diabetes

Question 1

what is hyperglycemia

Answer 1

• too much glucose in blood
• lack of adequate uptake by cells
• 3.5-8 good BGL

Question 2

Hyperglycemia pathway and S+S

Answer 2

If too much glucose in blood =
- Glucose going into filtrate in urine
- Glucosuria occurs + H2O loss
- Turns into polyuria = increase plasma osmolarity = polydipsia

Question 3

No insulin response pathway

Answer 3

• Glucose in blood stream cannot be absorbed
• Cells send out appetite signals
  = increase hunger
• Increase lipids in blood = adipose tissue = atherosclerosis
• Lipids only = not enough oxyloacetic acid generates for Krebs cycle = build up of Acety CoA
  = converted into ketone bodies
  = go into blood (acidic)
  = ketoacidosis

Question 4

Complications type 2 diabetes

Answer 4

1. Retinopathies
   Due to retinal vascular glycosylation
2. Nephropathies
   Due to glomerular vascular glycosylation
3. Atherosclerotic conditions
   CAD, PAD
4. Neuropathies
   Due to neural glycosylation
   Mostly affects peripheral neurons
5. Keto acidosis
   Due to changes in cellular metabolism
   Leads to acidity in blood
   Causes dehydration
   Disrupts electrolyte levels
   If occurs, treatment includes
   Insulin, iv fluids, K+

Question 5

Diagnosis and evaluation

Answer 5

• Fasting blood glucose levels
• Oral glucose tolerance test = (GDM diagnostic)
• HbA1C
  = Hemoglobin in RBC
• Hb Accumulate glucose over the lifetime if RBC
• Accumulation is proportional to glucose levels in blood
  = get average blood glucose levels over life of RBC (120 days)
  values =
  below 55mol/mol

Question 6

Management for type 1 and 2/GDM

Answer 6

• Type 1
  Insulin
  Glucose monitoring
  Diet + exercise
• Type 2/GDM
  Diet and exercise
  Oral hypoglycemics
  Insulin
  + glucose monitoring