Diabetes Flashcards
exocrine pancreatic enzymes
digestive enzymes and sodium bicarb
which type of cells make the exocrine pancreatic enzymes?
acini cells
endocrine pancreatic hormones
insulin, glucagon and somatostatin
which type of cells make the endocrine pancreatic hormones?
cells in Islets of Langerhans
which type of cells make insulin
beta cells
which type of cells make glucagon
alpha cells
which type of cells make somatostatin
delta cells
where do exocrine enzymes go after they are made?
pancreatic duct
where do endocrine hormones go after they are made?
capillaries
how does insulin lower glucose levels?
it allows glucose to enter into cells
glucagon function
they release glucose from liver into blood in between times of eating
how does Somatostatin lower glucose levels?
decreases GI activity to extend time for food absorption
pancreatic polypeptide
helps to stimulate appetite
what happens to blood glucose after a meal?
it rises which insulin gets secreted, glucose is stored as fatty acids
glycogenesis
glucose stored in liver as glycogen
what happens to blood glucose between meals in order to maintain levels?
liver releases glucose
glycogenolysis
glycogen broken down to release glucose to feed brain
gluconeogenesis
making glucose from amino acids, glycerol and lactate
insulin is made up of how many peptides?
3
hypoglycemia s/s
hunger, tremor, sweating, weakness, malaise, irritability
hyperglycemia s/s
polydipsia, polyphagia, polyuria, dehydration
insulin action on potassium
it increases cell uptake which lowers the K levels in the blood
insulin action on adipose tissue
increases glucose uptake
insulin action on muscle
increase glucose and amino acids
insulin action on liver
increases glycogen uptake
Anabolic insulin action
promotes synthesis of proteins
how do catecholamines maintain blood glucose during stress?
mobilize glycogen stores, decreases movement of glucose into cells in order to feed brain, inhibits insulin release
what happens to people who are onbeta blockers?
hypogycemia s/s dont come through as well
growth hormone function
increases protein synthesis in ALL cells, it doesnt want glucose to go into cells
GLP-1 and GIP and Amylin
hormones released from gut, slow metabolism down and stop glucagon from being released
4 cells that dont require insulin to get glucose?
nerve cells, endothelial cells, RBCs, glamerial lining
type 1 has polyuria, polydipsia and polyphagia but what does type 2 have?
polyuria and polydipsia
which diagnostic test is preferred?
fasting plasma glucose
who uses oral glucose tolerance test (OGTT)
pregnant people
postprandial plasma glucose (PPG)
taken 2 hours after a meal to see how well insulin brings down BS level
Glycosylated Hemoglobin (HbA1C)
most specific, reflects average BS over 2-3months
urine glucose only reflects what?
glucose in urine
c-peptide assaays
reliable indicator for pancreatic beta cell function, this distinguishes between type 1 and type2
syndrome x
people who are “apple shape”, have low HDL, SBP130, fasting lgucose 110, if you have 3 of these you have thi syndrome!
increased uric acid levels, fatty liver, polycystic ovarian syndrome, hemochtomatosis (iron overload) and acanthosis nigricans are associated with what?
syndrome x
if you think a person is in DKA what test do you do?
random plasma glucose >200
Gestational diabetes
lack of BS control during pregnancy that wasnt there before
Diabetic Ketoacidosis (DKA)
type 1, onset within 24hrs, glucose accumulates in blood , fatty acids accumulate in liver and convert to ketones which then accumulate in blood and urine
halmark for DKA
fruity breath
DKA s/s
kussmaul respirations, fruity breath, decreased intracellular K and phosphorous levels, dehydrated, ketonuria, serum glucose 250-600
Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNK)
type 2, have insulin insufficiency, polyuria for several days, serum glucose >600
is there ketoses with Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNK)?
no because there is some insulin!
which system kicks in with hypoglycemia?
the SNS system
neuroglycopenia
hypoglycemia that causes altered cerebral function d/t brain starvation, thats why you get confused, are irritable, and weak
noctunal hypoglycemia
morning headaches, night sweats, nightmares
somogyi effect
unrecognized hypoglycemia at night then hyperglycemia in am, check BS in middle of night
dawn phenomenon
hyperglycemia in am without hypoglycemia in middle of the night because the liver gives us a morning “snack”
glucose overutilization, changes in short-lived glycoproteins, tissue oxygenation, non-enzymatic glycosylation are theories about what?
reasons for diabetic complications
polyneuropathies, mononeuropathies and amyotrophy are which kind of peripheral neuropathies
somatic, youll have tingling in extremities, muscle weakness and diminished reflexes
impaired vasomotor function, impaired GI function, and cranial nerve problems are which kind of peripheral neuropathy?
autonomic
Retinopathy is more prevalent in which type of diabetic?
type 1
what happens to kidneys with diabetics?
it hypertrophies, starts to leak, proteinuria
what prevents nephropathy in diabetics?
Ace inhibitors protect kidneys
best prevention for neuropathy
prevention!, be sure shoes are good fit, inspect for ulcers
granuloma annulare
smooth plaque that are thickened and ring shaped
xanthomas
papules and nodules found in hands and feet
necrobiosis lipoidica
skin condition that puts person at risk for skin carcinoma
acanthosis nigricans
brown build up, see around neck and creases
