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HD & T SG > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What is the definition of diabetes?

A

relative or absolute deficiency of insulin, causing glucose intolerance

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2
Q

At what level is a diabetic’s fasting blood sugar?

A

> 125 mg/dL

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3
Q

Where will a diabetic’s glucose levels fall after a 75 gm glucose tolerance test?

A

> 200 mg/dL after 2 hours

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4
Q

What percent of the US population are diabetic?

A

8-9%

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5
Q

How many people in the US die per year from diabetes?

A

73,000

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6
Q

What percent of diabetics go un-diagnosed?

A

50%

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7
Q

What percent of the population is in a pre-diabetic state?

A

14%

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8
Q

What fasting blood glucose level defines being pre-diabetic?

A

100-125 mg/dL, or HbAlc is 5.75-6.4%

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9
Q

What are 4 symptoms of diabetes?

A
  1. Polydipsia
  2. Polyphagia
  3. Polyuria
  4. Unexplained weight loss
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10
Q

Insulin does not effect glucose uptake in what?

A

neurons, kidney and red blood cells

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11
Q

Insulin is what type of hormone (anabolic or catabolic)?

A

anabolic hormone (helps control normal growth patterns and tissue development)

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12
Q

What is the main function of insulin?

A

Promote glucose and amino acids

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13
Q

Through which membranes does insulin promote glucose and amino acids?

A

skeletal/smooth/cardiac muscle cells, fibroblasts, and fat cells

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14
Q

Through which membranes does insulin promote glucose and amino acids?

A

skeletal/smooth/cardiac muscle cells, fibroblasts, and fat cells

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15
Q

List 3 consequences of diabetes

A
  1. Increased lipolysis resulting in blood ketosis and elevated triglycerides
  2. Increased glycogenolysis and gluconeogenesis
  3. Anabolic effect (protein catabolism of muscle-can cause wasting)
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16
Q

Which type of diabetes requires insulin?

A

Type I

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17
Q

What is the more common age of patients with type I diabetes?

A

3-20

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18
Q

Where can glucose levels often fall before type I diabetes is diagnosed?

A

up to >500 mg/dl

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19
Q

(T/F) Type I diabetics are often overweight

A

False

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20
Q

What are 5 common effects on the body of a type I diabetic?

A
  1. Ketoacidosis-dehydration;
  2. Deep labored breathing (caused by acidosis)
  3. Nausea
  4. Coma
  5. Anorexia
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21
Q

What happens to the autoimmune system of a type I diabetic?

A

Loss of beta cells an autoimmune process-probably triggered by environment such as a viral infection

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22
Q

What type of diabetes is commonly known as “adult-onset?”

A

Type II

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23
Q

In type II diabetes, insulin levels are usually:

A

Normal

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24
Q

What is a type II diabetic’s problem with insulin?

A

Resistance of insulin receptors to insulin stimulation

25
Q

Type II diabetes correlates with what two things?

A

Excessive visceral fat and hypertension/ risk for atherosclerosis, dyslipidemia

26
Q

Most type II diabetics are over what age?

A

30

27
Q

There are increasing numbers of type II diabetics due to what?

A

Obesity

28
Q

What percentage of type II diabetics are obese, where proper diet and exercise will reverse symptoms?

A

80-90%

29
Q

(T/F) Type II diabetics have very high glucose

A

True

30
Q

(T/F) There are MINIMAL ketones or acidosis for type II diabetics.

A

True

31
Q

Are certain ethnic groups at higher risk for type II diabetes?

A

Yes, Pima Indians, Hispanics, African Americans, etc.

32
Q

What are the likely genetics that stem type II diabetes?

A

Polygenic autosomal

33
Q

What is Metabolic Syndrome (Syndrome X)?

A

A group of risk factors that can increase your chance of developing heart disease, diabetes, and stroke.

34
Q

What are some features of metabolic syndrome (In short atherogenesis and thrombus?

