Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Kin 187 > Diabetes M > Flashcards

Diabetes M Flashcards

1
Q

Estimated population with DM

What about in 2018

A

7% US
1.5 million new cases each year

  1. 5%
  2. 2 million US
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is diabetes mellitus

A

A group of metabolic disease with elevated blood glucose levels (hyperglycemia) over a prolonged period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What complications may occur if DM is not treated

Acute

A

Acute:
Diabetic ketoacidosis
Nonketotic hyperosmolar coma
Death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What complications may occur if DM is not treated

Chronic

A 
Heart disease
Stroke
Chronic kidney failure
Neuropathies
Retinopathy
Nephropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the clinical symptoms of DM

A 
Polyuria
Polydipsia
Polyphagia
Blurred vision
Weight loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is polyuria

A

Excessive urination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is polydipsia

A

Excessive drinking/thirst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is polyphagia

A

Excessive eating/hunger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is type 1 DM

A

Insulin dependent DM

Autoimmune destruction of beta cells in pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is type 2 DM

A

Non insulin dependent DM

Insulin resistance in skeletal muscle,liver and adipose tissue
Insulin secretory defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the other types of DM

A

Gestational diabetes

Specific genetic syndromes

Drugs

Surgery

Other illnesses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Levels for:HbA1C for:

Normal
Prediabetes
Diabetes

A

Normal:
< 5.7%

Prediabetes:
5.7 - 6.4%

Diabetes
>= 6.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Levels for fasting plasma glucose for:

Normal
Prediabetes
Diabetes

A

Normal:
< 100 mg/dl

Prediabetes:
100 - 125 mg/dl

Diabetes:
>= 126 mg/dl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Levels for oral glucose tolerance test for:

Normal
Prediabetes
Diabetes

A

Normal:
< 140 mg/dl

Prediabetes:
140 - 199 mg/dl

Diabetes:
>= 200 mg/dl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is HbA1C

A

Glycosylated hemoglobic

Where there is an attachment of glucose to N terminal amino acid valine of the beta chain of hemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the advantages of finding HbA1C

A

Easy to measure

Relatively cheap

Predictive of vascular complications

Helps management decisions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the limitations of finding HbA1C

A

Only provides an approximate measure of glycemia

Unable to address GV or hypoglycemia

Unreliable in certain conditions such as RF, Hb abnormalilites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the pancreatic hormones

A

Insulin

Glucagon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where are beta and alpha cells in the pancreas found

A

Pancreatic islet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Where is insulin produced

A

Beta cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Where is glucagon produced

A

Alpha cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does insulin do

A

Promotes storage of glucose, amino acids and fats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does glucagon do

A

Promotes the mobilisation of fatty acids and glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Type 1 DM is found in (population)

Characteristics of it

A

Around 10%

Loss of insulin producing beta cells of the islets of langerhans in the pancreas

Idiopathic

T cell mediated autoimmune attack leads to loss of beta cells

Ketoacidosis common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

In type 1 DM what causes the loss of beta cells

A

T cell autoimmune attack

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Type 2 DM is found in (population)

Characteristics of it

A

Around 90%

Insulin resistance

Insensitivity of receptors

Lifestyle factors and genetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the evidence that someone has type 1 DM

A

Presence of anti insulin and anti islet cell antibodies

Presence of inflammatory cells around the islets

Activation of T lymphocytes

Association of diabetic genes with the incidence of development of diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the symptoms that occur with destruction of 80-90% of beta cell mass

A

Lack of insulin

Excessive hepatic glucose production

Decreased muscle glucose uptake

Glucose intolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

A lack of insulin causes several…

A

Intracellular abnormalities in both muscle and liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Excessive hepatic glucose production leads to

A

Gluconeogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Glucose is the main source for what organ

A lack of it causes

A

Brain

Fainting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What happens when no CHO (glucose) is available because of DM

A

Shift from CHO to fat metabolism

Ketoacidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

A shift from CHO to fat metabolism is because

This causes…

A

No glucose into the cell results in body shifting to other fuel sources - fat and protein

Increased fat metabolism results in increase keto acid levels

Sodium is excreted in the urine with the excess keto acids

Sodium is replaced by hydrogen ions in the extracellular fluid

Thus increasing acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Sodium is excreted into urine because of

A

Excess keto acids

Helps to neutralise the acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Diebetic ketoacidosis is seen in

A

Severe cases of UNCONTROLLED diabetes

Usually seen in people who have not yet been diagnosed with diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Those that have diabetic ketoacidosis will experience

A

Kussmaul respiration

Can develop into acidotic coma and death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is kussmaul respiration

A

Rapid and deep breathing which is resulting in loss of the bicarbonate content in the extracellular fluid

