020515 diabetes Flashcards

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1
Q

effects of GLP-1

A

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

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2
Q

what hemoglobin a1c is considered pre-diabetes

A

5.7-6.4%

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3
Q

short term complications of diabetes mellitus

A
electrolyte abnormalities
fatigue
poor wound healing
impaired immune defenses
prolonged hospital stay
increased inpt morbidity, mortality
DKA
hyperosmolar hyperglycemic state
tx related hypoglycemia
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4
Q

long term complications of diabetes mellitus

A

microvascular: retinopathy, nephropathy, neuropathy
macrovascular: coronary artery dis, peripheral vasc dis

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5
Q

two defects of diabetes mellitus type 2

A

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

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6
Q

how does obesity predispose one to type 2 diabetes?

A

it induces an inflam nature around the adipocytes. this inflam induces insulin resistance

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7
Q

meglitinide

A

works like sulfonylureas

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8
Q

antigen in T1DM

A

GAD65 from beta cells

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9
Q

when does type I diabetes usually present (in terms of beta cell fxn)?

A

when pt has lost 80% of beta cells

the pre-diabetes stage is asymptomatic

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10
Q

biochemistry of ketoacidosis

A

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

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11
Q

ketone bodies-list them

A

acetoacetate
beta hydroxybutyrate
acetone

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12
Q

what to do for severe hypoglycemia

A

emergency care with glucagon (to release glucose)

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13
Q

bed wetting

A

sign of type I diabetes in child

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