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Diabetes Flashcards

1
Q

What is diabetes mellitus?

A

the inability of the body to regulate blood glucose through insulin

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2
Q

What type of diabetes is described by the following?

autoimmune; loss of insulin producing beta cells

genetically linked

juvenile onset

A

type I diabetes - insulin-dependent diabetes mellitus

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3
Q

What type of diabetes is described by the following?

insensitivity to insulin

lifestyle and genetics

adult onset, though becoming more prevalent in juveniles

A

type II diabetes - non-insulin-dependent diabetes mellitus

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4
Q

What type of diabetes is described by the following?

develops during pregnancy

fetus-induced changes in metabolist

A

gestational diabetes

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5
Q

which cells in the pancreas release insulin and which release glucagon?

A
  • beta cells release insulin
  • alpha cells release glucagon
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6
Q

what does the pancreas release in response to high blood glucose levels? what about low blood glucose levels?

A
  • high blood glucose levels
    • pancreas releases insulin
    • stimulus: glucose is absorbed after a meal
  • low blood glucose levels
    • panreas releases glucagon
    • stimulus: cells use or store glucose between meals
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7
Q

T or F:

type I and II diabetes have different causes, but the symptoms of uncontrolled disease are similar

A

true

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8
Q

describe the symptoms of type I diabetes

A
  • polyuria and thirst: ++
  • weakness or fatigue: ++
  • polyphagia and weight loss: ++
  • blurred vision: +
  • peripheral neuropathy: +
  • nocturnal enuresis: ++
  • Other signs include sweet smelling breath, sweet smelling urine, and impaired wound healing
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9
Q

describe the symptoms of type II diabetes

A
  • polyuria and thirst: +
  • weakness or fatigue: +
  • polyphagia and weight loss: -
  • blurred vision: ++
  • peripheral neuropathy: ++
  • nocturnal enuresis: -
  • Other signs include sweet smelling breath, sweet smelling urine, and impaired wound healing
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10
Q

in type I diabetes, the onset is typically ___

A

juvenile

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11
Q

type I diabetes is a lack of ___ production

A

insulin

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12
Q

type I diabetes is a ___ disease that destroys ___ cells

A
  • genetic, autoimmune
  • beta
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13
Q

in type I diabetes, circulating ___ is absent

A

insulin

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14
Q

in type I diabetes, ___ is elevated at onset

A

plasma glucagon

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15
Q

in type I diabetes, pancreatic beta cells fail to respond to ___ stimuli

A

insulinogenic

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16
Q

in type I diabetes, insulin target tissues (liver, muscle, fat) fail to properly absorb ___

A

nutrients

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17
Q

in type I diabetes, ___, ___, and ___ are released into and dysregulated within the blood stream

A

glucose, fats, and amino acids

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18
Q

in type I diabetes, improper fatty acid metabolism increases ___ production and release

A

ketone

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19
Q

in type I diabetes, lack of insulin leads to what?

A

a dysregulated metabolic state of extreme fasting and starvation

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20
Q

autoimmune targeting of ___ drives type I diabetes

A

beta cells

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21
Q

delta cells in the pancreas release ___

A

somatostatin

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22
Q

___% of type I diabetes cases are immune-mediated, and ___% of cases are idiopathic

A
  • 95%
  • 5%
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23
Q

is the cause of type I diabetes known?

A

no, but there is a strong genetic predisposition and environmental triggers

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24
Q

in insulin-dependent diabetes, a ___ cell recognizes peptides from a beta cell-specific protein and kills the ___

