Diabetes Flashcards
Gland
Tissue that secretes something
Ducted gland that covers body surface or cavity
Exocrine gland
Ductless gland that secretes into surrounding tissue or the bloodstream
Endocrine gland
Exocrine gland examples
Oil, salivary and sweat glands. Pancreas
Endocrine examples
Pancreas, pituitary, thyroid, parathyroid
Glands secrete chemical messengers called ____
Hormones
What is a hormone?
Chemical messenger that triggers other chemical events in the body. Keeps body in homeostasis
Protein hormone:
Made out of amino acids chains called peptides. Cannot dissolve through the cell membrane easily. Makes proteins ideal for binding with cell surfaces
Hormone proteins target ____
Cell surface
Hormone proteins are the “____”
First messenger
First messenger
Binds to cell membranes that triggers another chemical reaction in the cell membrane. The chemical in the cell membrane is the second messenger.
Second messenger
The chemical in the cell membrane triggered by the first messenger when it comes to protein hormones.
Effects of protein hormones
Rapid acting
Cell activity
Water soluble
Peptide
Strings of amino acids arranged in a special way (i.e. insulin)
Hormones can be ___ or ____
Proteins and lipids
Lipids
Fat
Lipids are intercellular, meaning __________
They dissolve through the cell membrane
Why are lipids intercellar (able to dissolve through the cell membrane)?
The cell membrane is a lipid cell membrane
Amino acids combine to form ____
Proteins
Lipid hormones can be ____ or ____
Cholesterol, fatty acids
Effects of lipid hormones
Slower acting
Stimulates genetic machinary for synthesis
Fat soluble
Insulin is a type of ____ hormone
Protein
Types of protein/amino acid hormones
Epi, nor epi, thyroid
Type of lipid/cholestrol hormone
Type of lipid/fatty acid hormone
Steroids
Prostaglandins
The hypothalmus stimulates/inhibits the ___ gland
Pituitary
“Master Gland”
Pituitary gland
Pituitary gland produces what three hormones?
Thyroid stimulating hormone
Follicle stimulating hormone
Luteinizing hormone
Thyroid does what?
Metabolism
Produces T4, T3 and calcitonin (deposits serum calcium into bone)
Hormone that reduces circulatory serum calcium by making deposits into bone?
Calcitonin (produced by the thyroid)
Parathyroid does what?
Produces parathyroid hormone which increases serum calcium in the blood. Will pull the calcium out of the bone
What hormone increases the serum calcium in the blood by pulling calcium out of the bone?
Paraythroid hormone
Osteoprosis is because:
In post menopause, for women replacement in calcitonin is difficult. Can make withdrawels from bone but not deposits.
Adrenal cortex
Kidney function
Fluid/electrolytes
Inflammatory response
Adrenal medulla
Stress response
Thymus
Immune function
As make way through childhood, shrinks when finished with adolescense, will be gone
Pancreas is an ___ and ____ gland. Produces ____ and ____.
Exocrine and endocrine
Insulin and glucagon
Ovaries
Produce estrogen and progesterone. Produced in follicles of ovaries. Depends on where you are in your menstral cycle and whether or not you are pregnant
Testes
Testosterone
Hypothalmic control is controlled via a ____
Negative feedback loop
Negative feedback loop for hypothalmic control
Hypothalmus produces thyroid releasing hormone (TRH) which triggers the pituitary gland to produce thyroid stimulating hormone (TSH) which triggers to the tyroid to produce T3 and T4 which go to cells and do metabolism. The amount of T3 and T4 then results in a negative feedback loop, which tells the hypothalmus to stop producing TRH and the pituitary to stop producing TSH
Where is the pancreas located?
Left upper quadrant
Oriented posteriorly toward the right
Retroperitoneal space
The pancreas is a solid or hollow organ?
Solid
Pancreas endocrine glands are located where?
Ductless cells located in the Islets of Langorhauns
____ make up 70% of the Islets
Beta cells
What cells produce isulin?
Beta cells
____ cellsm make up 20% of the Islets
Alpha cells
What cells produce glucagon?
Alpha cells
What two hormones help regulate sugar?
Insulin and glucagon
Pancreas exocrine glands are ducted ___.
Acinar cells
What do acinar cells do?
Produce and secrete digestive enzymes
Most of the pancrease is an exocrine or endocrine gland?
Exocrine
Acinar cells secrete digestive enzymes into the ____
Duodenum
Insulin
Proteinaeous hormone
First messenger that triggers a second messenger to open up the cell to glucose
Where is insulin required?
For all cells except the brain and central nervous system because glucose passes freely through the blood brain barrier
Normal sugar metabolism (increase in glucose)
Increase in glucose->stimulates parasympathetic nervous system->stimulates beta cells->increase in insulin->can take sugar (glucose) into cells
Normal sugar metabolism (decrease in glucose)
Decrease in glucose->stimulates sympathetic nervous system->stimulates alpha cells->increase in glucagon-> mobilize sugar stores
Ingested carbohydrates
Carbon, hydrogen, Oxygen
Rapidly absorbed from gut into circulatory system
Carbohydrates
Fatty acid stored as an adipose tissue
Triglyceride
Short term storage in liver and muscle tissue
Glycogen
Glycogen stored in muscle is used for what?
