Diabetes Mellitus Flashcards
Name and define the types of diabetes
Type I – Absolute insulin deficiency, Juvenile onset
Type II – Adult onset secondary to relative deficiency
Type III – Genetic defect resulting in DM
Type IV – Gestational DM
Define the words “Diabetes Mellitus” (hint: Greek-> English translation) What does this refer to about the patient?
Diabetes= to siphon/pass through
Mellitus= sweet as honey
Sweet urine- comes from gluose levels about 250, spill into urine producing sweet smelling urin
Can the brain use fatty acids/lipids for energy if no glucose is available?
no, the CNS requires glucose as an energy source and therefore needs insulin to bring the gluocse within the cells
If insulin is absent or not working properly, would extracellular or intracellular glucose levels be elevated?
Extracellular
After the removal of the pancreas, what would you see evelate first, blood glucose or free fatty acids? What would the use of fatty acids by cells lead to?
Blood glucose would rise, bc the pancreas which produces and releases insulin to the body would be no more. The body would then breakdown lipids into fatty acids, these levels would rise. By using fatty acids for energy, acetoacetic acid would build up.
In a type II diabetic, what would be the first type of medication they would be put on?
A medication to increase the potency of insulin, in order to increase the sensitivity to the receptor
As a person continues to gain weight, what happens to the insulin and the insulin receptors?
it increases the demand on insulin to drive glucose into the cells, the causes an increase in size of the insulin receptors. Which leads to a decrease sensitivity to the receptors, which means you need more and more insulin to drive glucose into the cells
What is the most common type of diabetes in today population?
type II 80%
Which type of diabetic would not be able to survive without insulin?
Type I
In type I diabetes, what cells are attacked?
The beta cells of the islets (where insulin is produced) within the pancreas, they are attacked by antigens and destroyed
In the pre-diabetes phase, what could a person do to reverse their condition?
exercise
What are the two defects in the two principal defect model that lead to type II diabetes?
insulin resistance and beta-cell dysfunction/failure
Name in order the six steps in progression to type II diabetes.
1- prediposing factors 2- insulin resistance 3- imparied gulcose tolerance 4- increased beta cell produciton of insulin 5- beta cell exhaustion 6- inadequate insulin for the dree of insulin resistance
What is the fasting blood glucose magic number used to diagnosis type II diabetes?
> 126 mg/dl
What are some symptoms of hypoglycemia?
nervous, shakey, dizzy, confused, headache, hunger, cold clammy skin, fast heartbeat, irritability
What are some symptoms of hyperglycemia?
weak, tired, freuent urination, increased thirst, decreased appetite, blurry vision, itchy dry skin, breath smells fruity
What are the first signs of type II diabetes?
frequent urination, increased thirst
What are the three life threatening complications of diabetes?
1- Diabetic ketoacidosis 2-hyperosmolar, nonketotic coma 3- hypoglycemia
What are the four ways to treat DKA, and what is the correct order in treatment?
in order: 1st- give insulin, 2nd- give D5W to supplement glucose, 3rd- IV fluids to replace intravascular volume, 4th- give potassium to correct hypoK
During DKA, what is being metabolized? what is the end product of this metabolism?
fatty acids; ketone bodies
A build up of ketone bodies results in what?
anion gap acidosis
What are usual signs/symptoms of DKA?
dyspnea, abdominal pain, nausea and vomiting, mental status changes
What is the first and most important treatment in a hyperosmolar coma? what are the other treatments?
IV fluids!; give insulin, correct acidosis ( usually fixed by giving the IV fluids)
After there is a relative insulin deficiency and illness of injury, what are the two major mechanism that happen and ultimately begin the progression to hyperosomolar nonketotic coma?
Liver increases glucagon production and there is a decrease intracellular glucose, both of these together lead to hyperglycemia
In diabetic patients who take insulin, they are at risk for becoming hypoglycemic. What are the signs/symptoms of hypoglycemia?
diaphoresis, tachycardia, restlessness, confusion, coma, glucagon, and epinephrine
What are the five major complications of having diabetes and therefore elvated blood glucose levels for long period of time?
1- HTN 2- cardiovascular disease (CAD) 3- cerebral vascular disease 4- peripheral and autonomic neurophathies 5- renal failure
Why may it be hard to recognize a MI in a diabetic patient?
They may have whats called a silent MI, they wont feel the same pains and symptoms and person without diabetes would, because a diabeteic patient nerves are damage. They may just feel fatigued during an MI.
True or false: Diabetes can cause stiff joints.
True.
True or false: adrenal activity is increased in diabetic patients.
False. adrenal activity is decreased
What is your goal glucose level to stay under during the perioperative period?
<150 mg/dl
What can increased levels of glucose cause during the perioperative period?
impaired would healing, hyperosomolality, increased infections, decreased catecholamines
True or false: diabetes can have increased sweating.
False- one of the autonomic neuropathies is decreased sweating
