Diabetes Flashcards
Type 1 diabetes is caused by
lack of insulin secretion
Type 2 Diabetes is caused by
decreased sensitivity of target tissues to the metabolic effects of insulin (resistance)
T/F Insulin insufficiency leads to hyperglycemia from decreased cell entry, increased gluconeogenesis, and glucose release from the liver
TRUE
Glucose is reabsorbed by kidney until about ____
180gm/dl
DM s/s
hypovolemic hypotension, dehydration, polyuria(osmotic diuresis), polydipsia (intraveascular volume depletion), polyphagia and weight loss (increased appetite from hypothalamus ventromedial nucleus)
low insulin leads to muscle and fat ___
catabolism - increases the release of keo acids, causes an anion gap metabolic acidosis
DM neurologic
CNS irritability/confusion - hypertonic ECF leads to cell shrinkage
what causes visual disturbances
sorbitol formation in lens causes osmotic swelling, glycation leads to opacification. microvascular dz affects perfusion of retina
microvascular effects of DM include
nephrophathy, retinopathy, neuropath
DM1 - destruction of ___ cells results in loss of insulin release
beta
DM1 is caused by
viral infections or autoimmune disorders
T/F in DM1, receptor and cellular mechanisms are usually abolished
FALSE - usually preserved
DM2 is caused by
greatly diminished sensitivity of target tissues to metabolic effects of insulin
T/F High levels of keto acids are usually present in type 2 DM
FALSE
which type of DM is more common
2
Plasma insulin is ___ in type 2
elevated
normal Hgb A1C range
4-5.6%
T/F insulin inhibits inflammatory growth factors important in acute MI, and general inflammatory responses
TRUE
blood sugar > ___ should be treated
200
DKA occurs because of ___ insulin levels or __ counterregulatory hormones (glucagon, cortisol, GH, catechols) that render insulin ineffective
low, elevated
dehydration, acidosis, electrolyte depletion are characteristics of
DKA
patients with DKA have ___ protein breakdwon
accelerated - leads to increased liver gluconeogenesis, , worsening hyperglycemia
DKA leads to ___ of b-oxidation of fatty acids
activation
DKA symptoms:
n/v, polyuria/dipsia/phagia, anorexia, orthostatic changes, kussmaul breathing, acetone halitosis
LOC changes associated with DKA are related to ____
osmolality (not acidosis)
treatment for DKA includes ___ resuscitation, ___ replacement , and ___ therapy
fluid, electrolyte, insulin
DKA patients have severe __kalemia
HYPER
which dz is has symptoms of thrombosis from hyperviscosity, focal neuro/reflex signs, global neuro signs, confusion, sz. coma?
nonketotic hyperosmolar state
T/F treatment of nonketotic hyperosmolar state includes fluid resuscitation, K+, phos, and insulin if needed
TRUE
T/f the mortality is higher in DKA than nonketotic hyperosmolar state
FALSE
what is the formula for osmolarity
2[NA] + glucose/18 + BUN/2.8
early response from the liver to hypoglycemia is ___ breakdown
glycogen
late sign of hypoglycemia is ___ stim and ___ release
sympathetic stim, epi release
very late sign of hypoglycemia is ___ and ___ secreted
GH and cortisol
T/F Insulinoma is beta cell adenoma - shock=coma under 20mg/dl, and treat with glucose (glucagon, epi)
TRUE
hypoglycemia shock develops in range of ___
20-50
tx for hypoglycemic shock?
D50 + infusion of D5
