T2DM Flashcards
What is diabetes?
Insulin is the problem in diabetes where the blood gets turned to MUD
Causes or risk factors? Obesity GAG FACE
Obesity
Glucose intolerance
Advanced age
Gestational diabetes
Family hx
Acute pancreatitis/pancreatic cancer
Certain infections
Excess alcohol consumption
S+S?
MAIN = Hyperglycemia - normal is 3 to 8
Others = Polydipsia, glycosuria, polyuria, polyphagia, recurrent infections, prolonged wound healing, weight loss, fatigue, ketoacidosis
What is diabetes
Diabetes happens when the levels of blood glucose is too high due to insulin insufficiency. There are 2 types of diabetes
Type 1 and 2.
What is type 1
Total insulin deficiency where pancreas doesn’t produce an effective amount of insulin
What is type 2
Insufficient amount of insulin being produced and or insulin resistance.
What happens without insulin or adequate response to it?
Glucose wont enter most body cells leading to Hyperglycemia and cell glucose deprivation
What happens when not enough glucose go into cells?
Theres an increase of fats and protein breakdown increasing lipolysis which can either:
Increase fatty acid used by cells for ATP generation increasing production of ketone bodies
If the breakdown of fats is excessive or not properly regulated, it can result in:
Hyperlipidemia and hyper cholesterolemia = atherosclerosis
What is Hyperglycemia? What are the consequences?
Common consequences are:
The glucose transporters for reabsorption become saturated remains in the filtrate/urine which will cause glycosuria. This will then cause an osmotic gradient drawing more water into filtrate/urine causing polyuria. So the excess water loss leads to dehydration via increased plasma osmolarity stimulating polydipsia. If fluid intake not adequate, the plasma osmolarity will be balanced by a fluid shift leading to cellular dysfunction
Another consequence from Hyperglycemia?
It can lead to glycosylation
It’s the deposition of glucose on the basement membrane of blood vessels and neurons. It affects the ability of substances to move in/out of the blood stream effectively resulting in tissue ischemia and poor inflammatory response. This is why diabetics have poor wound healing and recurrent infections.
On neurons it’ll affect AP conduction affecting a variety of body functions
Complications?
Nephropathy
Retinopathy
Neuropathy
Diabetic feet
What is retinopathy?
A Microvascular disease
It’s a common complication of diabetes where the blood vessel damage from a diabetic retinopathy can cause vision loss in 2 ways.
Macular oedema = The glucose will build up in the capillaries reducing gas, nutrient and waste exchange harming the tissues. Once damaged, it causes leakage into the macular making it swell. Its responsible for sharp straight forward vision
Proliferative retinopathy = Fragile and abnormal new blood vessels form which easily break, leading to haemorrhages, scarring and retinal detachment.
What is nephropathy?
Microvascular damage that affects the glomeruli of the kidneys leading to kidney disease. Leading cause of renal failure
What are the autonomic neuropathy?
PEG
Postural hypotension = SNS is usually activated to respond to BP drop quickly to stabilise it but since there is a disruption of the AP output of sympathetic nerves that’s involved with responding to drop in BP, hypotension is not immediately corrected.
Erectile dysfunction = Happens bc there is a decrease in effective AP conduction along parasympathetic nerves to penis losing the ability to get erected
Gastrointestinal complication = Can include delayed gastric emptying, LBM and or constipation. This can cause bloating
What is peripheral neuropathy?
Similar to autonomic neuropathy but instead of the affected AP conduction on neurons, it’s the somatosensory neurons in the limbs (peripheries) that is affected. Not only is it sensory loss but increased susceptibility to tissue damage, prolonged wound healing and recurrent infections though lack of sensory awareness.
