April 12, 2016 - Intro to Diabetes Flashcards
Energy Storage Forms
Energy can be stored as glycogen or triglycerides.
Energy Retrieval
To retrieve the stored energy, we can utilize glyogenolysis, lipolysis, and gluconeogenesis.
Types of Diabetes
Diabetes insipidus - insulin secretion is intact (no response to ADH)
Diabetes mellitus - sweet urine because of the sugar that is being filtered but not being able to be bound by insulin and stored
Diabetes Presentation
Can present with or without symptoms.
Symptoms, if present can include polyuria (high concentration of urine overrides ADH), polydipsia (high osmolarity activates osmoreceptors in the brain), and polyphagia (not getting enough energy so you need to eat more).
Symptoms also include weight loss, fatigue, and blurry vision.
Classification of Diabetes
Type 1 - autoimmune cells have destroyed the beta cells in the pancreas and you therefore produce no insulin
Type 2 - insulin resistance where your body is not producing enough to meet the demands and the gap is what causes the high blood sugar
Type 3 - gestational during pregnancy because of the placenta
Type 4 - secondary diabetes related to excess hormones
Arteries and Diabetes
Any atherosclerotic disease you have will be worse with diabetes.
Metabolic Memory
Your body essentially remembers what it is like to be normal. It is easier to get a patient to a target A1C earlier in the disease compared to late stage. It is critically important to reach the normal range of 5-7 early in the disease and bring the metabolism back to what it was before the disease.
This makes screening very important. If you’ve had diabetes for 10 years that has not been well-controlled, the horse is out of the barn and it is too late. Early, good glycemic control is critical.
Hemoglobin A1C
A marker of average blood glucose over the last 3 months (lifespan of a RBC).
In diabetes, higher levels of A1C indicate poorer control of diabetes.
