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Medical Conditions II > Diabetes Mellitus > Flashcards

Diabetes Mellitus Flashcards

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USMLE® Step 1 flashcards
1
Q

Diabetes

A

-impairment of glucose metab in which glucose is underutilized and blood glucose levels become abnormally elevated (hyperglycemia)

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2
Q

1 Person Dies from DM every _____

A

7 Seconds

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3
Q

Insulin

A
  • protein hormone produced by islets of Langerhans cells in pancreas
  • stimulates cellular uptake of glucose and suppress production of glucose
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4
Q

in absence of insulin ____

A

-blood glucose rises to abnormally elevated levels

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5
Q

Cause of diabetes mellitus

A
  • impairment of glucose metabolism

- from defect in insulin production or reduction of insulin potency

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6
Q

DM

A

-diabetes mellitus

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7
Q

All cells in body require insulin for _____, except _____

A
  • glucose to enter cell

- CNS tissue & working/exercising Mm tissue

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8
Q

Normal Physiology of Insulin/Glucose Relationship

A
  • cells in body need glucose for energy
  • glucose too large to pass across cell membrane
  • insulin triggers transport proteins (GLUT 4) to go to cell wall
  • GLUT 4 transports glucose into cell
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9
Q

Abnormal Physiology

A

-insulin not present/not sufficient amounts
-glucose collects in blood and can’t enter cells
OR
-insulin present but cell wall/transport proteins resistant to its action
-glucose collects in blood and can’t enter cells

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10
Q

Type 1 Diabetes diagnosed:

A

-in childhood (under 20 years)

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11
Q

Type 1 Diabetes

A
  • body makes little/no insulin
  • insulin injections required
  • prone to ketoacidosis & disorders associated hyperglycemia
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12
Q

Type 2 Diabetes

A
  • adulthood (>40)
  • pancreas doesn’t make enough insulin for normal blood gluocose levels
  • body doesn’t respond well to insulin
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13
Q

Children have a ____chance of developing diabetes

A

-1/3

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14
Q

Gestational Diabetes

A

-develops at any time during pregnancy who does not have diabetes

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15
Q

S/Sx Type 1 Diabetes

A
  • polydipsia
  • polyuria
  • polyphagia
  • weight loss
  • fatigue
  • nausea
  • vomiting
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16
Q

S/Sx Type 2 Diabetes

A
  • polydipsia
  • polyuria
  • polyphagia
  • fatigue
  • blurred vision
  • slow-healing infections
  • impotentce
17
Q

Complications of DM

A
  • brain damage (stroke, dementia)
  • cardiovascular disease
  • urinary/sexual dysfunction
  • neuropathy
  • diabetic coma
  • retinopathy
  • atherosclerosis
  • kidney malfunction
  • poor wound healing
18
Q

to decrease risk of stroke:

A
  • physical activity
  • no smoking
  • moderate alcohol consumption
  • normal body weight
  • low-fat diet
  • high intake fruits/veggies
19
Q

Neuropathy

A
  • decr perfusion of nerve tissue

- accum of sorbitol, leading to fluid/electrolyte imbalance in nerve tissue

20
Q

Atherosclerosis

A
  • incr fat metabolism (type I)
  • incr blood cholesterol levels (type I and II)
  • connection between insulin resistance and atherosclerosis
21
Q

Osteoporosis

A

-bone matrix formation inadequate if insufficient circulating insulin levels

22
Q

Infection

A
  • vascular disease leads to tissue hypoxia, decr healing ability
  • pathogens which gain entrance feed on excess glucose in extracellular body tissues
  • vascular disease also leads to decr WBC response
23
Q

Atherosclerosis—>

A
  • CVA
  • MI
  • PVD
24
Q

Infection, neuropathy—->

A
  • ulceration

- amputation

25
Q

Retinopathy—>

A

blindness

26
Q

Nephrophathy—>

A
  • ESRD

- dialysis dependence

27
Q

Osteoporosis—>

A
  • spinal compression fractures

- hip fractures

28
Q

Management of DM

-Reduce controllable risk factors

A
  • -obesity
  • -first degree relatives with DM
  • -HTN
  • -Hypertriglyceridemia
  • -previous evidence of impaired glucose homeostasis
29
Q

DM Diagnosis

A
  • 2 hour glucose tolerance
  • HbA1C (glycosylated Hb)
  • fasting blood glucose
30
Q

Management of DM

A
  • earlier detection

- frequent monitoring

31
Q

Exercise for DM

A

-monitor blood glucose levels before and after

32
Q

Optimal blood glucose range prior to exercise

A

-100-150mg/dL

33
Q

Optimal timing of exercise

A
  • 2-3 hours after a meal

- moderate intensity to prevent abrupt changes in blood glucose

34
Q

Benefits of Exercise for DM

A
  • incr insulin sensitivity for up to 16 hours post ex’s
  • improve lipid profile
  • decr body fat
  • reduce BP
  • decr platelet stickiness
  • decr stress
  • prevent deconditioning
  • incr socialization
35
Q

Guidelines for Exercise

A
  • 150 min/week spread over at least 3 days each week

- resistance ex’s 2-3x/week

36
Q

Foot Care Instructions

A
  • check feet daily
  • wash feet daily (dry thoroughly)
  • soften dry skin with lotion/patroleum jelly
  • protect feet with comfy, well-fitting shoes
  • ex’s daily to promote circulation
  • podiatrist
  • remove socks and shoes at healthcare provider appts
  • stop smoking

Medical Conditions II (34 decks)

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