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MCBM Exam 4 Kat > Diabetes Mellitus > Flashcards

Diabetes Mellitus Flashcards

1
Q

What is Type 1 Diabetes?

A

An autoimune destruction of pancreatic beta cells resulting in a lack of insulin production

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2
Q

What is Type 2 Diabetes

A

Insulin resistance due to insulin signaling defect

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3
Q

What percent of women develop gestational diabetes?

A

4% or about 135,000 cases/yr

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4
Q

About how many americans have diabetes?

A

25.8 million (8.3%)

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5
Q

What percent of diabetics are Type 1?

A

5-10%

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6
Q

Define Polyuria and what causes it in diabetes.

A

Excess glucose, urea and ketone bodies are excreted and water goes with them

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7
Q

Define Polydypsia and what symptom of diabetes causes it.

A

Dehydration leads to excessive thirst

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8
Q

What dental issues come with polydypsia?

A

Xerostomia

Dental Caries

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9
Q

Define Polyphagia and what symptom of diabetes causes it?

A

Lack of insulin action on anorexigenic peptide synthesis leads to excessive hunger

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10
Q

What are the acute symptoms of uncontrolled diabetes?

A

Polyuria
Polydypsia
Polyphagia

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11
Q

What is Diabetic Ketoacidosis (DKA) caused by?

A

Insufficient insulin leading to persistent high blood glucose (>300mg%)

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12
Q

What is DKA often associated with?

A

Infection - 40%
Missed insulin - 25%
Untreated or undiagnosed - 15%

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13
Q

What are other stresses that may be associated with DKA?

A

Heart attack
Stroke
Trauma
Surgery

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14
Q

What are some symptoms of DKA?

A

Acetone Breath
Kussmaul breathing (short breath and increased respiration)
Excessively high blood glucose

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15
Q

What are the 4 main diagnostic tests for diabetes?

A

Fasting Plasma Glucose Test (FPG)
Oral Glucose Tolerance (OGTT)
Hemoglobin A1c
C-peptide

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16
Q

What is the pre-diabetic and diagnostic levels of FPG?

A

100-125 mg% in pre diabetics

>126 mg% is diagnostic

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17
Q

What is the pre-diabetic and diagnostic levels of OGTT?

A

140-199 mg% @ 2 hr is pre-diabetes

>200 mg% is diagnostic

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18
Q

What is the management goal of Hemoglobin A1c?

A

<7%

19
Q

What does the C-peptide diagnostic test do?

A

Verifies Type 1

20
Q

In the glucose tolerance test are [blood glucose] levels elevated or depressed?

A

Elevated when compared to normal

21
Q

When HbA1c levels go up what happens to the blood glucose levels?

A

It increases at a proportional rate

22
Q

What is a byproduct of converting proinsulin to mature insulin?

A

The C peptide

23
Q

What is the treatment goal of diabetes?

A

Lower blood glucose level

24
Q

What is the direct target of weight loss and what is its overall effect?

A

The direct target is adipose tissue with an overall effect of restoring insulin sensitivity

25
Q

What is the direct target of exercise and what is its overall effect?

A

The direct target is Muscle and AMPK Activation with an overall effect of enhancing glucose uptake

26
Q

What is the direct target of sulfonylureas and what is its overall effect?

A

The direct target is K+ channel blocker with an overall effect of enhancing insulin secretion

27
Q

What is the direct target of Biguanides and what is its overall effect?

A

The direct target is AMPK activator with an overall effect of enhancing glucose uptake

28
Q

What is the direct target of Thiazoladinediones and what is its overall effect?

A

The direct target is PPARgamma activator with an overall effect of potentiating insulin

29
Q

What is the direct target of insulin and what is its overall effect?

A

The direct targets are muscle and adipose with an overall effect of enhancing glucose uptake

30
Q

Long term sequelae of diabetes?

A 
Diabetic Retinopathy
Periodontal Disease
CVD and Stroke
End Stage Renal Disease
Peripheral Neuropathy
Prolonged wound healing
Infection
31
Q

What is glycation?

A

Stable, covalent ketoamine linkage of glucose to amino termini and lysine residues of proteins

32
Q

What results in glycation?

A

Glucose spontaneously participating in a Schiff reaction

33
Q

What are the end products of glycation called?

A

AGEs or Advanced Glycation End Products

34
Q

What are receptors of AGEs called?

A

RAGEs

35
Q

What do RAGEs trigger?

A

Increased oxidative stress

Mimics chronic inflammation via NFkB

36
Q

What are some sequelae of Chronic Vascular Inflammation?

A 
Increased risk for development of atherosclerotic plaques
Impaired vasodilation
Impaired flow-mediated dilation
Impaired response to adenosine
Increased stiffness of aorta
Renal & Carotid artery stenosis
37
Q

How does one diagnose Periodontitis?

A 
Appearance of gingival
Bleeding on probing
Pocket probign depth
Tooth Mobility
Alveolar bone loss
38
Q

What might perio disease contribute to?

A

Insulin resistance

39
Q

At what percent is HbA1c considered to increased the risk of severe periodontal disease by 3?

A

9%

40
Q

What does excess insulin lead to?

A

Hypoglycemia

41
Q

What are the symptoms of hypoglycemia?

A 
Confusion
Irritability
Sweating
Shakiness
Unconsciousness
42
Q

What should you do if blood glucose is <70 mg%?

A

Use the rule of 15

43
Q

What is the rule of 15?

A

15g carbs increases blood glucose by 15mg% in 15mins

MCBM Exam 4 Kat (10 decks)

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