(hydrogen that replaced sodium in extracellular fluid)

38
Q

Indication of kussmaul respiration is

A

Sweet smell from breath

39
Q

Acidotic coma and death can occur when

A

The pH of the blood falls below 7.0

Normal range is 7.35 - 7.45

40
Q

What is the pathophysiology of type 2 DM

A

Stomach converts food into glucose which enters the blood stream

Pancrease produces sufficient insulin

Insulin is resistant

Liver resistant to effects of insulin

Glucose cant get into the body’s cells, causes glucose to build in the blood stream

Causes serious dangerous complications

41
Q

What does type 2 DM cause in the MUSCLE

A

Insulin resistance

42
Q

What does type 2 DM cause in the LIVER

A

Insulin resistance

Increase hepatic glucose output

43
Q

What does type 2 DM cause in the GUT

A

Impaired incretin effect

44
Q

What does type 2 DM cause in the PANCREAS

A

Decrease insulin secretion

Increase BETA cell apoptosis

Decrease BETA cell mass

Hyperglucagonemia

45
Q

What does type 2 DM cause in the ADIPOCYTES

A

Increase circulating fatty acids

Hyperlipidemia

46
Q

What are the glucose level after eating for:

Normal people
Type 2 diabetics

A

Normal people is a small increase in blood glucose concentration - after a couple of hours blood glucose concentration goes lower than to begin with

Type 2 diabetes shows a huge increase in blood glucose concentration - takes significantly longer to go back down to resting

47
Q

Sources of blood glucose include

A

Intestinal absorption of food

Glycogenolysis from liver

Gluconeogenesis from liver

48
Q

Insulin causes a inhibition of

Stimulation of

A

Inhibition:
Glycogenolysis
Gluconeogenesis

Stimulation:
Transport of glucose into muscle and adipose tissue
Storage of glucose as glycogen

49
Q

What causes glycosuria

A

When blood glucose level is high over time

The kidney reaches threshold of reabsorption

Glucose excreted into urine

Increase osmotic pressure of urine

Inhibits reabsorption of water

Increase urine production - excess fluid loss

50
Q

How do we manage DM

A

Diet
Exercise
Medication

Intensive treatment to control blood glucose reduces the risk of progression of diabetic complications

51
Q

Exercise testing may not be necessary for….

A

Individuals with DM or Prediabetes who are ASYMPTOMATIC for cardiovascular disease and LOW RISK (< 10% risk)

52
Q

Medical supervised graded exercise test with ECG monitoring is needed for…

A

Individuals with DM or Prediabetes with a > 10% risk of cardiac event who want to begin VIGOROUS intensity exercise program

53
Q

What are the FITT recommendation for individuals with DIABETES with AEROBIC

(Time involves differences for type 1 and type 2)

A

3 - 7 days a week

Moderate (40 - 60%) to vigorous (60 - 90%)

For type 1:
150 min a week at moderate
or
75 min a week at vigorous

For type 2:
150 min a week at moderate/vigorous

Prolonged, using large muscle groups

54
Q

What are the FITT recommendation for individuals with DIABETES with RESISTANCE

A

Minimum of 2 nonconsecutive days per week - prefer 3 days

Moderate (50 - 70% 1RM) to vigorous (70 - 85% 1RM)

8 - 10 exercises
1 - 3 sets
10 - 15 reps to near fatigue

Gradually progress to
1 - 3 sets
8 - 10 reps of heavier weights

Resistance machines/ free weights

55
Q

What are the FITT recommendation for individuals with DIABETES with FLEXIBILITY

A

> = 2-3 days a week

Stretch to the point of discomfort

Hold stretch 10-30 secs
2 - 4 reps

Static/dynamic/PNF

56
Q

What is the special consideration with exercise for individuals with DM

A

Hypoglycemia - most serious problem for people with DM when they exercise

57
Q

What is hypoglycemia

When does it occur

A

Blood glucose level < 70mg/dl

During exercise
Delayed up to 12 hr post exercise

58
Q

Hypoglycemia is a concern for

A

People with DM

People who are taking insulin or oral hypoglycemic agents that increase insulin secretion

59
Q

What are the common symptoms of hypoglycemia

A 
Shakiness
Weakness
Abnormal sweating
Nervousness
Anxiety
60
Q

Neuroglycopenic symptoms of hypoglycemia

A 
Headache
Visual disturbance
Mental dullness
Seizures
Coma
61
Q

How do we prevent hypoglycemia both during and after exercise

A

Blood glucose monitoring before and for several hours following exercise

Timing of exercise should be considered in individuals taking insulin or other medicine

Exercise with a partner or under supervision to reduce the risk of problems associated with hypoglycemia

