Diabetes Flashcards
What are the symptoms of diabetes?
polyuria, polydipsia, tiredness
Describe type I diabetes.
insulin deficiency; autoimmune condition, immune mediated pancreatic B cell destruction, autoantibodies (IAA - insulin autoantibodies, ICA - islet cell antibodies), often in young people, but LADA (latent autoimmune diabetes in adults).
What are the management options for diabetes?
type I: insulin regiments
type II: weight loss, diet restriction (avoid carbohydrates), surgery (gastric bypass), oral hypoglycaemia agents (sulphonylureas increase insulin secretion - gliclazide, biguanides increase insulin sensitivity - metformin, thiazolidinediones - rosiglitazone)
What are the complications of diabetes?
large vessel - atheroma, angina, MI, claudication, anneurysm
small vessel - poor wound healing, infection risk, renal disease, eye disease (retinopathy), neuropathy
type I: hypoglycaemia (unconscious, confused, pale), diabetic ketoacidosis, hyperglycaemia
What is the dental relevance of diabetes?
poor wound healing, appointment time, hypoglycaemic episodes, infection risk, CVS risk
Describe type II diabetes.
insulin insensitivity; older, obese, MODY possible (maturity onset diabetes in young), strong family history, dyslipidaemia, procoagulant epithelial markers, early and accelerated atherosclerosis, gradual onset
What is the action of insulin? When is it released?
Released in response to raised blood glucose concentration
Acts to lower blood glucose
Facilitates glucose entry into: muscle cells, adipocytes (glucose uptake by liver is not insulin dependent)
Promotes formation of: glycogen, triglycerides, facilitates protein synthesis
What is the action of glucagon? When is it released?
Released in response to low blood glucose concentrations
Acts to raise blood glucose levels
Facilitates: glucogenesis in liver, gluconeogenesis in liver, lipolysis, ketone synthesis
