)
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National Benchmarks for Science Literacy
(AAAS Project 2061; 1993)
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Chapter 1 (The Scientific Enterprise), Section C, Numbers 5-8
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Acting in their areas of expertise, scientists can help people
understand the likely causes of events and estimate their possible
effects. (Excerpt)
The strongly held traditions of science, including its commitment to
peer review and publication, serve to keep the vast majority of
scientists well within the bounds of ethical professional behavior.
(Excerpt)
Funding influences the direction of science by virtue of the
decisions that are made on which research to support. Research
funding comes from various federal government agencies, industry,
and private foundations.
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Background Information
 Educational module
rationale
 Educational module organization
 Assumed student prerequisite knowledge
 Diabetes Mellitus: An Overview
 Symptoms, diagnoses, and treatments of Type 1 Diabetes
Mellitus
 Symptoms, diagnoses, and treatments of Type 2 Diabetes
Mellitus
 Useful engineering web sites
 Useful scientific inquiry web sites
 Professional ethics web sites
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Educational Module Activities
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Activity #1: “What Does a(n) Scientist/Engineer Look Like?”
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Activity #2: “Carbohydrates Anyone?”
Activity #3: “What Color is Your Cracker?” Investigative
Laboratory Exercise (Optional)
Activity #4: “Testing for Starch and Sugar” Investigative
Laboratory Exercise
Activity #5: “Understanding pH: How Acidic is it?”
Investigative Laboratory Exercise (Optional)
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Educational Module Activities
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Activity #6: “Digestion of Starch by Amylase” Laboratory
Investigation Exercise
Activity #7: “Designing Digestion: An Original Laboratory
Investigation” Exercise
Activity #8: “Animals in the Lab” (Optional)
Activity #9: “Type 1 Diabetes Mellitus and Chemical
Engineering”
Activity #10: “Type 2 Diabetes Mellitus: A National
Epidemic”
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2005 RET Workshop Projects
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Several pre-assessment questions, Activity #1
(Scientist/Engineer), and post-activity discussion.
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Introduction to Activity #2 (Carbohydrates),
explanation of the teaching technique involved, and
question/answer session.
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2005 RET Workshop Projects
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Activity #6 (Amylase lab) – Primary Project
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“Students” will be able to explain the purpose of carbohydrate
digestion as well as how the procedures in the exercise are used to
determine whether carbohydrate digestion has occurred.
Students determine if amylase is active in acidic conditions and why
the digestion of carbohydrates is important for the human body.
Post-lab discussions will center around how the lab relates to Type 1
Diabetes Mellitus and how “students” can design an additional
laboratory investigation based on another factor of digestion.
Ethical issues pertaining to HCl disposal and the environment as well
as additional student suggested topics will also be discussed.
Introduction to Activity #7, overview and demonstration of
GlucoSim—online blood glucose simulator (time permitting).
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Materials for Primary Workshop Project
Test tubes with racks
 Amylase
 Starch
 0.5% Hydrochloric acid
 Potassium iodide
 1-mL and 5-mL pipets
 Parafilm
 Wax marker
 Water
 pH paper
* Materials needed for other module activities will be listed on
the specific activity.
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Evaluation and Assessment
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Sample of planned concepts to assess:
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Students’ prior knowledge of engineering and engineering careers.
Analyzing and interpreting data presented in the form of graphs.
Glucose homeostasis.
The pH scale and how it affects digestive processes.
Understanding how the pancreas and insulin are involved in Type I
Diabetes Mellitus.
Managing Type I Diabetes Mellitus (i.e. diet, exercise, blood glucose
simulators).
Students’ ability to synthesize, analyze, and evaluate laboratory data
pertaining to blood glucose levels.
Comparing and contrasting Type 1 Diabetes Mellitus and Type 2
Diabetes Mellitus.
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Evaluation and Assessment
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Sample of planned evaluation and assessment tools:
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Pre and post assessment assignment complete with matrices and
scoring rubrics.
Higher level questioning based on Bloom’s Taxonomy of Cognitive
Objectives (Bloom, 1956).
