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flashcardlet > Diabetes > Flashcards

Diabetes Flashcards

1
Q

part of the pancreas that secretes hormones into the blood

  • made up of approximately a million cell clusters called islets of Langerhans
  • 4 main types of islets(alpha, beta, delta, pp cells)
  • most endocrine cells are in direct contact with blood vessels by either cytoplasmic processes or direct apposition
A

endocrine system

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2
Q

produces digestive enzymes and an alkaline fluid secretes them into the small intestine through a system of_______ ducts secrete a bicarbonate and salt rich solution into small intestine
-secretes products outwardly by duct

A

exocrine system

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3
Q

is central to regulating carbohydrate and fat metabolism

  • stops the use of fat as an energy source by inhibiting release of glucagon
  • provided within the body in constant proportion to remove excess glucose from the blood which otherwise would be toxic
A

insulin

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4
Q

compact collection of endocrine cells arranged in clusters and cords and are crisscrossed by a dense network of capillaries
-lined by layers of endocrine cells in direct contact with vessels

A

islet of langerhans

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5
Q

increased secretion of______ released after meals helps maintain euglycemia (normal blood glucose)

  • normal range 60-110mg/dL
  • maintained by INTERNAL FEEDBACK mechanism involving pancreas and liver
  • essential for the utilization of glucose for cellular metabolism as well as for proper metabolism of protein and fat
A

insulin

a peptide HORMONE produced by BETA CELLS of the pancreas

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6
Q

small amounts of the _______ insulin are released into the ____ _____ in response to changes in blood glucose levels throughout the day

A

Hormone

blood stream

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7
Q

insulin affects the conversion of glucose into glycogen for storage in the liver and skeletal muscles and allows for the immediate release and utilization of glucose by the cells

A

CARBOHYDRATE metabolism

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8
Q

amino acid conversion occurs in the presence of insulin to replace muscle tissue or to provide needed glucose

A

protein metabolism

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9
Q

storage of fat in adipose tissue and conversion of fatty acids from excess glucose occurs only in presence of insulin

A

fat metabolism

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10
Q

a gland organ in the digestive and endocrine system-a dual function gland
-has features of both endocrine and exocrine glands

A

pancreas

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11
Q

a simple monosaccharide found in plants

  • one of 3 dietary monosaccharaides absorbed directly into the bloodstream during digestion
  • cells use it as primary source of energy and a metabolic intermediate
  • this fuels cellular respiration
A

glucose

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12
Q

a metabolic disorder characterized by hyperglycemia and results from defective insulin production, secretion, or utilization

A

diabetes

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13
Q

an absolute or relative lack of insulin produced by the beta cells/defect at cell level impaired secretory response of insulin to increase in glucose and increase nocturnal hepatic glucose production in type 2

A

diabetes

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14
Q

insulin dependent and seen in juvenile diabetes

A

type 1

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15
Q

little or no endogenous insulin and requires injections to control diabetes and prevent ketoacidosis

A

type 1

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16
Q

5-10%of diabetic patients suffer this
autoimmunity, viral, genetics
most common in 30yr olds

rapid polydipsia, polyphagia, polyuria, and weight loss

A

type 1

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17
Q

non insulin dependent
adult onset
caused by combination of insulin resistant and relative insulin deficiency
90% of patients have this

A

type 2

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18
Q

strong hereditary component associated with obesity

slow and typically insidious with symptoms of fatigue, weight gain, poor wound healing, recurrent infection

A

type 2

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19
Q

abnormality in glucose levels between normal and overt diabetes

  • asymptomatic; can progress or remain the same
  • may be at risk for hypertension, coronary heart disease and hyperlipidemia
A

prediabetes

impaired glucose tolerance: >140 <200 in 2 hour sample

20
Q

carbohydrate intolerance during pregnancy
-occurs in 4% of pregnancies and usually goes away after birth
-puts at higher risk for later diabetes
screening should occur between 24-28 weeks gestation

A

gestational diabetes

21
Q

what drugs decrease insulin activity resulting in hyperglycemia?

A

corticosteroids (prednisone)
thiazide diuretics (hydrochlorothiazide)
estrogen
phenytoin(Dilantin)

22
Q

what disease states affect the pancreas or insulin receptors?

