Diabetes Mellitus Flashcards
What is the exocrine part of the pancreas?
Acini cells
What are the three enzymes released by the acini cells?
- Amylase
- Lipase
- Trypsin
What is the endocrine part of the pancreas?
islet of Langerhaans
What do the alpha and beta cells release?
- alpha - glucagon
- beta - insulin
What is another name for Diabetes Mellitus 1?
insulin dependent
When does DM1 occur?
as early as 6 years old or birth
What percentage of DM patients does DM1 affect?
10%
What is the cause of DM1?
Heredity
What is the management of DM1?
insulin
What are the manifestations of Diabetic Ketoacidosis in DM1?
- Kussmaul’s breathing
- Fruity breath / acetone breath
- Monomorphic tachycardia
When does DM2 occcur?
Usual onset is adulthood
What is the cause of DM2?
- Diet
- Sedentary lifestyle
- Obesity
What is another name for DM2?
insulin resistant
What percentage of DM patients does DM2 affect?
90%
What is the management for DM2?
Oral hypoglycemic agents
What is the complication of DM2?
Hyperosmolar Hyperglycemic Nonketotic Acidosis
What are the hallmark signs of diabetes?
- Polyphagia
- Polydipsia
- Polyuria
What causes polyphagia in diabetic patients?
No glucose for cell = cell starvation = signals the hypothalamus to increase appetite
What causes polyuria and polydipsia in diabetic patients?
Increased glucose in the blood increases diuresis = frequent urination and dehydration
What is glycosuria?
excretion of glucose in urine, occurs when blood sugar level reaches 180 g/dL
What are the manifesations of increased glucose in the blood?
Reduced blood viscosity and diuresis
What occurs if there is reduced blood viscosity?
- Reduced tissue perfusion
- Delayed wound healing
What occurs when there is decreased tissue perfusion?
- Retinopathy
- Nephropathy
- Neuropathy
What occurs when there is delayed wound healing?
Parasthesia
What causes Gestaional Diabetes Mellitus?
human placental lactogen has an anti-insulin effect on the mother so that the glucose in the mother’s body can go to the fetus
What can HPL cause?
Macrosomia
What is the important reminders for Diabetic Foot Care?
BASICS TA
Bawal barefoot
Apply lotion
Shoes well-fitted
Inspect foot daily
Cotton socks
Soap, mild
Tapping motion when drying
Avoid hot water
What are the diagnostic procedures for Diabetes Mellitus?
- Capillary Blood Glucose
- Hemoglobin A1C
- FBS
- Oral Glucose Tolerance Test
What important question should you ask the patient for CBG?
Ask if they have eaten in the last 30 minutes to 1 hour
What is the expected values for CBG?
70 - 100 g/dL
What is HbA1C?
Glycosylated hemoglobin
What is the benefit of HbA1C?
It can test the compliance of the patient to the regimen as it can test the blood sugar for the past 3 months
What important reminders should you give the patient for FBS?
No meals post midnight or 6-8 hours of fasting
What are the expected values in FBS?
- 70 - 100 g/dL (Normal)
- 100 - 125 g/dL (Prediabetic)
- 125 and above (Diabetic)
What is the best test for diagnosing DM?
Oral Glucose Tolerance Test
How long should you wait after giving the patient a sweet drink?
2 hours
What is the criteria for diagnosing DM in OGTT?
140 g/dL and above (Diabetic)
What are the types of insulin?
RARE IN LOVE
- Rapid
- Regular
- Intermediate
- Long
- Very Long
What are examples of Rapid Insulin?
- Humalog
- Aspart
- Lispro
When is the peak of Rapid Insulin?
30 - 60 minutes
What are examples of Regular Insulin?
Suffix R
When is the peak of Regular Insulin?
2-3 hours
What are examples of Intermediate Insulin?
Suffix N
When is the peak of Intermediate Insulin?
6-12 hours
What are examples of Long Acting Insulin?
Suffix U or ultratente
When is the peak of Long Acting Insulin?
12-16 hours
What is an example of Very Long Acting Insulin?
Lantus
When is the peak of Very Long Acting Insulin?
no peak, works for 24 hours
