Diabetes Mellitus Flashcards
Endocrine pancreas
- Islets of langerhans
- alpha cells produce glucagon
- beta cells produce insulin
Normal blood glucose
75-125
Glucagon
- gluconeogenesis and glycolysis in liver
- epinephrine also does this
glycogenolysis
- breakdown of glycogen to it’s glucose components
gluconeogenesis
- conversion of protein and fat substrate to glucose
Type 1 diabetes
- more common in dogs
- insulin dependant juvenile dz in humans
Type 2 diabetes
- more common in cats
- non-insulin-dependent diabetes adult onset in humans
Secondary diabetes
- Pancreatic disease
- Hormonal
- Drug-induced
- Insulin receptor abnormalities
- Specific genetic syndromes
Consequence of diestrus in intact diabetic patients
Diestrus => inc progesterone => inc Growth Hormone => Peripheral insulin resistence
Clinical signs of diabetes Mellitus
- Not very sick
- PU/PD
- Weight loss
- Sick
- Dehydration
- Depression
- Anorexia
- Tachypnea
- Vomiting
Insulin depletion is a ____ event
catabolic
Diagnosis of Diabetes Mellitus
- Clinical Signs
- Persistant hyperglycemia > 150
- Glycosuria
Uterine pathologies can be _____ mediated
Progesterone
Complicating coexisting problems with diabetes mellitus
- acute pancreatitis
- renal disease
- liver disease
- cardiovascular disease
- infections
- sepsis
Rapid acting insulin (insulin R)
- used in veterinary emergencies
- given SQ
- absorbed in 15-20 minutes
- peaks at around 4-6 hours
- lasts about 6-8 hours
Intermediate acting insulines
- Vetsulin
- insulin plus amorphous insulin (more rapid action)
- NPH
Ultra long acting insulin
- protamine, Zinc & Iletin
- may only cover animals for 12 hours
- Insulin glargine
standard starting dose
(not so sick patient)
- NPH - dogs
- PZI or Glargine insulin - cats
- starting dose - 0.5 unit per Kg SQ divided BID
Brain Insurance for insulin overdose
- Glucagon Rx for seizing patient
- Karo syrup for conscious person
Monitoring the diabetic patient
- Clinical signs: PU/PD
- Spot blood glucose tests by DVM
- Blood testing by pet owner
- Blood glucose tests by DVM
- Serum fructosamine and HB…
- Urine glucose and ketones
Somogyi reaction
Posthypoglycemic hyperglycemia
- Fido getting too much insulin in the am
- solve this by splitting dose
Oral hypoglycemic drugs
- Glipizide
- Not used in dogs
- Only used for type 2 DM in cats
Common causes of insulin resistance in the dog
- Estrus and diestrus
- Progestagen Rx
- Acromegaly (too much Growth hormone)
- Hypercortisolism
- Bacterial infection
Obesity
- Causes insulin resistance in humans and cats
