Diabetes Mellitus

Question 1

Endocrine pancreas

Answer 1

• Islets of langerhans
  
  • alpha cells produce glucagon
  • beta cells produce insulin

Question 2

Normal blood glucose

Answer 2

75-125

Question 3

Glucagon

Answer 3

• gluconeogenesis and glycolysis in liver
  
  • epinephrine also does this

Question 4

glycogenolysis

Answer 4

• breakdown of glycogen to it’s glucose components

Question 5

gluconeogenesis

Answer 5

• conversion of protein and fat substrate to glucose

Question 6

Type 1 diabetes

Answer 6

• more common in dogs
• insulin dependant juvenile dz in humans

Question 7

Type 2 diabetes

Answer 7

• more common in cats
• non-insulin-dependent diabetes adult onset in humans

Question 8

Secondary diabetes

Answer 8

• Pancreatic disease
• Hormonal
• Drug-induced
• Insulin receptor abnormalities
• Specific genetic syndromes

Question 9

Consequence of diestrus in intact diabetic patients

Answer 9

Diestrus => inc progesterone => inc Growth Hormone => Peripheral insulin resistence

Question 10

Clinical signs of diabetes Mellitus

Answer 10

• Not very sick
  
  • PU/PD
  • Weight loss
• Sick
  
  • Dehydration
  • Depression
  • Anorexia
  • Tachypnea
  • Vomiting

Question 11

Insulin depletion is a ____ event

Answer 11

catabolic

Question 12

Diagnosis of Diabetes Mellitus

Answer 12

1. Clinical Signs
2. Persistant hyperglycemia > 150
3. Glycosuria

Question 13

Uterine pathologies can be _____ mediated

Answer 13

Progesterone

Question 14

Complicating coexisting problems with diabetes mellitus

Answer 14

1. acute pancreatitis
2. renal disease
3. liver disease
4. cardiovascular disease
5. infections
6. sepsis

Question 15

Rapid acting insulin (insulin R)

Answer 15

• used in veterinary emergencies
• given SQ
• absorbed in 15-20 minutes
• peaks at around 4-6 hours
• lasts about 6-8 hours

Question 16

Intermediate acting insulines

Answer 16

• Vetsulin
  
  • insulin plus amorphous insulin (more rapid action)
• NPH

Question 17

Ultra long acting insulin

Answer 17

• protamine, Zinc & Iletin
  
  • may only cover animals for 12 hours
• Insulin glargine

Question 18

standard starting dose

(not so sick patient)

Answer 18

• NPH - dogs
• PZI or Glargine insulin - cats
• starting dose - 0.5 unit per Kg SQ divided BID

Question 19

Brain Insurance for insulin overdose

Answer 19

• Glucagon Rx for seizing patient
• Karo syrup for conscious person

Question 20

Monitoring the diabetic patient

Answer 20

• 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

Question 21

Somogyi reaction

Answer 21

Posthypoglycemic hyperglycemia

• Fido getting too much insulin in the am
• solve this by splitting dose

Question 22

Oral hypoglycemic drugs

Answer 22

• Glipizide
• Not used in dogs
• Only used for type 2 DM in cats

Question 23

Common causes of insulin resistance in the dog

Answer 23

• Estrus and diestrus
• Progestagen Rx
• Acromegaly (too much Growth hormone)
• Hypercortisolism
• Bacterial infection

Question 24

Obesity

Answer 24

• Causes insulin resistance in humans and cats