A
  • effector T cell
  • beta cell
  • …so the pancreas can still produce stomatostatin (delta cells) and glucagon (alpha cells), but can no longer produce insulin (no beta cells)
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25
describe loss of insulin signaling in type I diabetes
26
describe systemic mimicry of prolonged fasting in type I diabetes
27
uncontrolled type I diabetes leads to \_\_\_
ketoacidosis
28
describe how insulin deficiency can lead to coma and tachycardia?
29
what type of therapy is required by type I diabetes?
insulin replacement therapy
30
what are the three coordinated interventions used in insulin replacement therapy for type I diabetes?
* insulin administration * glucose monitoring * diet
31
describe insulin administration as a method of insulin replacement therapy for type I diabetes
* discovered by frederick banting and charles best in 1921 * required for survival * mimic normal insulin response to food * scaled use depending on blood sugar and diet
32
describe glucose monitoring as an insulin replacement therapy for type I diabetes
* glucometer or continuous interstitial fluid monitoring * allows correction for hyperglycemia and hypoglycemia
33
describe diet as an insulin replacement therapy for type I diabetes
* low CHO diet (35% or lower) * insulin administration is primarily scaled on CHO consumption * glycemic index affects blood sugar and insulin administration
34
what is the goal of insulin administration?
maintain fasting blood glucose between 80 and 140 mg/dl
35
what are 2 approaches of insulin administration?
* injections * pump
36
describe insulin injections
* several injections per day * different insulin types per basal and bolus use * basal insulin maintains low-level systemic insulin * bolus insulin given when food is consumed * highly variable per individual, scaled to CHO consumption
37
describe pumps as a form of insulin administration
* single insulin type * continuous (basal) administration * basal insulin when food is consumed * scaled to consumption and activity * improved control over injections
38
describe type II diabetes
* insulin insensitivity * progressive increase in fasting glucose due to reduced insulin sensitivity followed by a degeneration of insulin production
39
describe the progression of type II diabetes
40
type II diabetes is a ___ disorder, and is the most ___ form of diabetes
* heterogenous * prominent
41
type II diabetes is closely tied to \_\_\_
obesity and visceral adiposity
42
lifestyle factors play a prominent role in the development of which type of diabetes?
type II
43
does type II diabetes have a strong genetic link?
yes
44
there is a high incidence of type ___ diabetes in developed countries
II
45
what are the 3 possible mechanisms of insensitivity in type II diabetes?
* adipokine signaling * ectopic lipid storage and free fatty acids * inflammatory signaling
46
\_\_\_ may drive type II diabetes insulin insensitivity
adipose signaling
47
describe how adipose signaling can drive type II diabetes insulin insensitivity
48
what 3 things can manage type II diabetes?
* lifestyle changes * oral hypoglycemics * insulin
49
describe lifestyle changes as a type II diabetes management approach
* reduced CHO and simple sugar consumption * prevent glucose swings * increase physical activity * maintain healthy body weight
50
describe how oral hypoglycemics can be used to manage type II diabetes
* increase insulin secretion * increase insulin sensitivity * decrease CHO absorption
51
how is insulin used as a management approach for type II diabetes?
required when beta cell mass degenerates
52
at what stages of type II diabetes can the 3 management approaches be effective?
53
name 5 common type II drugs used to treat hyperglycemia
* sulfonylureas * metformin * peroxisome proliferator-activated receptor agonists * alpha-glucosidase inhibitors * drug combinations
54
describe how sulfonylureas can treat hyperglycemia
* increase beta cell insulin secretion (secretagogues) * glipizide, glyburide, and glimepiride
55
describe how metformin can treat hyperglycemia
* uncouples oxidative phosphorylation, reducing liver gluconeogenesis and lipogenesis * AMPK signaling pathway
56
describe how peroxisome proliferator-activated receptor agonists can treat hyperglycemia
* increase glucose transporter expression * thiazolidinediones
57
describe how alpha-glucosidase inhibitors can treat hyperglycemia
* prevent CHO absoprtion * acarbose, miglitol
58
what are the 5 primary methods used to detect diabetes?
* urinalysis * glucose monitoring * HBA1c * glucose tolerance test * c-peptide test
59
what is hypoglycemia?
low blood sugar
60
how is hypoglycemia treated?
* immediate sugar * glucagon * test blood sugar * repeatedly test * call 911 if necessary
61
what is hyperglycemia?
high blood sugar
62
how is hyperglycemia treated?
* insulin * oral hypoglycemic * activity * diet
63
what are some long-term diabetic complications?
* cardiovascular disorders * heart disease, stroke, peripheral vascular disease * blindness * glaucoma, retinopathy * kidney disease * neurologic complications * peripheral and autonomic neuropathy, erectile dysfunction * impaired wound healing and amputation

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