Diabetes Flashcards
Exocrine Function of pancreas
pancreatic cells secrete directly into ducts, not bloodstream
Endocrine function of pancreas
cells secrete insulin directly into bloodstream
What is the primary source of blood sugar that our body receives?
Carbohydrates
Where are carbs broken down?
duodenum and proximal jejunum
Where does the endocrine function of the pancreas occur?
Islet of Lagernans
Alpha cells function
secrete glucagon in response to low blood sugar
Glucagon function
stimulates liver to release stored glucose into the blood
Beta cells function
produces insulin which lowers blood sugar levels by stimulating the movement of glucose into the body tissues
What hormones raise blood glucose?
Glucagon
Epinephrine
Glucocorticoids
Steroids
growth hormone
Fat sparing effect
drives cells to use carbs instead of fat for energy
What are the three results of insulin deficiency?
Decreased glucose uptake
Increased proteolysis
Increased lipolysis
Free fatty acids
alternative source of energy for tissues
excess: cholesterol and phospholipids
can lead to ketogenesis and acidosis
Short term complications of impaired fat metabolism
increased ketones
severe metabolic acidosis - coma
Long term complications of impaired fat metabolism
atherosclerosis
increased serum lipid levels
Proteolysis
body is unable to store protein efficiently
Protein catabolism
can occur in starvation pts
muscle wasting
multiple organ dysfunction
aminoacidmia
increased BUN
more typical in type 1 DM
Glycosuria
excretion of sugar in urine
increased acetones in urine
positive urine dipstick
occurs when hyperglycemia gets beyond control of what kidneys can absorb
Polyphagia
increased hunger due to fat and protein catabolism
Polydipsia
increase thirst due to serum osmolality
Polyuria
frequent urination due to osmotic diuresis and loss of electrolytes
Diabetes Mellitus
metabolic disorders characterized by HYPERglycemia resulting from absolute or relative insulin deficiency
Hb A1C
3 month avg of blood sugar (%)
normal: 4-6
prediabetic: 5.7-6.4
diabetic: >6.5
Fasting plasma glucose
normal: <99
prediabetic: 100-125
diabetic: >126
Oral glucose tolerance test
*tests for gestational diabetes
normal: <139
prediabetic: 140-199
diabetic: >200
Type 1 DM
most common in pediatrics
autoimmune, genetic predisposition and environmental trigger
ACUTE onset, complications not present at diagnosis
Is Type 1 a rapid or slow onset?
Rapid
Which type of diabetes destroys beta cells?
Type 1
Type 1 S/Sx
3 Ps
fatigue
weight loss
prolonged wound healing
visual changes
Type 2 DM
genetic and environmental
Insulin RESISTANT- loss of sentivity of insulin receptors
Risk factors of Type 2 DM
Age
obesity
sedentary lifestyle
physical inactivity
HTN
family hx
Type 2 S/Sx
non specific
blurry vision
vision changes
increased thirst
increased urination
recurring infections
unexpected weight loss
slow wound healing
tingling in feet
Diabetic Ketoacidosis
more common in type 1
Hyperosmolar Hyperglycemia Syndrome
more common in type 2
Hypoglycemia
very rapid onset
BS <55-60
Hypoglycemia S/Sx
pallor
sweating
anxiety
tachycardia
increased hunger
headache
blurred vision
irritable
restlessness
palpitations
Microvascular complications
damage to capillaries
retinopathy
nephropathy
neuropathy
Macrovascular complications
more common in type 2
damage to large blood vessels
coronary artery
peripheral vascular
cerebral vascular
atherosclerosis
Microangiopathy
small blood vessel disease
What is the most common diabetic complication?
neuropathy
Diabetes and Infection
diminished warning signs
tissue hypoxia
rapid proliferation of pathogens
What type of injection is insulin given through?
SubQ
