Complications of diabetes - patho Flashcards
Does diabetic ketoacidosis occurs in type 1 or type 2 diabetes
type 1
What occurs in ketoacidosis
gluconeogenesis occurs forming ketones
Clinical manifestations of DKA
polyuria, polydipsia, polyphagia, nausea, vomiting, altered mental status, dehydration, kussmauls respirations
Diagnostic criteria of DKA
blood glucose 250 or greater, arterial pH lower than 7.3, serum bicarbonate lower than 18, ketonuria, ketonemia
Treatment of DKA
frequent blood glucose checks, fluid and electrolyte replacement, IV insulin
Does hyperosmolar hyperglycemia syndrome occur in type 1 or type 2 diabetes
Type 2
What occurs in HHS
hyperosmolarity of the blood occurs due to increased urination and fluid being pulled from the cells due to the presence of glucose –> dehydration
Clinical manifestations of HHS
polyuria, polydipsia, dehydration, altered mental status, seizures
Diagnostic criteria for HHS
blood glucose greater than 600, mild acidosis, blood osmolarity greater than 320, small urine ketone, small blood ketone
Treatment for HHS
fluid and electrolyte replacement, IV insulin, treat infection/cause
How does hyperglycemia cause immunosuppression
extra glucose diminishes the efficiency of WBCs, T-cell and phagocytic functions are affected by hyperglycemia
Micro vascular damage
retina, neurons, nephrons
Macro vascular damage
coronary artery disease, cerebrovascular disease, peripheral vascular disease
Peripheral neuropathy
damage to small arterioles that supply nerves –> no blood supply –> demyelination and axonal injury
Retinopathy
damage of endothelium and ischemia of retinal artery
