Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrine > Diabetes Mellitus > Flashcards

Diabetes Mellitus Flashcards

1
Q

What is the definition of Diabetes?

A

Clinically SIGNIFICANT insulin intolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is type 1 diabetes mellitus?

A

Normal insulin sensitivity and islet underactivity

In dogs normally due to an immune mediated destruction of the islets

This is the case for most diabetic dogs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What kind of diabetes do dogs normally get?

A

Diabetes due to absolute insulin deficiency (type 1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is type 2 diabetes melitus?

A

Insulin resistance which initially leads to islet hyperactivity then islet underactivity as the islets become exhausted

Common with cats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which species generally has variably reversible insulin deficiency?

A

Most diabetic cats

Commonly due to obesity, HAC or hypersomatotrophism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which species generally has absolute insulin deficieny due to decreased islet number?

A

dogs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is insulin resistance?

A

Decreased insulin activity leading to increased insulin secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the causes of insulin resistance?

A

Pregnancy, oestrus, obesity

Hormonal abnormalities (HAC, hypo/hyerthyroidism)

Decreased exercise

Illness

Hyperglycaemia

Increases in plasma NEFA concentration due to lipid disorders or other high levels of lipids

Pancreatitis

Idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you measure Pancreatitis? (in cats)

A

fPLI in the blood. On avergae higher in diabetic cats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What kind of diabetes does hypersomatotrophism cause?

A

Type 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do you generally measure to establish the presence of hypersomatrophism in cats?

A

IGF-1

Growth hormone plus Insulin –> IGF-1

Note IGF-1 probably not raised if insulin not present but GH not a good thing to measure as pulsatile secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What proportion of diabetic cats in the UK suffer from acromegaly?

A

1 in 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What proportion of acromegalic cats have the classic phenotype?

A

1 in 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Do all obese cats get diabetes?

A

Nope, need beta cell dysfunction as well

Genetic component?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the main age group for diabetes in dogs?

A

7-12 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why are females represtented more than males?

A

Because they get diestrus related diabetes. Increased progesterone –> Increased growth hormone at site of mammary gland –> insulin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Is obesity a risk factor in the dog?

A

Not really no, they mainly get type 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which breed is most predisposed to diabetes?

A

Samoyed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What factors increase your chance of getting diabetes if you’re a cat?

A

Age, mostly over 10, obesity (3-5x increased risk), Neutering (2x increased risk) males (1.5x increased risk)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which breed is over-represented in cat diabetes?

A

Burmese (2.3% get it)

Tend to get it when they’re older. If they have it their offspring have a 10% chance of getting it! Genetic component

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the main clinical signs of an animal with diabetes mellitus?

A

Weight loss with increased appetite, polydipsia, polyuria, possibly decreased activity, depression

Will only have inappetance if has another disease as well or ketoacidosis.

Normal diabetes mellitus shouldn’t cause decreased appetite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If a diabetes patient has ketones in the urine what does this mean?

A

They have ketosis, doesn’t necessarily mean they are ketoacidotic

“Sad” diabetics (those with ketoacidosis) have ketonuria AND acidosis.

Those with ketoacidosis will be V+, D+, dehydrated and in a bad way

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which species can have cataracts associated with diabetes?

A

dogs

NOT cats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Are all diabetic cats obese?

A

Nope, some have no history of obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Why might you get ataxia with diabetes?

A

Diabetes can cause diabetic neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which species is mot likely to get stress hyperglycaemia?

A

Cats! get it with illess and stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the clinpath changes you’d expect to see in a diabetic animal?

A

Fasting hyperglycaemia

Fasting hyperlipidaemia

Glucosuria +/- ketonuria

+/- Metabolic acidosis

Altered potassium and phosphate

Elevated ALP and ALT

Elevated fructosamine and glycosylated haemoglobin

28
Q

What does fructosamine represent?

A

Albumin with glucose irreversibly bound

When albumin is stable it represents average blood glucose over the last 3 weeks (ish)

hence can be used to monitor diabetic patients

29
Q

What wil happen to fructosamine levels if there is low albumin?

A

The fructosamine levels will drop, not related to how much glucose there is!

30
Q

Why do cows get ketosis?

A

Because they are in a negative energy balance, high glucose demand leads to NEFA –> ketone synthesis in the liver. Seen with a LOW blood sugar level.

31
Q

What are the six principles/methods of diabetic treatment?

A

Correct underlying causes

Oral hypoglycaemic agents

Insulin preparation

Daily dose & dose frequency

Amount and type of food

Insulin and meal times

32
Q

Is feline diabetes generally reversible?

A

Yes, by working on the acquired factors eg reduce abdominal fat, increase activity etc

33
Q

How long do you nee to have hyperglycaemia for before histological abnormalities in the pancreas are evident?

(Glucotoxicity)

A

Around 2 weeks

Includes glycogen deposition and cell death

34
Q

Why should you treat cats asap?

