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HFF - Exam 3 > Test 3 - Quiz 7 - Diabetes > Flashcards

Test 3 - Quiz 7 - Diabetes Flashcards

(47 cards)

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1
Q

What is type I diabetes?

A

Insulin-dependent diabetes mellitus

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2
Q

What are the immunological symptoms of type I diabetes?

A

Autoimmune disease - loss of beta-cells producing insulin

Genetically linked

Juvenile onset

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3
Q

What is type II diabetes?

A

Non-insulin-dependent diabetes mellitus

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4
Q

What are the characteristics of type II diabetes?

A

Insensitivity to insulin

Lifestyle and genetics

Adult onset, though becoming more prevalent in juveniles

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5
Q

What is gestational diabetes?

A

Develops during pregnancy - fetus induces changes in metabolism

*Chances of getting type II diabetes greatly increases for later in life

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6
Q

Diabetes dysregulates what?

A

Balanced insulin and glucagon signaling

  • Alpha - glucagon
  • Beta - insulin
  • Delta - somatostatin
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7
Q

Type I and II have different causes, but the symptoms of uncontrolled disease are _____________.

A

SIMILAR

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8
Q

What are some key characteristics of type I diabetes?

A

Circulating insulin is absent

Target tissues fail to properly absorb nutrients

*This leads to a dysregulated metabolic state of extreme fasting and starvation

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9
Q

The autoimmune disorder is caused by what?

A

95% immune-mediated

5% idiopathic (spontaneous and cause unknown)

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10
Q

Because insulin cannot get to the target tissues, what ensues?

A

Body is in “starvation,” and starts beta-oxidation for energy. This results in increased ketone body formation, and ketoacidosis will soon follow.

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11
Q

Prolonged fasting does what to ACTH, leptin, corticosterone, insulin, and glucagon?

A

Increased ACTH, corticosterone, and glucagon

Decreased leptin and insulin

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12
Q

What are the 3 ketone bodies?

A

Acetoacetate
Acetone
D-beta-hydroxybutyrate

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13
Q

Insulin deficiency leads to what?

A

Reduced glucose uptake.

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14
Q

Reduced glucose uptake leads to what?

A

Cellular energy deficiency

Elevated blood glucose

Fatty acid oxidation

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15
Q

Elevated blood glucose leads to what?

A

Osmotic diuresis (excessive urination)

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16
Q

FA oxidation leads to what?

A

Liver gluconeogenesis

Liver ketone bodies

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17
Q

Liver ketone bodies lead to what?

A

Elevated blood ketones

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18
Q

Elevated blood ketones lead to what?

A

Increased blood acidity

Osmotic diuresis

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19
Q

Osmotic diuresis leads to ____________, which then leads to reduced blood volume, and electrolyte imbalance.

20
Q

Reduced blood volume can lead to what?

Study These Flashcards
A

Tachycardia

Coma

*It also feeds forward to elevate blood glucose, elevate blood ketones, and increase blood acidity

21
Q

What are the 3 coordinated interventions for type I diabetes?

Study These Flashcards
A

Insulin administration

Glucose monitoring

Diet

22
Q

What is the desired target range that diabetics want for fasting blood glucose?

23
Q

What are the two current approaches to insulin administration?

Study These Flashcards
A

Injections
-Several per day
-Two types: basal and bolus
—Basal - insulin maintains low-level systemic insulin
—Bolus - insulin given when food is consumed
This is scaled to carb consumption

Pump

  • Dose given when food consumed
  • Scaled to consumption and activity
24
Q

Generally, what is type II diabetes?

Study These Flashcards
A

Progressive increase in fasting glucose due to reduced insulin sensitivity followed by a degeneration of insulin production

25
What are the 5 things that type II diabetes is tied to?
Heterogeneous disorder and most prominent form of diabetes Closely tied to obesity and visceral adiposity Lifestyle factors play a role in development Strong genetic link High incidence in developed countries
26
What are 3 possible mechanisms of insulin insensitivity?
Adipokine signaling Ectopic lipid storage and free FAs Inflammatory signaling
27
___________ ____________ may drive type II diabetes insulin insensitivity.
Adipose signaling
28
__________ fill adipocytes until enlarged. Once enlarged, adipocytes produce _________ ___________ _________.
Triglycerides Macrophage chemotaxis protein (MCP-1)
29
What infiltrates adipose tissue in response to MCP-1?
Macrophages
30
Macrophages produce what in adipose tissue that favors export of fatty acids?
TNF-alpha
31
Adipocytes export FA to ____________, where what forms?
Muscle Ectopic lipid deposits
32
Ectopic lipid interferes with ________ movement, and that produces what?
GLUT4 Insulin resistance
33
What are three ways that type II diabetes is managed?
Lifestyle - Reduced carb consumption - Prevent glucose swings - Increase physical activity - Maintain healthy body weight Oral Hypoglycemics - Increase insulin secretion - Increase insulin sensitivity - Decrease carbohydrate absorption Insulin -Required when beta-cell mass degenerates (Once the disease progresses to that point
34
What do sulfonylureases do?
Increase beta-cell insulin secretion
35
What do metformins do?
Uncouples oxidative phosphorylation *This reduces liver gluconeogenesis and lipogenesis
36
What do peroxisome proliferator-activated receptor agonists (PPARs) do?
Increase glucose transporter expression
37
What do alpha-glucosidase inhibitors do?
Prevent carbohydrate absorption
38
What are the 5 primary methods for detecting diabetes?
Urinalysis Glucose monitoring HBA1c Glucose tolerance test C-peptide test
39
*TEST - If a patient fails the urinalysis (glucose present in urine), fails glucose monitoring, and passes the C-peptide test, what do they have?
Type II. Insulin is still being produced because C-peptide is present, but excess glucose is present in the urine.
40
What are the neuroglycopenic symptoms of hypoglycemia? (8)
``` Exhaustion Loss of lucidity Irritability Blurred vision Dizziness Headache Loss of speech Coma and death ```
41
What are the autonomic symptoms of hypoglycemia? (5)
``` Increased heart rate Sweating Trembling Nausea Hunger ```
42
What are the causes of hypoglycemia? (4)
Excess insulin Activity Insufficient food Illness
43
What are treatment options for hypoglycemia? (5)
``` Sugar Test blood sugar Test again Call 911, if necessary GLUCAGON -This would increase gluconeogenesis resulting in more glucose being put into the blood ```
44
What are the signs of hyperglycemia? (6)
``` Headache Nausea Thirst, dry mouth Excessive urination Ketones Blurred vision ```
45
What are the causes of hyperglycemia? (5)
``` High blood sugar Lack of insulin Inactivity Excess food Illness ```
46
What are the treatment options for hyperglycemia? (4)
Insulin Oral hypoglycemic Activity Diet
47
What are 5 long-term diabetic complications?
``` Cardiovascular disorders Blindness Kidney disease Neurologic complications -Neuropathy -ED Impaired wound healing/amputation ```

HFF - Exam 3 (19 decks)

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