62
Q

People with DM who exercise are also at risk of

A

Retinopathy

Autonomic Neuropathy

63
Q

What is retinopathy and how do we avoid it

A

Rentinal detachment and vitreous hemorrhage associated with vigorous intensity aerobic and resistance exercise

Avoid activities that dramatically elevate BP

64
Q

How do we avoid autonomic neuropathy

A

Chronotropic incompetence - blunted BP response

Monitor potential silent ischemia - unusual shortness of breath or back pain

Monitor BP before and after exercise to manage hypotension and hypertension

Monitor HR and BP response to exercise - may be blunted

Use RPE to assess exercise intensity

65
Q

What is overall acute response to exercise in DM dependent on

A

Use and type of medication

Timing of medication

Blood glucose level prior to exercise

Timing, amount, and type of previous food intake

Presence and severity of diabetic complications

Intensity, duration and type of exercise

66
Q

How does exercise lower blood glucose

A

Has an insulin like effect (muscle contraction)

Stimulates glucose transport and metabolism

Increases blood flow to exercising muscles

More glucose to enter the muscle to be utilised for energy production

67
Q

What are the chronic adaptations of exercise

What do these adaptation inversely result in

A

Increase vasodilator signaling
Increase capillary density
Increase insulin/P13K signaling

Decreases HbA1c
Leads to decrease insulin secretion
Leads to micro complications

68
Q

What is the overall effect of exercise training in DM

A

Improvement in blood glucose control
= improves glucose tolerance

Increase insulin sensitivity on skeletal muscle cells
= reduces insulin requirements in individuals with type 1 DM

Vascular adaptation

69
Q

Individuals taking lipid lowering medications (e.g., Statins) may experience myalgia

A

True

70
Q

Majority of obesity is caused by abnormal prevalence of gut bacteria

A

False

71
Q

If your male client’s waist circumference is 105cm, and fasting glucose level is 130mg/dL, and HDL level is 45mg/dL. He has metabolic syndrome

A

False

72
Q

Excessive amount of adipose tissue in the body can increase inflammation; thus, more pro-inflammatory markers (e.g., TNF-alpha) are found in the bloodstream

A

True

73
Q

Following examples are potential causes of abnormal vascular remodeling

A

High sympathetic nerve activity

Insulin resistance

74
Q

_______ higher than 48mmol/mol is considered to be diabetic

A

HbA1C

75
Q

Ketoaciidosis is common in type 1 diabetes

A

True

76
Q

Skeletal muscles and liver tend to build insulin resistance over a long period of time which develops type 1 diabetes

A

False

77
Q

What is “not” the action of insulin

A

It stimulates glycogenolysis

78
Q

When blood glucose level is high over time, kidney reaches a threshold of reabsorption. Thus, glucose is excreted in the urine. This phenomenon is called _____

A

Glycosuria

79
Q

Acidotic coma or death can occur if the pH of the blood is higher than 7.3 in diabetic patients

A

False

80
Q

If diabetic patients want to begin a vigorous intensity exercise program, they should undergo a medically supervised graded exercise test with electrographic monitoring

A

True

81
Q

The most serious problem with diabetes who exercise is _____ because it can cause neuroglycopenic symptoms such as seizures and coma during and after exercise

A

Hypoglycemia

82
Q

Muscle contraction causes translocation of AMPK to sarcolemma; this action opens up the pathway for glucose uptake

A

False

83
Q

Muscle contractions from exercise can stimulate and transport _____ from cytosol to cell membrane; thus, glucose can enter the muscle cell to be utilized for energy production. Muscle contraction can also stimulate ____ to produce ___ in order to cause vasodilation and to increase microvascular surface area

A

Glut 4

Endothelial cells

Nitric oxide

84
Q

___ are all clinical symptoms for diagnosis of diabetes mellitus

A

Poly dipsia

Polyuria

Polyphagia

85
Q

Exercise testing may not be necessary for individuals with diabetes who are asymptomatic for cardiovascular disease and low risk

A

True

86
Q

To prevent hypoglycemia both during and after exercise, timing of exercise should be considered in individuals taking insulin or other medicine

A

True

87
Q

HR reserve or VO2 reserve can be used to identify exercise intensity for individuals with diabetes and with other complications, such as autonomic neuropathy

A

False

88
Q

According to journal club article #1, at the point where speech first became difficult, exercise intensity was almost exactly equivalent to lactate threshold

A

False

89
Q

According to journal club article #2, eight weeks of cycle training in people with metabolic syndrome increased insulin receptors and GLUT4 expression in vastus lateralis muscle

A

True

90
Q

According to article #3, exercise training improved endothelial function in adolescents with type 2 diabetes depicted by flow mediated dilation and improvement on action of nitric oxide

A

True

Kin 187 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions