16/17: Diabetes - Dodge Flashcards
(45 cards)
how many ppl have diabetes?
1/11
increased in native americans, hispanics, and lower education
increased in the south
what does calcium rushing into the islet cell in response to glucose cause?
ca2+ activates insulin gene expression via CREB –> exocytosis of stored insulin
insulin is created in…
beta islet cells of pancreas
insulin binding to cell receptors –>
glut 4 translocation to the cell membrane –> cell takes in glucose
common theme between dif. DM types
dysregulation of the insulin/glucose interplay leading to hyperglycemia
typeII DM
insulin resistance
95% of adult DM
type I diabetes is caused by…
complete or near complete insulin deficiency usually seen with >70% destruction of beta cells
no insulie
IDDM
insulin dependent diabetes mellitus
insulin is being used to treat
genetic component of DM type I
HLA DR3/DR4 gene
twin studies 50%
diabetic ketoacidosis –>
type I DM
30% children or adolescents diagnosed with type I DM after being treated for DKA
which type of DM has a higher genetic component?
type II
MODY
maturity onset diabetes of youth
- early onset of hyperglycemia, beta cell genetic defects
- appears morel like type 2 DM in a younger person
- AD, most common monogenetic syndrome associated with DM
LADA latent autoimmune diabetes of adults
WILL require treatment with insulin much like type I DM
- slow destruction of beta islet cells
- misdiagnosed as type 2
- tequire insulin due to insulin deficiency from autoimmune islet destruction
- will have low c peptide
drugs/medications that may cause diabetes
- thiazides
- pentamidine
- protease inhibitors
symptoms of DM
- always tired
- frequent urination
- wounds willnot heal
- blurry vision
- always thirsty
- vaginal infections
- numbness or tingling of feet
- sexual problems
- always hungry
- sudden weight loss
diabetes screening guidlines
every 3 yrs starting at age 45
if pt overweight with at least one additional risk factor screen earlier
prediabetes and diabetes fasting plasma glucose
100-125
>126
glucose tolerance test prediabetes; diabetes
140-199
>200
hemoglobin A1c prediabetes
- 7-6.4%
6. 5% —> diagnostic of diabetes**
what hemoglobin A1c level is diagnostic of diabetes?
> 6.5%
type I DM treatment :
require insulin!
- in basal/bolus (long and short)
- continuous infusion (short with short)
- split/mixed
does type 2 require insulin?
not at first, many will eventually require insulin as the disease progresses
> 10-12% A1c with ketosis and/or weight loss = insulin required; >10-12 alone is strongly recommended
standard oral therapy for type II DM
metformin
when do type II DM need more than one med?
greater than 9.0% A1c –> recommend treatment with two oral agents or insulin mono-therapy