A 
pancreatitis
pancreatic cancer
cushing's 
muscular dystrophy
hunnington's
23
Q

accurate determination of capillary blood glucose assists patients in control/management of diabetes, helps evaluate effectiveness of meds, reflects glucose excursion after meals and helps determine treatment

A

blood glucose monitoring

patients with type 2 monitor at lease 2 times a day
patients with type 1 monitor 4-6 times a day

24
Q

involves SQ injection immediate, short or long term insulin
injection sites: upper arms, abdomen, upper thighs, and upper asscheeks!
do NOT shake, ROLL in palms and mix clear to cloudy injecting air into cloudy first

A

insulin therapy

25
Q

onset: 5-15 mins
peak: 0.5-1.5 hours (30-90 mins)
duration: <5 hours

A

immediate acting
lispro(Humalog)
aspart(novolog)
apidra(glulisine)

26
Q

onset: 30-60 mins
peak: 2-3 hours
duration: 5-8 hours

A

fast/short acting

humulin-R
novolin-R

27
Q

onset: 2-4 hours
peak: 4-10 hours
duration: 10-16 hours

A

intermediate acting

insulin isophane, suspension. NPH, humulin N. novulin Nm

28
Q

onset: 3-8 hours
peak: no peak
duration: 15-13 hours

A

long acting

levemir(detemir)

29
Q

onset: 2-4 hours
peak: no peak
duration: 20-24 hours

A

long acting

Lantus

30
Q

designed to mimic the body’s normal insulin responses to glucose
uses multiple daily injections of insulin
can be flexible to accommodate mealtimes and physical activity

A

intensive insulin therapy

31
Q

appropriate only in type 2 diabetes

  • NPH or long acting is given in the evening or oral sulfonylurea in the morning
  • BIDS: bedtime insulin daytime sulfonylurea
A

combination oral and insulin therapy

32
Q

continuous infusion of regular or lispro insulin via SQ catheter in abdomen

  • cath changes Q72hs and removed for bathing
  • usually only in type 1 but now common in type 2 who require multiple daily injections
A

pump therapy

33
Q

uses regular or intermediate insulin to retrospectively correct hyperglycemia

  • individualized to patient
  • exercise decreased blood sugar
A

sliding scale

34
Q

2x common in diabetics

  • increase risk of stroke, hypertension
  • change in mental status aphasia and hemiparesis
  • maintain target blood glucose, hyperglycemia leads to dehydration which affects platelet aggregation
A

CVD cerebrovascular disease

35
Q

A(alpha) cells secrete what?

A

glucagon

36
Q

B(beta) cells secrete what?

A

insulin

37
Q

O(delta) cells secrete what?

A

somatostatin

38
Q

PP cells secrete what?

A

pancreatic polypeptides

39
Q

drawn at anytime- non fasting

  • note time and content of last meal
  • sugar>200 with signs of diabetes
  • advise to refrain from smoking prior to test
A

random glucose

40
Q

drawn 2 hours after meal to evaluate glucose metabolism

-advise to refrain from smoking prior to test

A

postprandial test

41
Q

drawn after 8 hour fast to evaluate circulating amounts of glucose

  • FBS: >126 on 2 occasions
  • result of >100 demands close follow up and monitoring
A

fasting blood sugar

42
Q

evaluates insulin response to glucose loading. patient must remain seated and refrain from smoking

  • samples taken 1/2, 1, 2, 3 hours
  • usual diet and exercise must be followed for 3 days prior to test
  • oral contraceptives, diuretics, nicotine acid, can impair results
A

oral glucose tolerance test (OGTT)

43
Q

measures glycemic control over 60-100 day period by measuring the irreversible reaction of glucose to hemoglobin through freely permeable erythrocytes

  • no prior preparation
  • fasting and with holding insulin are necessary
  • results can be affected by RBCs
A

glycated hemoglobin A1C

44
Q

What are 4 main types of islets of langerhans and which one produces insulin.

A

alpha, beta, delta, pp cells. Beta cells

45
Q

What protein in the pancreas produces insulin.

A

C-peptide

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