A
  1. Complex interaction between obesity and Insulin resistance
  2. Type II diabetes-insulin receptors refractory to insulin
  3. Abnormal lipid metabolism-high triglycerides & LDL, low HDL
  4. excess fat around waist
  5. Hypertension
    Increased risk for atherosclerosis
  6. Prothrombic tendency
  7. Proinflammatory state
35
Q

What are three pathogenesis factors of metabolic syndrome?

A
  1. Increased visceral adiposity
  2. Impaired glucose metabolism and insulin sensitivity
  3. Increased hepatic inflammation and cirrhosis
36
Q

What are 3 major metabolic complication of metabolic syndrome?

A
  1. Very high glucose
  2. Hyperosmolar consequences, including coma
  3. Brain swelling due to increased osmolarity
37
Q

What percent of pregnancies result in gestational diabetes due to the stress of pregnancy?

A

3-10% of pregnancies

38
Q

(T/F) Gestational diabetes lasts beyond pregnancy

A

False

39
Q

What are two risks in babies with diabetic mothers?

A

Early hypoglycemia in baby if mothers not well controlled

Fetal malformation if mothers not well controlled

40
Q

What can diabetes do to the placenta?

A

Can cause problems with insufficient placental function and babies that are abnormally large with excessive insulin secretion

41
Q

Glucose becomes sorbitol and is trapped in lens of eye. Opthalmic swelling follows and causes what?

A

Swelling, cataracts, retinopathy, neuropathy, glaucoma and blindness

42
Q

Diabetics are (more/less) prone to infection and have (fast/slow) healing

A

more, slow

43
Q

(T/F) Diabetics’ symptoms often worsen with stress

A

True

44
Q

What is the most common cause of death in diabetics?

A

Coronary atherosclerosis with MI

45
Q

Other secondary complications associated with diabetes:

A 
Autonomic nerve dysfunction 
abnormal GI motility 
hypotonic bladder
increased UTI
Accelerated atherosclerosis 
unhealthy cholesterols
lipid metabolism
Kidney, heart, and brain complications
46
Q

What often happens to the feet and extremities of diabetics?

A

Peripheral neuropathies –loss of touch and pain in extremities (such as feet); gangrene (frequent feet amputations)

47
Q

What are 4 oral concerns with diabetic patients?

A

Increased gingivitis and periodontitis
Poor wound healing (issue with oral surgery or implants)
Abnormal infections such as thrush/candida
Xerostomia (increased caries)

48
Q

What are the 5 types of insulin?

A

Rapid-acting, short acting, NPH (neutral protein hagedorn), Insulin glargine, Insulin determir

49
Q

Which two types of insulin are good long-acting, background insulins?

A

Insulin determir and insulin glargine

50
Q

How long is the onset, peak, and persist of short-acting insulin?

A

30 min. onset, peaks 2-3 hours, persists 5-8 hours

51
Q

What substance helps to delay onset and lengthen duration of short-acting insulin?

A

crystalline zinc

52
Q

What are the pharmacokinetic features of NPH (neutral protein hagedorn)?

A

onset=2-15 hrs; duration=4-12 hours

53
Q

Which type of insulin is often mixed with other shorter acting insulins for both immediate insulin and sustained insulin needs?

A

NPH (neutral protein hagedorn)

54
Q

What HbA1C level is considered to be diabetic?

A

Greater than 6.5%

55
Q

Insulin from beta cells promotes amino acid and glucose movement into what five types of cells?

A
  1. Skeletal
  2. Smooth muscle
  3. Cardiac Muscle
  4. Fibroblasts
  5. Fat cells
56
Q

What cell is particularly sensitive to disruptions in insulin? And Why?

A

Fat cells MOST IMPORTANT - CAN CAUSE DIABETES BY SELECTIVELY BLOCKING INSULIN EFFECTS IN FAT CELLS

57
Q

Insulin works with what receptor on cell membranes?

A

GLUT 4

58
Q

Which two peptides are secreted from beta cells in the islets of Langehans?

A

Glucose and Peptide C

HD & T SG (12 decks)

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