Diabetes mellitus Flashcards Preview

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Flashcards in Diabetes mellitus Deck (41):
1

what is diabetes?

the inability of the body to regulate blood glucose through insulin

2

type I diabetes

insulin dependent
auto immune; loss of insulin producing beta cells
genetically linked
triggered environmentally

3

type II diabetes

non-insulin-dependent
insensitivity to insulin
lifestyle and genetics
adult onset, though becoming more prevalent in juveniles

4

gestational

develops during pregnancy
40% increased likelihood of developing type II later
-fetus-induces changes in metabolism

5

what percent of the population has diabetes?

10%

6

do more people have type I or type II?

type II

7

how many are type I diabetics?

2 million

8

when you have a spike in glucose levels what else spikes?

insulin

9

if you eat sucrose rich foot compared to starch rich foods what is different?

the level of glucose and insulin released is higher

10

what are signs of diabetes?

polyuria and thirst
weakness or fatigue
polyphagia(excessive hunger) and weight loss
blurred vision
peripheral neuropathy
nocturnal enuresis

11

what are some other signs of diabetes?

sweet smelling breath
sweet smelling urine
impaired wound-healing

12

type I key characteristics

insulin absent
elevated glucagon
glucose, fats, and AAs released into and
improper fatty acid metabolism
increases in ketone production and release

13

lack of insulin leads to what?

dysregulated metabolic state of extreme fasting and starvation

14

autoimmune targeting of beta cells drives type I how?

it is currently unknown
95% of cases are immune medated
5% idopathic
strong genetic predisposition
environmental trigger

15

pathogenesis of type I diabetes

loss of insulin signaling
system mimicry of prolonged fasting
loss of glucose transporters on membrane
thus no glycolysis in cells leading to FA metabolism

16

adipose tissue is starved of triglycerides due to glucose not being able to enter cells. this leads to what in leptin?

a decrease, so you are hungry all the time leading the hyperglycemia
decrease in insulin leads to decrease in leptin

17

with insulin deficiency fatty acid oxidation is increased which leads to an increase in ketone bodies. what are the ketone bodies?

acetone - toxic
beta hydroxybutyrate - metabolized
acetoacetate
l

18

elevated blood ketones leads to what?

osmotic diuresis->dehydration->reduced blood flow->coma and tachycardia

19

type I diabetes requires what 3 things?

insulin administration
glucose monitoring
diet control

20

what is the goal of insulin administration

maintain blood glucose between 80-140 mg/dl

21

what are the two ways to give insulin?

injection
pump-more control over injection

22

basal insulin does what?


maintains low-level systemic insulin
long half life

23

what does bolus insulin do

given when food is consumed

24

hypoglycemia neuroglycopenic symptoms

exhaustion
loss of lucidity
irritibility
blurred vision
dizziness
headache
loss of speech
coma and death

25

hypoglycemia autonomic symptoms

increased heart rate
sweating
trembling
nausea
hunger

26

causes of hypoglycemia

excess insulin
too much activity
insufficient food
illness

27

treatment for hypoglycemia

immediate sugar
glucagon
test blood sugar
repeatedly test
call 911 if necessary

28

hyperglycemia signs

headache
nausea
thirst
dry mouth
excessive urnination
ketones
blurred vision

29

causes of hyperglycemia

high blood sugar
lack of insulin
inactivity
excess food
illness

30

treatment of hyperglycemia

insulin
oral hypoglycemic
activity
diet

31

long term diabetic complications

cardiovascular disease
blindness
kidney disease
neuropathy
impaired wound healing and amputation

32

type II diabetes

progressive increase in fasting glucose due to reduced insulin sensitivity followed by a degeneration of insulin production (destroyed beta cells)

33

possible mechanisms for insensitivity

adipokine signaling
extopic lipid storage
inflammatory signaling

34

what is macrophage chemotaxis protein (MCP-1)

released by adipose tissue and recruit macs once they reach a certain capacity of fat

35

what do macs release once they get to the adipose tissue

TNF alpha which releases fatty acids from adipose tissue, which makes muscles use fatty acids for energy and not glucose, thus insensitivity to glucose

36

treatment for type II diabetes

lifestyle changes
oral hypoglycemics
insulin once beta cell masses degenerate, reversible

37

what do oral hypoglycemics do? 3 things

increase insulin
increase insulin sensitivity
decrease carb absorption

38

type II drugs to treat hyperglycemia

metformin
sulfonylureas
peroxisome proliferator-activated receptor agonists
alpha-glucosidase inhibitors

39

what are the five ways to detect diabetes

urinalysis
glucose monitoring (fasting)
HGA1c
glucose tolerance test
C-peptide test

40

**what is the glucose tolerance test**

known amount of glucose is given (100grams)
levels are tested at 30 min and 90-120 min
if glucose levels stay high then they may have diabetes, BUT DOES NOT TELL YOU WHICH TYPE THEY HAVE

41

**what is a C-peptide test **

done to determine type I or type II
**if you have no C-peptide then you have no insulin being produced and thus you are type I
**if you have C-peptide then you have type II