Diabetes Flashcards
(35 cards)
What are the general risk factors for type 2 diabetes mellitus (T2DM)?
- Pancreatitis or pancreatic cancer
- Obesity
- Advanced age
- Glucose intolerance
- Family history of glucose intolerance or diabetes
- Gestational diabetes
- Sedentary lifestyle
- Certain infections
What are the risk factors specific to this case study?
- Previous acute pancreatitis
- Increasing weight/obesity
- Possibly excess alcohol consumption (remember high alcohol consumption increases the risk of glucose intolerance, insulin resistance and therefore possibly type 2 diabetes)
What are the general signs and symptoms of T2DM?
- Hyperglycemia
- Glycosuria
- Polyuria
- Prolonged wound healing
- Polyphagia
- Ketoacidosis
- Fatigue
- Polydipsia
- Recurrent infections
- Weight loss
What are the signs and symptoms specific to this case study?
- Hyperglycemia
- Glycosuria
- Polydipsia (Ben said he was drinking a lot)
- Polyuria
- Ketoacidosis
What is diabetes?
Disease that occurs when levels of blood glucose are too high due to insulin insufficiency. There are two types 1 and type 2
What is type 1 diabetes?
When there is total insulin deficiency i.e. the pancreas does not produce an effective amount of insulin
What is type 2 diabetes?
Related to an insufficient amount of insulin production and/or insulin resistance.
What is hyperglycemia?
excess glucose in the blood
What kind of complications can hyperglycemia lead to?
Excess amounts of sugar being filtered at the kidneys. Lead to glycosylation. This leads to glucose transporters for reabsorption becoming saturated, thus glucose remains in the filtrate/urine causing glycosuria and polydipsia due to excess water loss.
What can the lack of glucose availability for cellular metabolism lead to?
Increased lipolysis and hyperlipidemia which can lead to cardiovascular complications such as atherosclerosis, and ketoacidosis due to increased use of fats for cellular metabolism
What complication of increased lipolysis can lead to atherosclerosis?
Hyperlipideamia
Hypercholesterolemia
What complication of increased lipolysis can lead to ketoacidosis?
Increased fatty acid use by cells for ATP generation
What is glycosylation?
The deposition of glucose on the basement membrane of blood vessels and neurons. This affects the ability of substances to move into or out of the blood stream effectively
What kind of complications can glycosylation lead to?
- Nephropathies
- Rentinopathies
- Neuropathies
What is retinopathy?
A common complication of diabetes, blood vessel damage from a diabetic retinopathy can cause vision loss in two ways, Macular oedema or proliferative retinopathy.
What is macular oedema?
Retinopathy when fluid leaks into the part of the retina responsible for sharp, straight-ahead vision causing swelling & blurred vision
What is proliferative retinopathy?
Fragile and abnormal new blood vessels form which easily break, leading to hemorrhages, scarring & retinal detachment
How can diabetes lead to vascular damage in the eye?
Hyperglycemia can lead to glycosylation of blood vessels, whereby glucose gets deposited in the basement membrane of capillaries. This decreases effective gas, nutrient and waste and can lead to localised tissue damage, including microvascular damage. The capillaries of the retina are particularly susceptible to this.
What is Nephropathy?
Microvascular damage can also affect the glomeruli of the kidneys, leading to kidney disease. Diabetic nephropathy is the leading cause of renal failure.
How does diabetes lead to autonomic nephropathy?
Hyperglycemia leads to glycosylation of neurons. This disrupts normal action potential conduction, and when this occurs on neurons of the autonomic nervous system it can affect a variety of functions.
What is the cause of the patients bloating and how has he managed this?
The cause is gastroparesis. He manages this by reducing his meals to only one a day with only one or two small snacks; he avoids a big meal before bed.
Which division of the autonomic nervous system is affected by neuropathy in the case of erectile dysfunction?
Parasympathetic nervous system. With a decrease in effective action potential conduction along parasympathetic nerves to the penis, there is a loss of the ability to gain an erection.
What symptom does the patient experience related to BP and how is this related to autonomic neuropathy?
Postural (orthostatic) hypotension. Standing up too quickly, especially after lying down can lead to a drop in BP. Normally the sympathetic NS is activated to respond to this drop to quickly stabalise BP. With autonomic neuropathy, there is disruption to the action potential output of sympathetic nerves involved in responding to the drop in BP
What is peripheral neuropathy?
Similar to autonomic neuropathy in that glycosylation affects action potential conduction in neurons, however, in this case, it is somatosensory neurons in the periphery (mostly the limbs) that are affected.
