Week 4 Diabetes Review and Clinical Presentation Lecture Flashcards Preview

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Flashcards in Week 4 Diabetes Review and Clinical Presentation Lecture Deck (25)
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1
Q

today, 1 in __ adults have diabetes

A

11

2
Q

is diabetes a problem?

A

LOLZ. yes. it is a growing problem with increasing prevalence worldwide, and increasing cost (1 in 9 health dollars spent on diabetes). serious, common, costly

3
Q

what three factors are largely contributing to the soaring diabetes prevalence worldwide?

A
  1. poor diet
  2. sedentary lifestyle
  3. longer life
4
Q

what explains why children from low-income homes are more likely to be obese?

A

unhealthy food is cheaper than healthy food

5
Q

we see that Asian countries do not have a high BMI, yet they have a high prevalence of diabetes. what does this suggest?

A

these individuals may experience metabolic complications before having an obese BMI. Suggesting a lower BMI in which to test for diabetes in these populations.

6
Q

what are some adverse health affects that diabetes is the leading cause for? 4

A
  • 6th leading cause of death in the US
  • leading cause of new blindness in adults
  • leading cause of renal failure
  • leading cause of non-traumatic lower limb amputations
7
Q

most of the medical cost of diabetes goes into which aspect of diabetes care?

A

treating the complications, NOT preventing the disease

8
Q

Diabetes is a disease in which the body doesnt (3)

A
  1. doesnt produce insulin at all
  2. doesnt produce sufficient insulin
  3. doesnt properly use (sense) insulin
9
Q

contrast type I and II diabetes; age of onset, gradual or sudden, body type

A

Type I: younger, sudden, usually thin

Type II: older, gradual, usually obese

10
Q

what are some causes (4) of insulin resistance?

A

obesity (increase in FFAs and adipokines (leptin, TNF-alpha, decreased adiponectin)

stress: counter regulatory hormones (adrenaline/NE, cortisol)

Pregnancy: placental hormones

Infection

11
Q

what are two clinical presentations of insulin resistance? whats the difference?

A

glucose intolerance and type II DM: glucose intolerance is a pre-diabetic condition

12
Q

Generally, at the time of Type II DM diagnosis what is the condition of B cells? what does this suggest?

A

B cell fxn is 50% of normal. suggests that B cells were declining in fxn many years before diagnosis, a progressive disorder

13
Q

what are the symptoms of hyperglycemia? 6

A

thirst (polydipsia), frequent urination (polyuria), blurry vision, weight loss, fatigue, hunger

14
Q

when should diabetes screening be conducted?2

A
  • every 3 years for individual over 45

- in those with a BMI>25 (overweight)

15
Q

what are the compication ABCs of diabetes?

A

A: HbA1C
B: Blood pressure (high)
C: LDL cholesterol (high)

16
Q

In general what is the role of TZD

A

diabetes medication that decreases insulin resistance of skeletal muscle

17
Q

in general what is the role of Metformin

A

inhibits gluconeogenesis in the liver

18
Q

what is the general role of Acarbose and miglitol

A

decrease glucose absorption from the gut

19
Q

what is general role of sulfonylureas

A

enhance insulin secretion

20
Q

when is insulin needed (4)

A

type I (for life), acute illness, pregnancy, type 2 when intolerance or contra-indications to other therapies

21
Q

what are two type of insulin? what are their roles?

A

Basal insulin: long acting

bolus insulin: short acting, after meals

22
Q

what are the current methods of blood glucose testing 2

A

fingerstick, continuous glucose monitoring

23
Q

what are the 3 general macrovascular complications seen in patients with diabetes 3

A

metabolic injury to large blood vessels that supply heart (myocardial infarct), brain (stroke), or extremities (amputations)

24
Q

what are the 3 general microvascular complications associated with diabetes?

A

complications in the small blood vessels (capillaries): retinopathy (blindness), nephropathy (kidney failure), neurpathy (amputation)

25
Q

what is the best way to prevent DM in pre-diabetics?

A

lifestyle change!

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