020515 diabetes Flashcards
effects of GLP-1
slows gastric emptying
stimulates beta cell glucose-dependent insulin secretion and beta cell proliferation
inhibits glucagon release to reduce hepatic glucose output
inhibits alpha cell glucagon secretion
what hemoglobin a1c is considered pre-diabetes
5.7-6.4%
short term complications of diabetes mellitus
electrolyte abnormalities fatigue poor wound healing impaired immune defenses prolonged hospital stay increased inpt morbidity, mortality DKA hyperosmolar hyperglycemic state tx related hypoglycemia
long term complications of diabetes mellitus
microvascular: retinopathy, nephropathy, neuropathy
macrovascular: coronary artery dis, peripheral vasc dis
two defects of diabetes mellitus type 2
insulin resistance (impaired suppresion of systemic glucose production, impaired glucose uptake by insulin sensitive tissues after meals)
inadequate insulin secretion in response to insulin resistance
how does obesity predispose one to type 2 diabetes?
it induces an inflam nature around the adipocytes. this inflam induces insulin resistance
meglitinide
works like sulfonylureas
antigen in T1DM
GAD65 from beta cells
when does type I diabetes usually present (in terms of beta cell fxn)?
when pt has lost 80% of beta cells
the pre-diabetes stage is asymptomatic
biochemistry of ketoacidosis
insulin DEFICIENCY causes hyperglycemia, leading to glycosuria and osmotic diuresis, leading to decreased GFR and severe hyperglycemia, leading to dehydration and shock
meanwhile, lipolysis causes fatty acid transport to hepatocytes and beta oxidation to ketoacids. ketoacids lead to vomiting, which worsens dehydration. ketoacids also cause anion gap metabolic acidosis-leading to compensatory TACHYPNEA
ketone bodies-list them
acetoacetate
beta hydroxybutyrate
acetone
what to do for severe hypoglycemia
emergency care with glucagon (to release glucose)
bed wetting
sign of type I diabetes in child
