23. Diabetes Flashcards
What is diabetes mellitus?
Chronically elevated blood glucose
What is a normal level of fasting blood glucose?
What range of fasting blood glucose characterizes pre-diabetes (impaired glucose tolerance)?
110-125
What range of fasting blood glucose characterizes diabetes mellitus?
> 125
What characterizes type I diabetes?
- Low, no insulin
- Auto-immune destruction of insulin-making cells
- Not a hypokinetic disease (not related to inactivity or accumulation of body fat)
What % of diabetes cases are type I?
10%
What % of diabetes are type II?
> 90%
When is the onset of type II diabetes?
Mid-life
What is the criteria of the metabolic syndrome?
- Abdominal obesity (BMI > 25; waist circum > 35 in for females or > 40 in for males)
- Hyperlipidemia (esp. low HDL, high triglycerides)
- Diabetes
- Hypertension
What characterizes type II diabetes?
- Insulin levels are normal or high
- Insulin receptors are insulin resistant
- Highly related to inactivity and excess fat
What are the acute, immediate manifestations of hyperglycemia?
- Polyuria (excessive peeing)
- Polydypsia (excessive thirst)
- Polyphagia (excessive eating) and/or spontaneous weight loss
Explain diabetic keto-acidosis.
- Elevated blood glucose cannot enter the cells w/o insulin
- Cell must rely on internal energy stores (fat oxidation)
- Final carbon fragments produce acidic ketone bodies
What does the ADA recommend after the 1st diagnosis of diabetes?
GXT or other CV screening 10 years after 1st diagnosis
What are the short term complications of diabetes?
- Dehydration due to polyuria and polydypsia
- Weight loss and muscle-wasting
- Hypoglycemia (due to Rx)
What are the long term complications of diabetes?
- Accelerated atherosclerosis
- Micro-vascular occlusion (retina, kidneys, nerves, extremities)
