diabetes mellitus

Question 1

exocrine function of the pancreas?

Answer 1

acini cells secrete digestive enzymes, involved in the breakdown of food

Question 2

endocrine function of the pancreas?

Answer 2

islets of langerhan cells (hormone secretion cells) produce and release insulin and glucagon

Question 3

function of insulin?

Answer 3

regulates glucose uptake and metabolism, increased glycogen synthesis, increases synthesis and esterficiation of fatty acids

Question 4

describe insulin

Answer 4

peptide hormone with 51 amino acids, produced by the islets of Langerhans of the pancreas

Question 5

which cells require insulin to absorb glucose?

Answer 5

skeletal muscle cells, fat cells

Question 6

what happens when the body has low blood sugar levels?

Answer 6

signals the pancreas to release glucagon, which stimulates glycogen breakdown and raises blood sugar levels [glucagon increases]

Question 7

what happens when the body has high blood sugar levels?

Answer 7

signals the pancreas to release insulin, which stimulates glucose uptake from the blood, stimulates glycogen formation and lowers blood sugar [insulin lowers]

Question 8

acute consequences of insulin deficiency?

Answer 8

hyperglycaemia, ketosis, acidosis, hyperosmolar state

Question 9

chronic consequences of insulin deficiency?

Answer 9

cardiovascular disease, nephropathy, neuropathy, retinopathy

Question 10

describe type one diabetes mellitus?

Answer 10

autoimmune destruction of B-cells in the pancreas, so that the pancreas cannot produce insulin. this leads to more glucose in the blood and high blood sugar levels

Question 11

symptoms of T1DM?

Answer 11

polyuria, polydipsia, hunger, weight loss

Question 12

describe type two diabetes mellitus?

Answer 12

when the muscle cells are insulin resistant; B-cells response to glucose is delayed or absent so the muscle cells cannot use the glucose

Question 13

lifestyle factors that may lead to T2DM?

Answer 13

obesity, inheritance

Question 14

what is gestational diabetes?

Answer 14

insulin resistance diabetes, triggered by hormonal changes in pregnancy

Question 15

risk factors for gestational diabetes?

Answer 15

maternal age, family history of T2DM, smoking, previous history, baby over 4kg, African or North American

Question 16

risks of gestational diabetes for the mother?

Answer 16

risk of developing T2DM, hypertension, pre-eclampsia, eclampsia, obstructed labour

Question 17

risks of gestational diabetes for the child?

Answer 17

risk of T2DM, risk of obesity, macrosomia, neonatal hypoglycaemia, neonatal jaundice, respiratory distress syndrome

Question 18

how is diabetes diagnosed?

Answer 18

fasting plasma glucose level at or above 7.0mmol/L, or above 11.1mmol/L two hours after a 75g of oral glucose load

Question 19

acute presentations of diabetes?

Answer 19

ketoacidosis, hyperosmolar nonketotic state, hypoglycaemia, diabetic foot

Question 20

chronic presentations of diabetes?

Answer 20

macrovascular; ischeamic heart disease, stroke, vascular disease. microvascular; retinopathy, neuropathy, nephropathy. cataract

Question 21

describe ketoacidosis?

Answer 21

rapid breakdown of fats and proteins, releasing ketones and acids into the blood stream. can lead to coma and death.

Question 22

what is hyperosmolar non-ketotic state?

Answer 22

severe dehydration `

Question 23

describe hypoglycaemia:

Answer 23

low blood sugar levels caused by insulin overdose. can lead to coma and death

Question 24

describe diabetic retinopathy:

Answer 24

proliferation of blood vessels in the retina; retinal haemorrhages, and macular oedema; fluid exudation into retina

Question 25

describe diabetic neuropathy

Answer 25

microangiopathy of vasa nervosum leading to peripheral numbness, tingling, neuropathic pain, muscle weakness, autonomic neuropathy

Question 26

signs and symptoms of diabetic neuropathy?

Answer 26

vomit, diarrhoea, constipation, impotence, incontinence, anorgasmia, postural hypotension

Question 27

describe diabetic nephropathy

Answer 27

microangiopathy of glomerular capillaries; clinically chronic renal failure, nephrotic syndrome or hypertension

Question 28

infections in diabetes mellitus?

Answer 28

osteomyelitis, septicaemia, post-op infections, rectal abscesses, pyleonphritis