Diabetes Mellitus Flashcards
What happens on Type 1 diabetes?
Type 1 diabetes is characterized by an absolute deficiency of insulin caused by an autoimmune attack on the beta cells of the pancreas. The islets of Langerhans become infiltrated with activated T lymphocytes, leading to a condition called insulitis. This type of diabetes leads to ketoacidosis. Beta cell destruction requires both a stimulus from the environment (such as a viral infection) and a genetic determinant that allows the beta cell to be recognized as “nonself”
When is the onset of type 1 diabetes?
It is usually during childhood or puberty. They can usually be recognized by the abrupt appearance of polyuria (frequent urination), polydipsia (excessive thirst), and polyphagia (excessive hunger)
What is the usual fasting blood glucose (FBG) of a type 1 diabetic patient?
The diagnosis is confirmed by a FBG greater than or equal to 126mg/dl, commonly accompanied by ketoacidosis.
Overall description on VLDL levels, Chylomicrons, glucose, ketone bodies type 1 diabetes?
Ketosis result form the massive mobilization of fatty acids from the adipose followed by hepatic ketogenesis. Heperglycemia results form increased hepatic gluconeogenesis and decreased glucose uptake by insulin-dependent GLUT-4 of adipose tissue and muscle. Chylomicrons accumulate, VLDL accumulate, no insulin, and glucagon excreted from pancreas.
Why Type 1 diabetic patients have hypertriacylglycerolemia?
Because lipoprotein degradation by lipoprotein lipase is low in adipose tissue. (Synthesis of the enzyme is decreased when insulin level are low), the plasma chylomicron and VLDL levels are elevated, resulting in hypertriacylglycerolemia.
What happens to type I diabetic pt. almost universally after four years of diagnosis?
They develop a deficiency of glucagon secretion. These pts thus rely on epinephrine secretion to prevent severe hypoglycemia. However as teh disease progresses, Type I diabetes pts show diabetic autonomic neuropathy and impaired ability to secrete epinephrine in response to hypoglycemia.
What happens with obese people who have insulin resistance but working beta cells?
Obesity is the most common cause of insulin resistance. Most people with obesity and insuling resistance do not become diabetic. In the absence of a defct in Beta -cell function, nondiabetic, obese individuals can compensate for insulin resistance with elevated levels of insulin.
Where will we primarily see insulin resistance on type 2 diabetes pts.?
We will see insulin resistance on liver, muscle, and adipose tissue.
What patient with diabetes suffer from cataracts?
Because the lens of the eye is not insulin dependent, hence pts are hyperglycemic. The overflow of glucose will cause the formation of sorbitol, which in turn will produce cataracts.
What happens in Type 2 diabetes?
Type 2 diabetes has a strong genetic component. It results from a conbination of insulin resistance and dysfunctional Beta cells. The metabolic alterations observed in type 2 diabetes are milder than those described for the insulin-dependent form of the disease, in part because we have some insulin secretion which does restrain ketogenesis and blunts the development of diabetic ketoacidosis (DKA)
What are the chronic complications of diabetes?
Premature atherosclerosis, retinopathy, nephropathy, and neuropathy.
