Diabetes Mellitus Flashcards
What are the counter regulatory hormones?
Glucagon, epinephrine,GH, cortisol =opposite effects of insulin —> INCREASE blood glucose by stimulating glucose production and liver output
Combo of the 4 + insulin = sustained release of glucose for energy during food intake and periods of fasting
What does insulin do?
Released from the pancreas –> beta cells
Promotes transport of glucose from blood across cell membrane and into the cytoplasm of the cell
….—> picks up glucose and puts it in cells
Impacted my INCRETIN
What is the normal blood glucose range?
70-100 mg/dl
What does the rise in insulin after a meal mean?
Stimulates storage of glucose ass glycogen in the liver and muscle (glycogenesis)
Inhibits conversion of proteins to glucose (gluconeogenisis)
Enhances fat cells to store TG
Increases protein synthesis
What does the INCRETIN hormone do?
Produced in intestines
Secreted in response to the presence of food
Increases insulin , decreases glucagon
Slows rate of gastric emptying= if have food to fast BG Will SPIKE fast
Assists in relate of insulin in the pancreas
Ex) Biaeta
Types of DM: MODY (maturity onset DM of the young)
Not related to CV or obesity
Genetic: autosomal dominant : over time ps crease starts to die out–> beta cell dysfunction
Types of DM: type 1
Nick Jonas
Insulin dependent Failure of pancreas- NOT producing insulin= need supplements Genetic- recessive ? Can be Caused by toxins / virus 5-10% of all diabetics
Type 1…
Requires exogenous insulin
DKA
3 P’s: polydipsia (thirst), polyphagia (hunger- cellular starvation), polyuria (>250-300 BG)
If no insulin = cells starve …BG builds up= hyperglycemia in blood and NOT in cells =NO Insulin to put glucose in the cells
RENAL THRESHOLD–> once exceed >250 then glucose goes into urine bc glucose is so high will have pool of water with it—- osmotic dieresis = polyuria & dehydration
What is prediabetes/ impaired glucose tolerance (igt) / IFG ?
Beta cells become fatigued from over production
Beta dysfunction is mild (a symptomatic– slight increase in glucose)
Pts. W/ IGT are at risk for DM 2 w/in 10 yrs
Have functioning pancreas– overtime pancreas is working overtime and eventually starts to fail
How do you know if have this?? Get BG checked !!
Pre diabetes
100-126( fasting)
Danger to CV is already occurring
Chem 7 will show glucose #
EDUCATE: healthy diet & exercise to prevent full blown DM
What is type 2
Adult onset 90% of pts. Genetics/ dominant, multifactor INSULIN RESISTANT ---> pt. produces insulin but lacks receptors it are sensitive to insulin AA & Hispanics
Type 2…
Hyperinsulemia & hyperglycemia
Correlated w obesity
> 35 y.o. increase kids w DM
INSULIN PRODUCTION = is insufficient to meet needs of body and or poorly utilized in tissues
NOT UTILIZING INSULIN= NOT GETTING GLUCOSE INTO CELL ( no uptake by cells) = NO ENERGY
Can result in HHNK:
Hyperosmolar
Hyperglycemic
Nonketotic state
Type 2…
Insulin Resistant
Receptors/ tissue don’t respond to insulin = insufficient # or unresponsive receptors
3P's: NOT SIGNIFICANT unless INCREASED BG Fatigue Recurrent infections Visual changes Prolonged healing time
Type 2: metabolic syndrome = cluster of abnormalities working together to increase CV disease & Stroke & DM
⬆️ BG ⬆️TG ⬆️ldl ⬇️hdl HTN Obesity (fat on abdomen-⬆️ insulin resistance) No exercise
Tx: EDUCATION ON EXERCISE AND WEIGHT LOSS
Diagnosis of DM type 2
IFG , random glucose , OGTT
Fasting plasma glucose : no caloricintajr for at least 8 hours
PREGGO Dx: 2 hr. Oral glucose tolerance test (OGTT): multiple blood draws > 2h after glucose load of 75g –> >200 = DM , >140& 500
Random glucose:
Drawn anytime
Meals, drugs, stress can increase this
Critical values: >180 on 2 occasions / >200 w s/s of hyperglycemia
