Diabetes Flashcards
What does the first step of energy production require
insulin
What type of cells excrete insulin
beta cells from pancreas
What is the role of the pancreas when the blood sugar level starts to drop too low
excretes glucagon
What population is most affected by Diabetes type 1
children and adolescents
What population is more effected by type 2 diabetes and why
middle age - older adults from prolonged hyperglycemia from poor lifestyle and diet
What are some early symptoms of diabetes
polydipsia
polyphagia
polyuria
blurred vision
How do you diagnose diabetes
plasma glucose
what is the leading cause of mortality in diabetics
heart disease
Where is the islets of langerhans found and what do they contain
pancreas
Alpha and beta cells
What is the job of beta cells
insulin producing
What is the job of alpha cells
glucagon secreting
What is type 1 diabetes
destruction of pancreatic beta cells- generally from an autoimmune process
*leave insulin levels extremely low
What is type 2 diabetes
Insidious onset of imbalance between insulin levels and insulin sensitivity causing a functional deficit
What is a common cause of insulin resistance
obesity and aging
Which type of diabetes is associated with HLA antigens
Type 1
What influences a persons risk for developing type 1 DM
Polymorphins (MHC and HLA)
Which type of diabetes is more effected by genetics
type 2
What is MODY
Non-insulin dependent diabetes diagnosed at a young ago (<25y/o)
-autosomal dominant (no autoantibodies)
What is gestational diabetes
diabetes during pregnancy
What is the etiology of diabetes
people who have endocrinopathies
-cushings, acromegaly, hyperthyroidism etc
Which ethnicity is at an increased risk of DM type 1
Hispanic youth
Which socioeconomic area is most effected by type 2 diabetes
low to middle income and a higher prevalence in other ethnicities besides whites
At what serum glucose level are you likely to experience symptoms of polyuria and polydipsia
> 250mg/dL
What is insulin resistance
excess fatty acids and pro inflammatory cytokines leads to impaired glucose transport and increased fat breakdown
What is the biggest problem with type 2 DM
They have inadequate production of insulin to compensate for their insulin resistance
What does glycated hemoglobin (HbA1c) measure
Non-enzymatic glycation of proteins and lipids
What does glycation lead to
microvascular damage in retina, kidney, and peripheral nerves ultimately leading to diabetic retinopathy and nephropathy
What will be seen on physical exam with hyperglycemia
fatigue
poor skin turgor
distinctive fruity odor on their breath
+/- DKA
Macular hemorrhages
If a patient is in DKA, what symptoms should you expect
Kussmal’s breathing
N/V
What other things on PE help differentiate between Type 1&2
Type 2 is usually overwheight
-blurry vision
-frequent yeast/fungal infections
-numbness/neuropathic pain
-acanthosis nigricans
What is the most sensitive and best test for DM
OGTT (oral glucose tolerance testing)
What are the types of tests can you do for diabetes
Fasting plasma glucose (FPG)
Glycosylated HB (HbA1C)
OGTT
What is the diagnostic criteria for diabetes type 1&2
FPG >126
Random glucose >200 w/ symptoms
2hr plasma glucose >200 during 75g OGTT
What HbA1C indicated type 2 DM
> 6.5%
What is the pre diabetic criteria
FPG >100-125
2hr OGTT plasma glucose 140-199
HbA1C 5.7-6.4%
What are some factors that can effects the HbA1C
Hemoglobinopathies
iron deficiency
hemolytic anemia
thalassemia
spherocytosis
severe hepatic/renal disease
When is screening for diabetes recommended by the USPSTF
starting at 35 regardless of risk factors
What is home glucose testing useful for
trends of hyper/hypo glycemia