Diabetes Mellitus

Question 1

how is insulin synthesized?

Answer 1

in the pancreas by the beta cells of the islets of Langerhans

Question 2

what secretes glucagon?

Answer 2

alpha cells

Question 3

What is the primary stimulus for release of insulin from the pancreatic beta cell?

Answer 3

glucose

Question 4

What are the 2 states in in glucose metabolism?

Answer 4

fed and fasting

Question 5

What occurs during fed/absorptive?

Answer 5

occurs after ingestion of a meal and is characterized buy utilization and storage of ingested energy nutrients

Question 6

Besides glucose, what else does insulin appear to increase the uptake and decrease the release of?

Answer 6

aa by the skeletal muscles, there inducing protein synthesis and preventing muscle breakdown

Question 7

Which main control undergoes anabolism and catabolism in cells?

Answer 7

insulin= anabolism (storing foodstuffs into cells) and glucagon= catabolism

Question 8

Type 1 Diabetes

Answer 8

insulin deficiency due to the destruction of beta cells in the pancreatic islets

Question 9

Etiology of Type 1

Answer 9

immune-mediated (type 1A) idiopathic (type 1B)

Question 10

Si/Sx of Type 1 Diabetes

Answer 10

overproduction og glucagon stimulates glycogeogenesis and glycogenolysis leading to hyperglycemia and glucosuria causing polyuria, polydipsia, polyphagia and ketoacidosis

Question 11

Type 2 Diabetes

Answer 11

impaired ability of tissues to use insulin and lack of insulin or impaired release of inulin from dysfunctional beta cells

Question 12

Risk factors of Type 2

Answer 12

sedentary lifestyle and obesity

Question 13

Acute Hyerglycemia in diabetes

Answer 13

hyperglycemia, polydipsia, polyuria, polyphagia and concomittant fluid and metabolic problems

Question 14

2 types of chronic hyperglycemia

Answer 14

vascular and neuropathy

Question 15

what are the 2 types of vascular complications and their differences?

Answer 15

macrovascular- complications of diabetes mellitus are defined as damage to the large vessels providing circulation to the brain, heart, and extremities

Microvascular- complications of diabetes are retiniopathy and nephropathy which are though to result from abnormal thickening of the basement membrane in capillaries

Question 16

What are the 2 types of neuropathic complications?

Answer 16

autonomic and sensory dysfunctions

Question 17

What does autonomic dysfunction include?

Answer 17

GI disturbances, bladder dysfunction, tachycardia, postural hypertension, and sexual dysfxn

Question 18

What does sensory dysfxn include?

Answer 18

carpal tunnel syndrome, and parathesias

Question 19

What is most responsible for the increased risk of foot amputation?

Answer 19

neuropathy

Question 20

Patho of type 1 diabetes

Answer 20

since insulin production is completely deficient, glucose cannot be uptaken by the tissues and neurons, so the liver undergoes glycogenolysis and gluconeogenesis to provide FFA & KA and adipose produce FFA these FFA and KA are uptaken by the neural tissue and muscle tissues while the pancreas secretes glucagon

Question 21

Patho of type 2

Answer 21

since insulin is resistant on peripheral tissues, the liver undergoes glycogenolysis and gluconeogenesis to secrete glucose, the glucose is uptaken by adipose tissue, muscle tissue and neural tissue, while the pancreas secretes glucagon

Question 22

Diabetes mellitus is most accurately defined as a disorder that affects

Answer 22

the utilization of all energy nutrients

Question 23

For the individual with type 2 diabetes, the immediate problems brought about by hyperglycemia can lead to which of the following?

Answer 23

insulin resistance, further diminished insulin secretions, polyuria and polydipsia

Question 24

Ketoacidosis results in which of the following?

Answer 24

increase in hormonal levels of cortisol, continued insulin deficiency, and accumulation of fatty acids,

Question 25

Elevated glucose levels in individuals with diabetes mellitus greatly influence fluid balance and hydration because

Answer 25

Fluids are lost as the kidneys clear excessive glucose during hyperglycemia

Question 26

What likelihood is there that gestational diabetes will persist or recur after pregnancy?

Answer 26

About 90% of women with a history of gestational diabetes mellitus will have a recurrence in subsequent pregnancies.

Question 27

Elevated glucose levels in individuals with diabetes mellitus greatly influence fluid balance and hydration because

Answer 27

Fluids are lost as the kidneys clear excessive glucose during hyperglycemia

Question 28

Which statement is true regarding insulin preparations available for use in the United States?

Answer 28

U.S. insulin is limited to bioengineered human insulin.

Question 29

Nonketotic hyperglycemic hyperosmolar coma in type 2 diabetes is characterized by which of the following?

Answer 29

striking dehydration, mortality rate of 1.1%, and with or slight ketosis,

Question 30

Which datum supports a diagnosis of compensatory metabolic alkalosis?

Answer 30

history of diabetes, deep labored respirations, and presence of infection

Question 31

Individuals with diabetes mellitus are particularly susceptible to infections of which of the following?

Answer 31

skin, vagina, and urinary tract