The muscle in which it is stored
Glycogen stored in the liver is used for what?
Systemic use
Long term storage in liver and adipose tissue
Fat
With carbohydrates, for long term storage, take glucose and turn it into ____
Fatty acid
Proteins are made up of
Carbon, hydrogen, oxygen, nitrogen
C, H, O and N are components of ____
Amino acids
Why are proteins a more sustainable source of energy:
More complex, so take longer to break down
Breaking down proteins
Protein->->broken down into glucose (energy) and amino acids (protein synthesis)->glucose and amino acids absorbed into the bloodstreem
Fat breaks down into_____
Fatty acids and glycerol
Fats are ___ uptake and ____ conversion
Slow, slow
When blood glucose level decreases:
Glucagon triggers mobilization of your stores
Breaking of glucose
Glycogemolysis
When burn through glycogen, have to access ___
Fats
Fats->->->->glucose=
Gluconeogenesis
Gluconeogenesis
The creation of new glucose
Why do we burn through glycogen before fats?
Because gluconeogenesis is a clunky process. It is a more complicated pathway
Normal blood sugar
80-140 mg/dL
Fasting blood sugar
Post meal blood sugar
70-100
90-140
Decreased insulin production
Diabetes
Type I diabetes
No insulin production so patients are insulin dependent
Reuslt of autoimmune process??
Usually happens in childhood-“juvenile onset”-genetic component
Type II diabetes
Insulin produced but insufficient quality and quantity
Start off on orgal agents to stimulate pancreas
Patients are non-insulin dependent but may end up becoming partially dependent on insulin
Adult onset diabetes-usually due to lifestyle (diet, obesity, alcohal), but there may be a genetic component
In type 1 diabetes, there is no insulin, so what is happening to blood sugar?
Blood sugar is increasing and glucose is accumulating in the circulatory system
Oncotic pressure and type 1 diabetics
Patient is hyperglycemic (blood sugar >200)=glucose in your urine (sweet urine)->oncotic pressure draws water from cells into vessels. The cells are dehydrated. On a vascular level, there is lots of pressure. The kidneys are overwhelmed.
Signs of type I diabetes
Polyuria
Polydipsia (thirst)
Polyphagia (hunger)
Why are type 1 diabetics experiencing polyphagia?
Cells are not producing enough energy (because no insulin to bind to cell to trigger second messenger to let glucose in) so always hungry
What happens when cannot let glucose into the cells?
The body starts breaking down proteins and fats. Proteins have amino acids and uric acid and fats have fatty acids and ketones
Rapid, deep sighing respirations
Kussmaul respirations
Juicy fruit breath
Acetine breath
Poisoning that results from all the chemicals (amino acids+uric acid+fatty acid+ketones) that shouldn’t be there
Diabetic keto acidosis
Type 1 diabetics: Skin HR RR BP?
Warm and dry
Tachycardic
Increased RR because blowing off acid (remember diabetic keto acidosis)
BP? Not super hypertensive????
Type 2 diabetics have what kind of metabolism?
Hybrid metabolism because have some insulin, but not enough
Type 2 diabetes has:
Hyperglycemia Hyperasmolar non ketatic syndrome
Type 2 diabetics have what symptoms:
Polyuria
Polydipsia (thirst)
Polyphagia (hunger)
Do you need to be diabetic to have hypoglycemia?
No
Onset of hypoglycemia
Rapid
S/S of hypoglycemia
Hungry, irrittable, headache, dizzy, weak, syncope, combative, may eventually seize
Pale, cool, diapheretic
Increased heart rate
nausa
The ____ nervous system is activated when an individual is hypoglycemic
sympathetic
When hypoglygemic, go to ___ cells to stimulate then to relese glucagon
alpha
Go to alpha cells to release glucagon
Adrenergic stimulation
Reasons for hypoglycemia
Too much insulin
Too little food
Too much exercise
When do you give glucose?
Blood sugar <20
Medications that affect blood sugar
Diuretics, steroid, benzodiazponienes, sometimes beta blockers
Other things can can affect blood sugar?
Pregnancy, illness, alcohal
Complications with diabetes -coronary artery disease
Episodes of acidosis->can lead to vascular damage->if damange inside of lumen=plaque build up->hypertension->coronary artery disease
Complications with diabetes-nerve damage
Screws with sodium/potassium pumps across cell membranes=nerves->results in nerve damanger->can have diabetic “nerve pain”, neuropathy, retinopathy,
Vascular damage and nerve damage=set the stage for ____
Necrotic wounds=>healing issues=>amputations
Diabetes are prone to ___, ___ and ____
Renal failure, CVA and silent MI
