Diabetes

Question 1

def’n of diabetes

Answer 1

disorder of carb, protein and fat metabolism resulting from an imbalance b/w insulin availability and insulin need resulting in hyperglycemia – multi-system disease

Question 2

diabetes prevalence

Answer 2

6.6% for over 12 years old

Question 3

type 1 diabetes rate

Answer 3

10%; aka juvenile diabetes, IDDM

Question 4

type 2 diabetes

Answer 4

90-95%; NIDDM

Question 5

gestational diabetes

Answer 5

glucose intolerance that is first detected during pregnancy

Question 6

type 1 def’n

Answer 6

pancreatic beta cells are progressively destroyed resulting in an absolute insulin deficiency (10%); onset usually rapid; more common in young people; catabolic disorder

Question 7

type 1 causes

Answer 7

1. type 1A autoimmune destruction (95%)

2. type 1B ideopathic diabetes (5%). inherited, non evidence of autoimmunity.

Question 8

with an insulin deficiency…

Answer 8

stored fat is broken down to provide energy resulting in production of ketone bodies (which can lead to ketosis)

Question 9

clinical manis of hyperglycemia

Answer 9

polyuria (glucose in urine)
polydipsia (increased thirst)
polyphagia (increased appetite)
wt loss (d/t mm wasting)
blurred vision 
weakness, fatigue
skin infection (too much glucose helps bacteria multiply)
ketoacidosis

Question 10

type 2 diabetes def’n

Answer 10

pancreas usually continues to produce insulin but it is either insufficient for the needs of the body or is poorly utilized by the tissues or both; 95%; a/w obesity; risk increased after 35 years; genetic (runs in fams); aboriginals 3-5x more likely

Question 11

hyperinsulinemia (a/w diabesity)

Answer 11

increased resistance to the action of insulin

Question 12

(3) major metabolic anomalies have a role in development of type 2:

Answer 12

1. insulin resistance (body tissues do not respond to insulin)
2. marked decrease in ability to produce insulin (cells become fatigued from overproduction of insulin)
3. inappropriate glucose production by the liver

Question 13

insulin resistance

Answer 13

• Insulin resistance stimulates an increase in insulin secretion (hyperinsulinemia), beta cells are trying to maintain a normal blood glucose level. In time, the increased demand for insulin secretion leads to beta cell exhaustion and failure. This results in elevated postprandial blood glucose levels and an eventual increase in glucose production by the liver.
• Increased insulin resistance at the receptor sites of muscle tissue

Question 14

what type of DM is LESS prone to ketoacidosis?

Answer 14

type 2

Question 15

type 2 clinical manis

Answer 15

-develops gradually (S&S may take years)
-symptoms are non-specific (fatigue, irritability, polyuria, polydipsia)
the following cause ppl to seek med attention:
–Pruritis (hyperglycemia and glucosuria favour fungal growth)
–recurrent infections (increased gluc levels stimulates growth of microorganisms and impaired blood supply hinders healing)
–parasthesias (tingling/numbness)

Question 16

type 2 DM – insulin resistance & metabolic syndrome CRITERIA

Answer 16

THREE OR MORE OF:

• abdominal obesity: waist >35” women, 40” men
• triglycerides >1.7 mmol/L
• HDL 130/85 mm Hg
• FBS > 6.1 mmol/L

Question 17

dx tests: FBS

Answer 17

value = or > 7 mmol/L suggests DM

capillary blood glucose (10-15% higher than serum)

Question 18

dx tests: random BS

Answer 18

= or > 11.1 mmol/L plus classic DM S&S

Question 19

dx tests: 2 hr PC blood sugar (postprandial serum glucose)

Answer 19

postload blood glucose level

normal <7.8 mmol/L

Question 20

oral glucose tolerance test (OGTT)

Answer 20

measures body's ability to store glucose by removing it from the blood; 75g concentrated glucose PO; serum and urine samples taken at test, 30 mins, 1 hr, 2 hr, 3 hrs. 
Normals:
-- fasting < 6.1 mmol/L
-- 30 mins < 11.1 mmol/L
-- 1 hr < 11.1 mmol/L
-- 2 hr < 7.8 mmol/L
ABNORMAL: = or > 11.1 mmol/L
3&4 hrs: <6.4 mmol/L