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Flashcards in Diabetes (week 5) Deck (41):
1

where does the insulin diabetics inject come from

recombinant DNA technology

2

what is used for insulin administration in compliant patients

insulin infusion pump

3

what do insulin infusion pumps do

programmed to release insulin at certain times of the day

4

what percent of total calories should be carbohydrates in diabetics

55-60%

5

what percent of total calories should be fat in diabetics

less than 30%

6

what percent of total calories should be protein in diabetics

15-20%

7

what must diabetics do when they exercise

must adjust food intake and insulin doses; can become hypoglycemic

8

what is the main difference between Type I and Type II Diabetes

Type 1= autoimmune; no beta cells; lack of insulin
Type 2= not autoimmune; still have functioning beta cells

9

speculation about cause of insulin resistance in Type II DM

compounds released from adipose cells will decrease peripheral insulin sensitivity

10

NIDDM stands for

Non Insulin Dependent Diabetes Mellitus

11

what is the biggest risk factor for Type II DM

obesity

12

age of Type II DM

over 40

13

clinical manifestations of Type II DM

abnormal glucose tolerance
overweight
hyperlipidemic (high LDL)

14

Tx for Type II DM

EXERCISE
restrict caloric intake
weight loss
dietary counseling

15

what is gestational diabetes

presence of glucose intolerance during pregnancy; typically during 3rd trimester
blood glucose returns to normal after parturition
Mimics Type II DM

16

possible causes of gestational diabetes

chorionic somatomaammopropin (produced by placenta)
estrogen
cortisol
weight gain during pregnancy

17

risk factors for gestational diabetes

family history of diabetes
obesity
high maternal age
parity greater than 5
previous complicated pregnancy
glycosuria (presence of glucose in urine)

18

tx for gestational diabetes

dietary counseling
exercise
monitor blood glucose and urine ketones
glyburide

19

glyburide

promotes release of insulin
does not cross placenta

20

teratogenicity

likelihood of a drug to create defects in developing fetus

21

chronic complications of Diabetes

higher incidence of peripheral vascular disease
cardiac disease
renal disease retinopathy
neuropathy

22

AGE stands for

advanced glycosylation end-products

23

normal AGE process

glucose will attach reversibly to proteins, lipids, and nucleic acids without benefit of enzymes;
bad when bound irreversibly????

24

problem with AGE

-can attach to basement membranes of blood vessels and verves, thickening them and decreasing permeability
-promotes production of free radicals
-inactivates nitric oxide which is a vasodilator, which leads to vasoconstriction and ischemia
-causes damage to nerves

25

polyol pathway

pathway for glucose metabolism used by tissues that do not need insulin for glucose transport

26

tissues that utilize polyol pathway

kidnes
endothelium of blood vessels
retinal tissue
eye lens
nerves

27

what happens in the polyol pathway when a person is hyperglycemic

excess glucose shunted to polyol pathway

28

why is it bad that there is excess glucose shunted to polyol pathway

excessive byproducts (sorbitol, fructose) are produced, causing osmotic injury (lysis)

29

how does AGE contribute to diabetic neuropathy

causes hypoxia

30

how does polyol pathway contribute to diabetic neuropathy/retinopathy

sorbitol damages Schwann cells, interferes with ion pumps, and distrupts nerve conduction

31

how does AGE contribute to microvascular disease

-thickening of basement membrane
interfering with diffusion which interferes with supply of oxygen and nutrients to tissue
-damages endothelial cells, increasing plaque formation

32

which type of diabetes is more common to die of renal failure

type I

33

how does AGE lead to nephropathy

alters basement membrane of glomerulus, leading to glomerularsclerosis (thickening of glomerulus)
-will decrease filtration
-glucose toxicity

34

how does polyol pathway lead to nephropathy

damages tubular cells

35

how is the development of nephropathy slowed

ACE (angiotensin converting enzyme) inhibitors
control blood glucose

36

macrovascular disease

includes:
coronary artery disease (CAD)
CVA
peripheral vascular disease (PVD)

37

which type of diabetes is more common to have macrovascular disease

type II

38

what is the most common cause of death in NIDDM, especially in women

Coronary artery disease

39

what does your risk of stroke increase by if you have diabetes

2x (due to increased BP)

40

what does peripheral vascular disease typically lead to?

amputation

41

why do diabetics have increased risk of infection

-impaired sensation
-hypoxia (due to decreased BF and decreased release of O2 to tissue)
-pathogens proliferate because of increased glucose
-blood supply is decreased
-WBCs have decreased chemotaxis