Lecture 1 (Background) Flashcards
(30 cards)
Definition of Diabetes Mellitus
A metabolic disorder characterized by the presence of hyperglycemia due to defective insulin secretion, insulin action, or both
What are the three main hormones from the pancreas and their cells?
somatostatin - delta
glucagon - alpha
insulin - beta
What is the balance with glucagon and insulin?
insulin is secreted when the BG is too high and tells the cells to open and take in the glucose from the blood
Glucagon is secreted when there is too low of BG and it tells the liver to produce more glucose from stores
List the different types of DB
prediabetes - IGT (impaired glucose tolerance)
- IFG (impaired fasting glucose)
Type 1
Type 2
gestational diabetes
Main cause of T1DM
lack of insulin secretion
autoimmune beta cell destruction
usually diagnosed young
Explain prediabetes
An intermediate state between normal glucose levels and diabetes
Includes IFG (impaired fasting glucose) and IGT (impaired glucose tolerance)
Is a strong predictor of T2DM & CVD
What is the FPG for IFG?
6.1-6.9
What is 2h PG for IGT?
7.8-11.0
What is A1C for prediabetes?
6.0-6.4
What is the general cause of T2DM?
impaired insulin secretion and insulin resistance
mainly genetic and environmental factors
What are some factors for T2DM?
Genetics: certain genes have been shown to determine risk for T2DM
Enviro: excessive caloric intake, sedentary lifestyle
Aging
List as many risk factors as you can for T2DM
Age ≥40 years
First-degree relative with type 2 diabetes
Member of high-risk population (e.g., African, Arab, Asian, Hispanic, Indigenous or South Asian descent, low socioeconomic status)
Overweight / obesity
History of prediabetes
History of GDM
History of delivery of a macrosomic infant
Presence of end organ damage associated with diabetes:
Microvascular (retinopathy, neuropathy, nephropathy)
CV (coronary, cerebrovascular, peripheral)
Associated diseases: Acanthosis nigricans, PCOS, obstructive sleep apnea, HIV infection, psychiatric illnesses (schizophrenia, bipolar), gout, non-alcoholic steatohepatitis, cystic fibrosis, history of pancreatitis
Vascular risk factors (low HDL, high TG, hypertension, overweight/obesity, smoking)
Medications
What is insulin resistance?
there is a decrease in sensitivity to the actions of insulin by the target tissues (muscle, liver, and adipocytes)
List some clinical symptoms of T1DM
Usually presents as acute symptoms of short duration
Polyuria
Polyphagia
Polydipsia
Weight loss
Fatigue
Blurred vision
Infections
DKA after several days of the sx above
List some clinical sx of T2DM
Is commonly discovered incidentally, as patients may be asymptomatic
May have nonspecific symptoms (i.e. fatigue) or:
polyuria
polydipsia
nocturia
May already have established diabetic complications at diagnosis
List some risk factors for children and T2DM
T2DM in a first- or second-degree relative
Member of a high risk ethnic or racial group
Obesity
IGT
PCOS
Exposure to diabetes in utero
Acanthosis nigricans
Hypertension and dyslipidemia
Nonalcoholic fatty liver disease (NAFLD)
Use of atypical antipsychotic medications
Define gestational diabetes mellitus (GDM)
a condition that develops during pregnancy primarily due to insulin resistance
What does GDM increase the risk of?
the risk of fetal hyperinsulinemia,
heavier birth weight,
higher rates of cesarian deliveries,
and neonatal hypoglycemia
List some risk factors of GDM
Previous GDM
Member of high-risk population
Previous delivery of macrosomic infant
Age ≥ 35yo
Obesity
PCOS
Acanthosis nigricans
Corticosteroid use
Can you prevent T1DM?
there is some research of ideas but nothing has been confirmed
What can prevent T2DM?
mainly lifestyle modifications
but also some drugs can stop it from processing into something
When should you be screening for T2DM in adults?
screen q3y for >40 or people with high risk
more frequent for the more risk factors
What is the risk assessment tool for DB?
CANRISK
helps to see what level of risk people have to become prediabetic or have T2DM
What are the diagnosis for DM for FPG, A1C, and 2hPG?
> 7mmol/L
6.5%
11.1 mmol/L
