4 - Diabetes Flashcards by marilee welch

Definition of diabetes

A group of metabolic disease characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both.

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What is chronic hyperglycemia associated with?

Long-term damage, dysfunction and failure of: the eyes, kidneys, nerves, heart, and blood vessels.

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3 types of tests to screen for diabetes?

Random plasma glucose test, fasting glucose level test, and oral glucose tolerance test.

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Diagnostic criteria of diabetes

Symptoms + a random plasma glucose greater than 11.1 mmol/L; or, a fasting blood glucose greater than 7.0 mmol/L, or a 2 hour post-meal glucose test greater than 11.1 mmol/L.

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Polydipsia

excessive thirst

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Polyuria

frequent urination

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High blood sugar symptoms

Increased thirst, increase urination, ketones in urine, aching/weak, heavy breathing, nausea, vomiting, and fatigue.

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Low blood sugar symptoms

Cold sweats, headache, trembling, pounding heart, sleepiness, personality changes, and excessive hunger.

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What is insulin secretion promoted by?

Increased blood glucose levels

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What organ is the main target for glucagon?

The liver

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What is glucagon secretion mainly promoted by?

Decreased blood glucose levels.

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Glucagon causes blood sugar to rise, in contrast with…

insulin, that causes blood sugar to drop.

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What are various triggers for glucagon release?

Exercise, starvation, decreased insulin, certain hormones, and sympathetic stimulation.

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4 types of diabetes classification based on pathogenesis

Type 1, type 2, secondary, and gestational.

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Insulin dependent diabetes mellitus

An absolute deficiency of insulin secretion.

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Description of type 1 diabetes

Insulin dependent diabetes, autoimmune destruction of beta cells, autoantibodies, genetic predisposition, and commonly occurs in childhood.

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Causes of ketoacidosis

Not enough insulin, not enough food, not enough blood sugar.

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Symptoms of ketoacidosis

Excessive thirst, frequent urination, nausea and vomiting, abdominal pain, weakness or fatigue, shortness of breath, fruity-scented breath, confusion, hyperglycemia, high ketones in urine.

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Type 2 diabetes begins with…

insulin resistance

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Insulin resistance leads to…

decreased glucose uptake and an inability to suppress gluconeogenesis.

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Onset of signs and symptoms occurs…

Usually after 30 years of age.

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Which type of diabetes is more strongly associated with genetic factors?

Type 2

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Environmental risk factors for type 2 diabetes

Westernized lifestyle, high energy diet, and reduced physical activity.

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Modifiable risk factors of diabetes

Weight, activity level, cholesterol level, and high blood pressure.

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Non-modifiable risk factors of diabetes

45+ years, close relatives with diabetes, other medical conditions, high-risk ethnic backgrounds, and gestational diabetes.

What tissues and organs are involved in insulin resistance?

Muscle, adipose tissue and the liver.

Secondary diabetes mellitus is the result of...

some other condition or medication.

Examples of hyperglycemia associated with identifiable causes of islet destruction...

Pancreatitis, removal of the pancreas, pancreatic cancer, and hemochromatosis.

Which populations is gestational diabetes more common in?

Women who are obese and women with a family history of diabetes.

What percentage of women with gestational diabetes are found to have type 2 diabetes immediately after pregnancy?

5% to 10%

Women who have had gestational diabetes have a __ to __ percent chance of developing diabetes in the next __ to __ years.

40%-60% in the next 5 to 10 years

Long-term complications of poorly controlled diabetes

Nephropathy, neuropathy, retinopathy, vascular disease, immunodeficiency, and atherosclerosis.

Diabetic nephropathy pathology

lesions and inflammation of the kidney. eventually can cause renal failure. also characterized by schwann cell injury, myelin degeneration and axonal damage.

Diabetic retinopathy pathology

Microaneurysms, neovascularization, retinal detachment, glaucoma, and cataract formation.

Purpura

red/purple skin spots

hyaline arteriolosclerosis

thickening of the arterial wall

Examples of immunodeficiency caused by diabetes

Decreased immune defenses. UTIs. Skin lesions. Candidiasis.

Number of people globally with diabetes has decreased, increased or stayed the same over the last 20 years?

Increased

In 2014, global prevalence of diabetes among adults is __%

8.5%

Diabetes prevalence has been rising more rapidly in ___ and ___ income countries.

Middle and low income

In 2016, how many deaths were directly caused by diabetes?

1.6 million

Half the people with diabetes in the world live in what 3 countries?

China, India and USA

Why are prevalence rates slightly higher in elderly women?

Women have greater longevity.

What percent of all-cause global mortality was due to diabetes in 2014.

6.8% (or about 7% is fine too)

How many of the deaths attributable to diabetes occurred in developing countries?

2/3

Canada is ___ in prevalence of diabetes around the world.

3rd

Where do we get data on diabetes from in Canada?

Physician claim files, hospital files, and health insurance registry.

How many people are living with diabetes in BC?

220,000 people

What is the prevalence of diabetes in BC?

5.2%

What are the incident cases of diabetes per year in BC?

20,000

Financially, diabetes is a major cause of...

personal crisis for people living with diabetes and financial crisis for our healthcare system.

Direct costs of diabetes to individuals and their families

Medical care, drugs, insulin, and supplies.

Direct costs of diabetes to the healthcare sector...

hospitalization costs, CVD-related hospital costs, and GP costs.

What does "mortality costs" refer to?

Premature death.

What does "long-term disability costs" refer to?

Absence from work, disability, premature retirement, and loss of earnings.

In Canada, we spent ___ on diabetes in 2010.

12.2 billion dollars

The direct cost of diabetes now accounts for __% of public healthcare spending in Canada.

3.5%

_/_ of the total costs of diabetes in 2010 was the cost associated with premature death (in Canada)

2/3rds

__% of the total cost of diabetes in Canada in 2010 was related to direct costs

17%

How many Canadians have diabetes today?

2 million

What percent of Canadians with diabetes will develop complications?

40%

Mortality rates among people with diabetes are ___ as high as those of similar age who do not have diabetes.

twice as high

What is the worldwide economic impact of diabetes

612 billion dollars