Student design and development of an original laboratory investigation.
Student design and presentation of a diet and exercise regimen for a
person with Type 1 Diabetes Mellitus.
Long-range investigative activity that uses actual students’ diet and
exercise preferences to assess the risk of developing Type 2 Diabetes
Mellitus.
Written laboratory reports/assignments for pH investigation, starch and
sugar investigation, and amylase investigation.
Student written reflection after completing personal “health profiles.”
Student-focused committees that conduct a survey to address
professional ethics issues involved with Type 1 and 2 Diabetes
Mellitus.
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What is Diabetes?
Normally,
eating food
containing
sugar or
starch is a
signal for the
pancreas to
release insulin
into the
bloodstream.
Insulin then
helps glucose
to enter the
body's cells.
Thus, insulin
is the key to
returning
blood glucose
levels to
normal.
Diabetes is the
name given to a
condition where
there is too
much glucose
(sugar) in the
blood. The body
is unable to
keep the blood
glucose level
within normal
limits (3.5 - 8.0
mmol/L).
Without
adequate
treatment, the
blood glucose
level becomes
much higher
than normal.
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Created by: Cinar, 2003
Type 1 Diabetes Mellitus - Overview
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Also known as Insulin-Dependent Diabetes Mellitus.
 Previously
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known as Juvenile or Juvenile Onset Diabetes.
Usually diagnosed in people under 30 years of age.
The pancreas does not make the hormone insulin.
Type 1 Diabetes Mellitus is an autoimmune disease; it
is a result of progressive and irreversible destruction
of the islets (pancreas tissue) by the patient's own
immune system.
Nearly 1 million people in the U.S. have Type 1
Diabetes Mellitus.
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Type 1 Diabetes Mellitus
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Symptoms:
 Increased
production of urine
 Excessive thirst
 Fatigue
 Loss of weight
 Increased appetite
 Feeling sick
 Blurred vision
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Type 1 Diabetes Mellitus
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Diagnosis:
 Urinalysis
shows glucose and ketone bodies in the urine,
but a blood test is required for diagnosis.
 Random (non-fasting) blood glucose exceeds 200 mg/dL.
 Insulin test (low or undetectable levels of insulin).
 C-peptide test (low or undetectable levels of the protein Cpeptide, a by-product of insulin production).
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Type 1 Diabetes Mellitus
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Treatments:
 Monitoring blood
sugar
 A healthy diet
 Exercise
 Maintain a
healthy body weight
 Medications
 Transplantation
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Type 2 Diabetes Mellitus - Overview
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Also known as Noninsulin-Dependent Diabetes
Mellitus.
Traditionally diagnosed in people over the age of
forty, but is now routinely seen in young children as
well.
The body cannot produce enough insulin or does not
utilize the insulin it produces efficiently.
Approximately 90% of the 18 million Americans
living with diabetes have Type 2 Diabetes Mellitus.
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Type 2 Diabetes Mellitus
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Symptoms:
 Increased
production of urine
 Unusual thirst
 Tiredness
 Loss of weight
 Increased appetite
 Feeling sick
 Blurred vision
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Type 2 Diabetes Mellitus
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Diagnosis:
 Fasting
blood glucose level—diabetes is diagnosed if
higher than 126 mg/dL on two occasions.
 Random (non-fasting) blood glucose level—diabetes is
suspected if higher than 200 mg/dL and accompanied by
classic symptoms (i.e. increased thirst, urination, fatigue).
 Oral glucose tolerance test—diabetes is diagnosed if
glucose level is higher than 200 mg/dL after 2 hours.
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Type 2 Diabetes Mellitus
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Treatments:
 Self-testing
 Diet
and weight control
 Regular physical activity
 Medications
 Foot care
 Maintaining long-term care
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Acknowledgements
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2005 RET Cohort of Teachers
Ali Cinar, Ph.D.
Alexander Flueck, Ph.D.
Robert Lapointe
Meriyan Eren
2005 RET Research Mentors
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