Exam 2 - Endocrine pancreas Flashcards Preview

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Flashcards in Exam 2 - Endocrine pancreas Deck (21):

What happens when low blood glucose?

-pancreas ALPHA cells release glucagon
-goes to liver
-liver releases glucose into blood


What happens when blood glucose is too high?

-pancreas BETA cells release insulin
-fat cells take in glucose from blood


Functions of insulin

-to decrease blood glucose levels
-affects CHO, fat, and protein metabolism
-goes to most tissues, adipose tissue, liver and muscle, and liver


What id diabetes mellitus?

-chronic, systemic disorder of the metabolic system characterized by hyperglycemia and altered metabolism of carbs, proteins, and fats

- can result from defects in insulin secretion, action, or both


Diabetes mellitus is the leading cause of what?

-blindness, renal failure, and non-traumatic lower limb amputation


Type 1 vs type 2 diabetes

Type 1: (5-10%) autoimmune response. destruction of BETA cells. cannot produce insulin

Type 2: (90%) improper utilization due to inadequate tissue response to insulin (insulin resistance) and/or the lack of insulin production


Type 1 clinical presentation

-acute onset
-typically younger, thinner
-prone to produce keytones
-used to be call "juvenile onset"
-pancreas no longer produces insulin
-insulin needed for survival!


Type 2 clinical presentation

-typically older and overweight
-associated with metabolic syndrome
-"adult onset" old term
-pancreas produces insulin but the body cannot use it correctly
-family hx, ethnicity, obesity, age, HTN, smoking, etc


Diabetes: additional classifications

-genetic defects
-genetically associated syndromes
-endocrine disorders

-steroid induced*
-*Gestational: develop during pregnancy
-*Pre-diabetes (impaired glucose tolerance)


Normal fasting glucose

normal = 60-110 mg/dl


Pre-diabetes fasting blood glucose and after 2 hr

fasting = 110-125 mg/dl
2 hr after oral test = 140-199 mg/dl


Diagnosis of DM

-fasting level: >126 mg/dl
- >200 mg/dl random sample plus symptoms of hyperglycemia
- >200 mg/dl 2 hrs post oral test


Hemoglobin A1C

-reflects avg blood glucose over 2-3 months

normal: < 5.6%
pre: 5.7 - 6.4%
diabetes: >6.5%


Diabetic ketoacidosis

-fats are used for energy when glucose not available
-keytones are breakdown product of fat metabolism
-accumulate in blood, exreted by kidney and lungs
-lead to metabolic acidosis

**when fats used as primary energy - can lead to atherosclerosis and heart disease


Hyperglycemia warning signs

-glucose in urine
-frequent urination
-unusual thirst

-others: extreme hunger, fatigue, weakness, dizziness, numbness in hands and feet


DM: treatment (Type 1 and 2)

Type 1: insulin therapy. (pump/injections)

Type 2:
-diet, exercise, oral agents, insulin


Management of type 1 vs type 2

type 1: need to monitor food and match with insulin injections

Type 2: life changes.


benefits of exercise on DM

-prevent type 2
-improves sensitivity and control
-weight loss
-heart fitness
-lower BP
-improve cholesterol
-overall health improvement


Hypoglycemia (blood glucose and symptoms)

-blood glucose 70 mg/dl or less

-inc sympathetic activity (sweating, etc.)
-dec glucose to brain (headache, etc.)


Treating hypoglycemia (mild vs moderate vs severe)

-Mild and moderate = 15-15 rule (15g of fast acting sugar, 15 min weight, retest. repeat if needed)

-severe = glucagon injection


DM: long term complication

Macrovascular: Atherosclerosis, PVD, CAD

Microvascular: Nephro, neuro, and retinopathy