A

The greater the duration and degree of hyperglycaemia, the more severe the damage

35
Q

What is the danger of aggressive diabetic treatment?

A

Hypoglycaemia

36
Q

WHat are the three general ways we improve the state of diabetes?

A

Decrease demand for insulin, Increase sensitivity for insulin, Increase Insulin availability

37
Q

If you have a female entire diabetic bitch, when should you neuter?

A

ASAP, no point trying to wait until diabetes is stable as will be intisically unstable until she is neutered!

38
Q

What are Sulphonylureas?

A

They are oral hypoglycaemic agents (the only ones proven to be potentially useful in dogs and cats)

39
Q

Why are oral hypoglycaemic agents not ideal

A

They are like red bull for the islets.

Allow compensation for a while but burn out the islets quicker and you need total exogenous insulin sooner.

Not really useful for dogs as their problem is because many of the islets destroyed. Only potentially useful for cats if it’s a situation of put them on it or euthanise, will not inject.

40
Q

What is the most common sulphylurea agent used in animals?

A

Glipizide

41
Q

How long after feeding is the glucose peak?

A

Around half an hour

42
Q

How long does it take the insulin injected to take effect?

A

Around 2 hours

43
Q

What is the only licensed insulin for dogs and what species is it derived from?

A

Caninsulin. Porcine derived

44
Q

How many times do you generally have to inject cats and dogs daily?

A

BID (twice daily)

45
Q

Most insulin preparations last longer or shorter in cats?

A

shorter (but variable)

46
Q

Why is Detemir difficult to use in small dogs?

A

Very potent - small change in dose = big change in impact

47
Q

Why should you rotate injection sites?

A

Causes inflammation and fibrosis at site which will alter absorption of the insulin

48
Q

How should you go about monitoring response to treatment in diabetic animals?

A

Ask owner about water intake, polyphagia and measure weight

Clinical picture is very important

Glucose curves (every 2 hours for 12 hours once settled on insulin dose)

Fructosamine good for telling you average but bad for detail.

One off glucose measurement NOT sufficient for dose change; levels fluctuate

49
Q

What should you do to calories in diabetic animals?

A

Give normal calorie requirement i.e. 60-80 kcal/kg

50
Q

What kind of fat content should you have in diabetic food?

A

moderate

51
Q

What levels of carbohydrates should you have for diabetic cats?

A

LOW levels of carbohydrates - better control and increased remission

52
Q

Is there a proven specific diet that’s best for diabetic dogs?

A

NOPE! Just that it is palatable to the dog and will therefore be eaten reliably.

If there’s another disease that has a specific diet prioritise this

53
Q

What kind of insulin should you give a dog and how often?

A

Lente insulin (eg caninsulin) about 12 hours apart

54
Q

If the glycaemia values look perfect but owner reports wobbly cat, should you worry?

A

YES! hypoglycaemia

55
Q

Do you get remission in dogs?

A

Not in a classic type 1 case, may be reversible if due to HAC, diestrus related etc

56
Q

What are the reported remission rates in cats?

A

25-50%

57
Q

How regularly should you monitor cats with diabetes if you’re trying to get them into remission?

A

Every 12-24 hours, but don’t change the dose this frequently!

Animal insulins are more longer acting than those that suggest daily dose change protocols in humans

58
Q

How quickly should you reduce the insluin dose once remission achieved?

A

Don’t be in a hurry

Reduce by 05 - 1 mg every few days

then to once daily dosing - 1 mg/cat/24h

check glucose evvery 12 hrs post insulin

only stop insulin totally if euglycemic at 12hrs

Continue low carboydrate diet

59
Q

Does the dose tend to increase or decrease in dogs?

A

Increase

tend to stabilise at around 0.75units/kg/12h

Need consistent diet

60
Q

What do you start cats on as a starting dose of insulin?

A

About 1 unit/cat/12h

Will end up probably on around 2 units/cat/12hr

61
Q

What drug would you give to an animal that comes in with ptonic clonic seizure?

A

Place catheter and give midazolam/diazepam

62
Q

True or false, hypoglycaemia can cause a seizure AND a seizure can cause hypoglycaemia?

A

true

63
Q

Is it easy to get hypoglycamia from fasting?

A

Nope, need to be fasting for very long time before you will get hypoglycaemia

64
Q

How badly would the liver need to be damaged to give you hypoglycaemia? (due to liver damage)

A

Very damaged, needs to be in failure

65
Q

What is a stress leukogram?

A

Lymphopenia, netrophila, monocytosis

Occurs due to raised cortisol. If fitting and this is absent think addisons.

66
Q

What does normal insulin levels in the presence of hypoglycaemia suggest?

A

Unregulated insulin secretion, if hypoglycaemic, should be shutting down insulin secretion, not chucking out normal amounts.

Endocrine (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions