13 Diabetes Mellitus Flashcards Preview

Endocrine (updated 2016) > 13 Diabetes Mellitus > Flashcards

Flashcards in 13 Diabetes Mellitus Deck (26):
1

What does glucagon do to blood glucose

raises blood glucose

2

What is diabetes characterized by

loss of insulin or decreased insulin responsiveness

*major disease in animals and people

3

What are 3 metabolic characteristics of diabetes

Decrease glucose uptake
Increase protein catabolism
Increase lipolysis

4

What are the 2 major forms of diabetes

Insulin dependent (IDDM)
Insulin independent (NIDDM)

5

What are diabetes mellitus clinical signs

hyperglycemia, glycosuria
polydipsia, polyuria hyperphagia

in severe cases:
weight loss
cataracts in dogs
plantigrade posture in cats

vascular changes, microangiopathies

6

What are some predisposing factors to diabetes

genetic factors
dogs: females > males
cats: neutered males slightly more common
pancreatitis
immune -mediated destruction (dogs?)
amyloidosis (cats)
obesity (decreased receptors > down-regulation)

7

Why does PU/PD occur

Excess glucose spills into urine and osmotically drags water with it > polyuria, polydipsia, weight loss

8

What is the more common diabetes in dogs

IDDM

9

What is the more common diabetus in cats

NIDDM and IDDM
1/3 of cats are NIDDM

10

What are the 4 risk factors for diabetes in the cat

Age, obesity, neutering, gender (male more common)

11

What drugs can you give to cats instead of insulin

Drugs that increase insulin receptors or sensitivity of the receptors

12

What does insulin do to blood glucose

Lowers blood glucose
- moves glucose intracellularly
- causes liver to store glycogen
- facilitates fat deposition in adipose tissue

13

What is the result of decreased glucose uptake?

hyperglycemia (increased blood sugar) causes:
decreased glyconeogenesis
increased polyuria, polydipsia, polyphagia

14

What is the result of increased protein catabolism?

increased plasma aa
increased weight loss > decrease in growth
increased negative nitrogen balance

15

What is the result of increased lipolysis?

increased free fatty acids
ketosis
acidocis

16

Insulin-dependent diabetes (IDDM)

Type I (often autoimmune)
- destruction or loss of function of pancreatic beta cells leads to low insulin levels
- animals often have relatively high glucagon and are prone to ketosis
- most severe form of the disease
- etiology is unclear but can involve genetics, pancreatitis, autoimmunity, obesity, and viral causes

17

non-insulin-dependent diabetes (NIDDM)

Type II
- decreased number or responsiveness of insulin RECEPTORS
- less severe than IDDM
- can progress to IDDM
- results from insulin resistance secondary to obesity r other causes

18

Diabetes-species differences

carnivores are relatively susceptible; herbivores less so
diabetes mellitus - most common endocrine malady
incidence varies with age, breed etc
major illness in both dogs and cats

19

renal threshold

dogs: 180-220 mg/dl (more like humans)
cats: 240-300 mg/dl

cat has amazing capacity to absorb glucose from the kidney so just bc no glucose in urine does NOT mean there are no metabolic changes

20

consequences of insulin deprivation on lipid & protein metabolism?

loss of calories > weight loss
compensatory effect > hyperphagia

21

diabetic ketoacidosis

insulin deficiency + dehydration + stress →
mobilization of fat →
ketone body formation →
ketone accumulation in blood →
acidosis, dehydration, hypotension, depression

glucose and ketones spill over into urine →
worsens dehydration

22

diabetes mellitus diagnostics

baseline glucose values
- street hyperglycemia in cats
- postprandial (after a meal) hyperglycemia
urinalysis
- glucose present in urine (glucosuria)

23

diabetes in the dog

IDDM much more common
disease of older dogs (7-9yrs)
treatment: insulin

24

diabetes in the cat

NIDDM and IDDM
1/3 of cats are NIDDM
treatment: insulin and/or drugs
cat very different than dog

25

transient diabetes

reversible suppression of the pancreatic β-cells
waxing and waning of clinical signs
may progress to permanent diabetes

20% of cats will stop being diabetic all on their own
dogs can show transient diabetes during pregnancy or progesterone treatment

26

Who purified insulin?

1921 xmas day
Banting > nobel prize
Best