Diabetes

Question 1

General Info

Answer 1

Two types: Type 1 (insulin def = IDDM) and Type 2 (Insulin resistant = NIDDM)
Both have hyperglcemia
Long term = macro and microvascular damage

Question 2

Diab Type 1

Answer 2

Typically associated with childhood, genetics, autoimmune attack on beta cells
No insulin secretion
Cannot stim Glut 4 (adipocytes and striated muscle)
Glucagon reigns
Hyperglycemia due to glucose having no destination leading to glucosuria and polyuria
Ketoacidosis

Question 3

Proteins and Type 1

Answer 3

Decreased protein synth, increased breakdown for gluconeo, more urea cycle

Question 4

Carbs and Type 1

Answer 4

Increased glycogenolysis and gluconeo since body thinks its starving

Question 5

Fat and Type 1

Answer 5

Increased lipolysis and ketogenesis, decreased lipogenesis

Question 6

Diab type 1 and Starvation

Answer 6

D1: glucagon at high levels, Insulin absent, hyperglycemic, ketoacidosis

Starve: Insulin low, normoglycemic, physio ketoacidosis

Question 7

Tx of type 1

Answer 7

exogenous insulin at correct dose to avoid hypoglycemia (too many Glut4)
Non fast
Electrolyte infusion (to make up for water loss)

Question 8

Diab Type 2

Answer 8

Due to chronic overeating, more prevalent in adults
Constant insulin due to constant food leading to insulin resistance due to desense of receptors
Hyperinsulinemia
Hyperglycemic due to low fx of insulin
Could be genetic (MODY - purely genetic, AD)

Question 9

Tx of type 2

Answer 9

Lose weight

metformin - reduces hyperglycemia by inhib gluconeogen

Question 10

Chronic effects of Diab

Answer 10

Hyperglycemia leads to glycation of proteins
Vessel occlusion
Glucose to sorbitol to cataracts
Retinopathy: glycated Hb stuck in retinal caps - blindness
Neuropathy: symmetrical loss of sensation
Autonomic dysfx
CVD due to increased chol
Nephropathy