Diabetes Flashcards
(50 cards)
definition of Diabetes Mellitus
- a metabolic disorder
- characterised by elevated blood glucose concentrations and disturbance of CHO, lipids and protein
- due to defective insulin secretion or action
classification (5)
DM1\DM2\Gestational diabetes(during pregnancy only)/pre-diabete/other: genetic defect, pancreatopathy
T/F insulin resistance can be indicated by a decreased insulin level
F IR can still maintain a normal insulin level or hyperinsulinemia. It cannot fully response to the level of blood glucose but the blood sugar level is just little impaired
mechanism of DM1
autoimmune or idiopthic destruction of pancreatic B cell. the cell degradation can because of aging
T/F all DM pts need insulin Tx
F
T/F all DM1 pts need insulin Tx
T
T/F all DM2 pts need insulin Tx
F
T/F all DM2 pts with ketosis prone need insulin Tx
T
T/F all DM pts who can resist ketosis do not need need insulin Tx
F
25% need insulin Tx
what is surveillance program for
and list two system/policies associated
it provides the equality to access the healthcare and education about DM
Canadian Diabetes Strategy/Aboriginal Diabetes Initiative/ Canadian Chronic Disease Surveillance System
List the factors affecting the DM prevalence
gender (M>F), region, age,
races, healthcare system, the trend of time
it is a global concern
List 4 common initial observation of DM2
polydipsia
polyuria
polyphagia
obesity
list three lab test reveal (more for DM2)
hyperglycemia
glycosuria
GTT: abnormal glucose tolerance
Why, in terms of metabolism, DM1 is suggested to fasting than eating under a severe condition?
A.A. do not used to do protein syn but go for gluconeogenesis and the CHO intake both NUTR components elevate the blood glucose level
definition of insulin resistance
- a lesser sensitivity to insulin’s action
- in suppressing hepatic glucose production and stimulation of glucose uptake
why say the mechanism of glucose intake in brain is a good survival mechanism?
- brain is insulin-independent, so it still can access fuel with IR exists
types of IR
which is common?
- receptor defects as decreased number and affinity
2. post receptor second message signalling failure (common)
the essential difference between MD1 and MD2
MD1: destruction of B cell, so no original insulin production
MD2: insulin resistance, so the signal cannot reach the cell’s regulation centre
what’s the cause of receptor-defect IR?
genetic mutations of INSR gene, but it is rare
T/F all DM2 is originated from over weight or obesity
F
genetic factor also
DM short-term complications
- Diabetic ketoacidosis: dehydration, skipped insulin, etc leads to coma [commonly in DM1]
- hyperglycemic hyperosmolar syndrome:dehydration or infection cause the burst of blood glucose ( >33M) [ commonly in DM2]
- Hypoglycemia: excess dose of insulin or impaired food intake to the dose, unplanned exercise
DM long-term complications
microvascular system:
retinopathy–> blindness
nephropathy (20-40%)–> kidney transplantation
neuropathy (50%)–> amputation, decreased GI movement
- Macrovascular: CVD, CHD and stroke
Hypoglycemia；
definition?
symptoms (early and late for 3 each)?
treatment?
- BG < 3.9M
- early: sweating, shaking, anxiety; late: confusion, blurred vision, coma
- 15-15 rule: give 15 g of fast absorbed glucose and check the BG in 15min. If not be normal, repeat.[ the pt is conscious] /severe: injection of glucagon or glucose by care provider
Explain how does DM affect CVD
the increased glucotoxicity makes more glycated proteins. As a result of endothelial damage, the acceleration of plaque expose the high risk of CVD
