Diabetes SEM 2 Flashcards
What causes hyperglycaemia?
Defects in insulin production, action or both.
Can chronic hyperglycaemia result in damage to organs?
Yes. E.g. eyes, vasculature and nerves.
Classify the different types of hyperglycaemia.
Type 1-Immunologically mediated, Idiopathic.
Type 2.
Other-Gestational diabetes.
Describe Type 1 Diabetes Mellitus.
The chronic disease of carbohydrate, protein and fat metabolism. Lack of insulin due to autoimmune beta cell destruction.
Describe how type 1 Diabetes Mellitus comes to exist.
Lack of insulin due to autoimmune beta cell destruction. Culmination of lymphocytic infiltration and destruction. As beta cell mass declines, insulin secretion decreases. Viral infection in genetically predisposed individual acts as trigger. Moat common antibodies are directed as Glutamic Acid Decarboxylase (GAD) and Islet cell antibodies (IA2).
Which age group is type 1 diabetes mellitus most common in?
Juveniles.
What are the most common symptoms of type 1 diabetes mellitus?
Polyuria. Polydipsia. Polyphagia. Fatigue. Nocturnal enuresis. Loss of weight with muscle wasting.
What are the recommended steps to living with type 1 diabetes mellitus?
Diet. Exercise program. Lifelong insulin therapy. Usually 2 or more subcutaneous insulin injections daily. Self monitoring blood glucose levels.
Describe the existence of type 2 diabetes mellitus.
Results from a combination of inadequate insulin secretion or resistance to insulin action or inappropriate and excessive glucagon secretion.
What are the two main factors contributing to type 2 diabetes?
Genes and lifestyle & diet.
The combination of genes and lifestyle factors results in what malfunction in the body?
Insulin resistance.
What two types of malfunctions may exist due to insulin resistance?
Normal b-cell function and Abnormal B-cell function.
What are the effects of Normal B-cell function resulting from insulin resistance?
Compensatory hyperinsulinemia and normoglycemia.
What are the effects of Abnormal B-cell function?
Relative insulin deficiency, hyperglycemia and Type 2 Diabetes.
What are some of the modifiable risk factors to type 2 diabetes?
Obesity, sedentary lifestyle, previously identified glucose intolerance, metabolic syndrome, dietary syndrome, intrauterine environment, smoking.
What are some of the nonmodifiable risk factors to type 2 diabetes?
Ethnicity (African-American, Native American, Asian-American, or Pacific Islander), family history of type 2 diabetes, age, gender, history of gestational diabetes, polycystic ovary syndrome, inflammation.
What are some of the long-term complications of diabetes?
Microvascular (neuropathy, nephropathy, retinopathy) and macrovascular (CVD, hypertension, dyslipidemia).
Describe the onset of type 1 diabetes.
Sudden onset, at any age (mostly young), thin or normal size.
Describe the onset of type 2 diabetes.
Gradual onset, mostly in adults, often obese adults.
Is ketoacidosis common or rare in type 1 diabetes?
Common.
Is ketoacidosis common or rare in type 2 diabetes?
Rare.
What are the levels or endogenous insulin in type 1 diabetes?
Low or absent.
What are the levels of endogenous insulin in type 2 diabetes?
Absent.
Describe diabetic ketoacidosis.
Diabetic ketoacidosis is an acute, life threatening complication which includes a disordered metabolic state with hyperglycaemia, ketone formation, acidosis and ketonuria.
What are the common symptoms of diabetic ketoacidosis.
Malaise and fatigue, nausea and vomiting, abdominal pain, rapid LOW, confusion or even comatose, signs of dehydration, characteristic acetone (ketotic) breath odor.
What management for diabetic ketoacidosis is recommended?
Rehydration, Insulin therapy, Electrolyte repletion, Management of complications and evaluation of therapy, Treat possible precipitant particularly infections.
What is the leading cause of bacterial infection in diabetic ketoacidosis.
Klebsiella pneumonia.
What does the abbreviation HHS stand for?
Hyperosmolar Hyperglycaemic State.
Describe HHS and the characteristic of the disease.
Commonly in type 2 diabetics with reduced fluid intake.
Common precipitant are illness, altered mental state, drugs, PE, or MI and CVAs.
Characterised by hyperglycaemia, hyperosmolarity, dehydration and absence of ketoacidosis.
Describe the approach to management of HHS.
Fluids (deficit of 11-12L; 1L normal saline bolus; 1L every 2-4 hours; watch sodium levels), Long term therapy, Insulin and electrolytes.
