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Foundations 1 - Week 4 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Describe the mecahnisms of Diabetic Ketoacidosis (DKA)?

A
  1. Without insulin, glucose in the blood can not be picked up by cells
  2. This triggers the pancreas to release glucagon, and the pituitary to release CRH.
  3. This stimulates Glycogenolysis, Gluconeogenesis, and Lipolysis, leading to more glucose in the blood.
  4. Eventually, fatty acids are broken down into ketones which supply energy to the body.
  5. The accumulation of ketone bodies increases the acdicity of the blood plasma.
  6. The increased glucose levels and ketone bodies lead to osmolatiy effects, which causes the kidneys to excrete lots of fluids.
  7. The paitent becomes dehydrated, which further increases the acidity of the blood. The cycle continues to repeat.
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2
Q

Who is more likely to get diabetic ketoacidosis, type I or type II? Why?

A

Type 1, becuase they don’t produce any insulin.

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3
Q

What is the difference between Type I, Type II, and gestational diabetes

A

Type I - immune system mistakenly destroys beta cells in the pancreas. The body does not produce ANY insulin

Type II - The body become resistant to insulin over time. The beta cells deminish in number and function over time producing less and less insulin.

Gestational - Pregnancy causes insulin resistance.

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4
Q

What are the 4 screening tests for diabetes?

What are the normal values?

What are values that indicate diabetes?

A
  • Fasting Blood Glucose
    • Normal - <100 mg/dL
    • Diabetic - >125 mg/dL
  • 2 hr Oral Glucose Tolerance Test (OGTT)
    • Normal - <140 mg/dL
    • Diabetic - >200 mg/dL
  • Random Blood Glucose (not very good)
    • Normal - N/A
    • Diabetic - >200 mg/dL
  • HbA1c - long term indicator of diabetes
    • Normal - <5.7%
    • Diabetic - >6.5%
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5
Q

What are some long term consequences of Diabetes?

A
  • Macrovascular Complications
    • Heart, Brain, Extremities
      • Heart Attacks, strokes, amputations
  • Microvascular complicatoins
    • Eye, Kidney, Nerves
      • Blindness, kidney failure, amputation
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6
Q

What are some clinical manifestations of Type I diabetes

A
  • Young
  • Sudden onset
  • Severe symptoms (ketosis)
  • Recent weight loss
  • Thin
  • Insulin Only
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7
Q

What are some clinical manifestations of Type II diabetes?

A
  • Older
  • Gradual Onset
  • May be no symptoms
  • Often no weight loss
  • Obese
  • Pills/Insulin
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8
Q

What is HbA1c testing for?

A

Hemoglobin A1c - a glycolated hemogloin. One that has glucose stuck to it. Since RBCs only last 120 days, it is a good inidcator of glucose levels over the last 3 months.

  • More Glucose in the blood = more HbA1c
  • Less Glucose in the blood = less HbA1c
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9
Q

What are 3 methods for the management of diabetes?

A
  1. Diet / Nutrition
  2. Exercise / Weight Loss
  3. Medications and Drugs
  4. Behavioral Therapy

However, management of diabetes should be taliored to the indiviuals needs and conditions.

  • Safety
  • Hypoglycemia concerns
  • Weight gain
  • Effectiveness
  • Blood sugar patterns
  • Durability
  • Cost
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10
Q

How much of a role does genetics play in developing diabetes?

Name 6 other risk factors.

A

Genetics is a small component related to the risk of getting diabetes.

Other risk factors include:

  • Obesity & BMI
  • Ethnicity
  • Family History
  • Environment
  • Stress
  • Other rare diseases
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11
Q

What is MODY?

A

Maturity Onset Diabetes of the Young - they are genetic defects of insulin producing genes.

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12
Q

What is the number one risk factor associated with diabetes?

A
  • Obesity
    • Body Fat Distribution - visceral wasit fat is worse
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13
Q

What are 4 risk factors for diabetes inutero?

A
  1. High Birth weight
  2. Low Birth Weight
  3. Pre-mature
  4. Child of Mother with Gestational Diabetes
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14
Q

What is the DPP (Diabetes Prevention Program)?

A

Study that looked at how lifestyle changes could delay the onset of type 2 diabetes.

Changes in lifestyle had the most effects. 1 kg of weight loss = 16% drop in risk of getting diabetes.

Does not necessarily lower risk of retinopathy

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15
Q

What is metabolic Syndrome?

What are 5 the risk factors?

A

A clustering of serveral interrelated metabolic risk factors that increases an individuals risk for cardiovascular disease, stroke, and type 2 diabetes. 3 or more risk factors below designate metabolic syndrome.

  1. Waist Circumference
    1. Men - >40 in
    2. Women - >35 in
  2. Triglycerides - >150 mg/dL
  3. HDL (good)
    1. Men - <40
    2. Women - <50
  4. Blood Pressure - >130/85
  5. Fasting Glucose - >100 mg/dL
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Foundations 1 - Week 4 (7 decks)

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