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):
1

today, 1 in __ adults have diabetes

11

2

is diabetes a problem?

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

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

1. poor diet
2. sedentary lifestyle
3. longer life

4

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

unhealthy food is cheaper than healthy food

5

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

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

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

-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

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

treating the complications, NOT preventing the disease

8

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

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

9

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

Type I: younger, sudden, usually thin

Type II: older, gradual, usually obese

10

what are some causes (4) of insulin resistance?

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

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

Pregnancy: placental hormones

Infection

11

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

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

12

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

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

13

what are the symptoms of hyperglycemia? 6

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

14

when should diabetes screening be conducted?2

-every 3 years for individual over 45
-in those with a BMI>25 (overweight)

15

what are the compication ABCs of diabetes?

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

16

In general what is the role of TZD

diabetes medication that decreases insulin resistance of skeletal muscle

17

in general what is the role of Metformin

inhibits gluconeogenesis in the liver

18

what is the general role of Acarbose and miglitol

decrease glucose absorption from the gut

19

what is general role of sulfonylureas

enhance insulin secretion

20

when is insulin needed (4)

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

21

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

Basal insulin: long acting
bolus insulin: short acting, after meals

22

what are the current methods of blood glucose testing 2

fingerstick, continuous glucose monitoring

23

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

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

24

what are the 3 general microvascular complications associated with diabetes?

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

25

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

lifestyle change!

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