Diabetes Mellitus Flashcards
Where is insulin produced?
In the beta cells of the islets of langerhans of the pancreas
What is diabetes mellitus?
Deficiency of insulin and resistance to the effects of insulin
What does insulin do?
Travels in the blood stream and binds to cell membrane receptors of target cells. Regulates glucose uptake and metabolism.
Skeletal muscles and fat cells require insulin to absorb what?
Glucose
What does not require insulin to absorb glucose?
Neurons and a variety of other cells.
What can hypo symptoms seem like?
Drunkness
What happens when someone is hypoglycaemic?
Over dose of insulin can cause loss of neurones if hypo for long time which can lead to brain damage etc..
What are the 5 actions of insulin?
Uptake of glucose by cells.
Uptake of amino acids by cells.
Increased glycogen synthesis.
Increased synthesis and storage of fatty acids.
Decreased lipolysis, proteinolysis and gluconeogenesis.
The feedback to control insulin release is mainly?
Direct feedback
What transporter do beta cells absorb glucose via?
GLUT2
Where else is insulin released?
By cholecystokinin derived from enteroendecrine cells of intestinal mucosa - food into small intestine, releases hormones.
What are four acute consequences of insulin deficiency?
Hyperglycaemia
Ketosis
Acidosis
Hyperosmolar state - draws fluid from other tissues.
Give four chronic consequences of insulin deficiency
Cardiovascular disease
Nephropathy
Neuropathy
Retinopathy
What are the four types of diabetes mellitus?
Type 1
Type 2
Gestational
Secondary
How does diabetes mellitus type 1 develop?
Autoimmune destruction of beta cells, probably triggered by viral infections - coxsackie or rubella viruses.
Diabetes mellitus type 1 susceptibility is dependent on what gene subtypes?
HLA - DR3, DR4
What does diabetes mellitus type 2 have a strong association with?
Lifestyle
What are 6 risk factors of gestational diabetes?
Age Family history African or North American Previous gestational diabetes Previous baby over 4kg Smoking
What are four dangers of gestational diabetes for the mother?
Greater risk of type 2 diabetes later in life
Hypertension
Pre-eclampsia or eclampsia
Obstructed labour
What are six dangers of gestational diabetes for the child?
Risk of type 2 diabetes later in life Risk of obesity later in life Macrosomia Neonatal hypoglycaemia Neonatal jaundice Respiratory disease syndrome
What 6 things can cause secondary diabetes mellitus?
Endocrine disease eg cushings syndrome Chronic pancreatitis Pancreatic surgery Cystic fibrosis Haemachromatosis Drug therapy eg high dose steroids
What are 4 classical symptoms of diabetes type 1?
Polyuria
Polydipsia
Hunger
Weight loss
What is the criteria for diagnoses of diabetes type 1?
Fasting glucose above 7
Glucose at or above 11.1 2 hours after 75g glucose load
Glucose level at or above 11.1 taken randomly
Why does ketoacidosis happen?
Rapid break down of fat and protein releases ketones and acids into blood stream.
Give four acute presentations of diabetes mellitus?
Ketoacidosis
Hyperosmolar nonketotic state
Hypoglycaemia
Diabetic foot
Give three macrovascular chronic presentations of diabetes mellitus
Ischaemic heart disease
Stroke
Peripheral vascular disease
Give 3 micro vascular chronic presentations of diabetes mellitus
Retinopathy
Neuropathy
Nephropathy
What is diabetic retinopathy?
Proliferation of blood vessels in the retina causing retinal haemorrhages and oedema.
What is diabetic neuropathy?
Damage to nerves in blood supply. Peripheral weakness and tingling Occasional neuropathic pain Muscle weakness Autonomic neuropathy
Which three infections are a big risk for those with diabetes mellitus?
Post op infections
Rectal abscess
Pyelonephritis
