SPP Case: Diabetes I Flashcards
4 ways to diagnose diabetes
- Random blood glucose > 200 with symptoms of hyperglycemia (symptoms include blurred vision, increased urinary frequency, increased thirst, increased hunger)
- Fasting serum or plasma glucose > 126
- 2-hour glucose level > 200
- HbA1c > 6.5%
(Gives you sense of blood sugar over last 2-3 months)
Patients who had gestational diabetes are at increased risk of developing
Type II Diabetes
Clinical presentation of type II diabetes (4)
- Over age of 20
- Obese
- Gradual onset
- Originally asymptomatic and slowly develop resistance to insulin over the years
Diabetes in adults is the leading cause of (3)
- Renal failure
- Blindness
- Lower extremity amputations
Diabetes results from (3)
- One or more genetic predispositions and
- Environmental influences
Leads to pancreatic dysfunction of beta cells, causing hyperglycemia
Transport of stored glucose (2)
- Stored glucose comes out of liver and goes into muscle and fat
- Pancreas monitors levels and releases insulin accordingly
If you can’t make enough insulin (or tissues are highly resistant to insulin) then
blood sugars are elevated and you develop diabetes
Insulin sensitivity and secretion (3)
- Has asymptotic curve shape so
- If lean and fit, insulin works well and pancreas responds effectively
- If overweight, insulin requirements increase
Hyperglycemia results when
Your beta cells do not work as well as they should or could
3 Types of diabetes (6)
- Type 1 diabetes: Beta cell defect is caused by autoimmune disorder (Something in immune system recognizes beta cells as foreign and attacks it)
- Single genes: Inherit a single gene that has a strong enough effect on beta cells (affects number of beta cells or their ability to make insulin) and it will take glucose up into diabetic range without any other factors
- Type 2 diabetes: Insulin resistance: tissues don’t respond to own insulin
In diabetics insulin is unable to
Lower blood glucose levels
Steps of diabetes epidemic (3)
- Positive energy balance (i.e. accumulation of fat over period of time)
- Obesity leads to inability of insulin to regulate blood sugars (insulin resistance)
- Beta cell failure (weak beta cells)
Fatty acids and adipokines
- Fatty acids go to liver and muscle and block insulin action
Beta cell mass (amount) ___ over time
declines slowly with age
Gene distribution for diabetes (6)
- 2 genes are linked to obesity (propensity to gain weight)
- 7 genes are related in insulin resistance
- 25 genes are related to beta cell malfunction
