Intro to Diabetes Flashcards
Preventative strategies for reducing the onset of T2DM
Lifestyle change
Dietary intake
Weight control
Exercise level
Epidemiology of DM
~37 million in the U.S. have DM
1 in 10
1 in 5 don’t know
~96 million cases of Pre-Diabetes
1 in 3 adults
Additional factors (besides glucose) that can stimulate insulin release from the β-cell
- Hormones: GLP-1, CCK, Glucagon
- Neurotransmitters: Acetylcholine, epi-/norepinephrine, somatostatin
- Glucose synergizes with these mediators
& enhances the secretory response of the
β-cell to these factors.
_____ Allows glucose transportation into the cell for metabolism
Insulin
Digestion also stimulates ____ release
insulin
Activation of the insulin receptor causes activation of _____
phosphatidylinositol 3-kinase
What triggers the liver to do gluconeogenesis?
Glucagon
____ separate C-peptide from insulin
Converting enzymes
_____ is characterized by β cell destruction (pancreas) and virtually absent circulating insulin
DM1
Pathophysiology of DM1
Mostly seen in children before school age & again around puberty
Rate of B cell destruction is variable
_____ is characterized by sufficient circulating endogenous insulin, & ↑ insulin resistance (↓ tissue sensitivity)
DM2
What happens with circulating glucagon in DM1?
Elevated
In this state, almost no carbohydrates are metabolized & all energy comes from fat
metabolism.
Ketoacidosis
Explain how ketoacidosis occurs
ADD
What are “Kussmaul” respirations?
slower, deeper & labored breathing
_____ + _____ = high serum osmolarity & metabolic acidosis
Hyperglycemia + osmotic diuresis
The lethality of ketoacidosis lies in ______
the changes to key ions like potassium
Diagnostic criteria of DM1
Increased Urination
Increased Appetite
Increased Thirst
Blurred Vision
Weight Loss
Hypotension ↓ blood volume from urination, K+ loss
Paresthesias (abormal sensations, tingling)
Diagnostic Criteria for DM2
↑ Urination & Thirst
Glycosuria or hyperglycemia
Neuropathies
Cardiovascular problems
Chronic skin infections
Generalized Pruritus
Vaginitis
Chronic Candidal vulvovaginitis
Marcosomia (large (>9lb) babies)
Balanoposthitis
Overweight or obese
↑ waist circumference
Acanthosis Nigricans
Eruptive xanthomas
Hypertrigliceridemia
Laboratory findings for Diabetes
- Urine Glucose
- Urine & Blood Ketones
- Plasma or Serum Glucose: ≥ 126 mg/dL on two separate occasions with at least 8 hours of
fasting is diagnostic for Diabetes Mellitus
≥ ____mg/dL on two separate occasions with at least 8 hours of fasting is diagnostic for Diabetes Mellitus
126
Normal vs. Fasting glucose laboratory testing
Normal: if 0 minute is < 100mg/dL & 120 minute is < 140 mg/dL
Fasting: >126 mg/dL or 120 minute is over > 200 mg/dL = DM
How is HgbA1c weighted?
HgbA1c is weighted to the most recent month & expressed as %
Correlates to glucose concentration over the last 8-12 weeks
Check this in all types of diabetics every 3-4 months
~5.7-6.4% HgbA1c indicates ______
higher risk (prediabetes or insulin resistance)
