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Pathophysiology > Diabetes (week 5) > Flashcards

Diabetes (week 5) Flashcards

1
Q

where does the insulin diabetics inject come from

A

recombinant DNA technology

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2
Q

what is used for insulin administration in compliant patients

A

insulin infusion pump

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3
Q

what do insulin infusion pumps do

A

programmed to release insulin at certain times of the day

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4
Q

what percent of total calories should be carbohydrates in diabetics

A

55-60%

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5
Q

what percent of total calories should be fat in diabetics

A

less than 30%

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6
Q

what percent of total calories should be protein in diabetics

A

15-20%

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7
Q

what must diabetics do when they exercise

A

must adjust food intake and insulin doses; can become hypoglycemic

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8
Q

what is the main difference between Type I and Type II Diabetes

A

Type 1= autoimmune; no beta cells; lack of insulin

Type 2= not autoimmune; still have functioning beta cells

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9
Q

speculation about cause of insulin resistance in Type II DM

A

compounds released from adipose cells will decrease peripheral insulin sensitivity

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10
Q

NIDDM stands for

A

Non Insulin Dependent Diabetes Mellitus

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11
Q

what is the biggest risk factor for Type II DM

A

obesity

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12
Q

age of Type II DM

A

over 40

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13
Q

clinical manifestations of Type II DM

A

abnormal glucose tolerance
overweight
hyperlipidemic (high LDL)

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14
Q

Tx for Type II DM

A

EXERCISE
restrict caloric intake
weight loss
dietary counseling

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15
Q

what is gestational diabetes

A

presence of glucose intolerance during pregnancy; typically during 3rd trimester
blood glucose returns to normal after parturition
Mimics Type II DM

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16
Q

possible causes of gestational diabetes

A

chorionic somatomaammopropin (produced by placenta)
estrogen
cortisol
weight gain during pregnancy

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17
Q

risk factors for gestational diabetes

A 
family history of diabetes
obesity
high maternal age
parity greater than 5
previous complicated pregnancy
glycosuria (presence of glucose in urine)
18
Q

tx for gestational diabetes

A

dietary counseling
exercise
monitor blood glucose and urine ketones
glyburide

19
Q

glyburide

A

promotes release of insulin

does not cross placenta

20
Q

teratogenicity

A

likelihood of a drug to create defects in developing fetus

21
Q

chronic complications of Diabetes

A

higher incidence of peripheral vascular disease
cardiac disease
renal disease retinopathy
neuropathy

22
Q

AGE stands for

A

advanced glycosylation end-products

23
Q

normal AGE process

A

glucose will attach reversibly to proteins, lipids, and nucleic acids without benefit of enzymes;
bad when bound irreversibly????

24
Q

problem with AGE

A
  • can attach to basement membranes of blood vessels and verves, thickening them and decreasing permeability
  • promotes production of free radicals
  • inactivates nitric oxide which is a vasodilator, which leads to vasoconstriction and ischemia
  • causes damage to nerves
25
Q

polyol pathway

A

pathway for glucose metabolism used by tissues that do not need insulin for glucose transport

26
Q

tissues that utilize polyol pathway

A 
kidnes
endothelium of blood vessels
retinal tissue
eye lens
nerves
27
Q

what happens in the polyol pathway when a person is hyperglycemic

A

excess glucose shunted to polyol pathway

28
Q

why is it bad that there is excess glucose shunted to polyol pathway

A

excessive byproducts (sorbitol, fructose) are produced, causing osmotic injury (lysis)

29
Q

how does AGE contribute to diabetic neuropathy

A

causes hypoxia

30
Q

how does polyol pathway contribute to diabetic neuropathy/retinopathy

A

sorbitol damages Schwann cells, interferes with ion pumps, and distrupts nerve conduction

31
Q

how does AGE contribute to microvascular disease

A

-thickening of basement membrane
interfering with diffusion which interferes with supply of oxygen and nutrients to tissue
-damages endothelial cells, increasing plaque formation

32
Q

which type of diabetes is more common to die of renal failure

A

type I

33
Q

how does AGE lead to nephropathy

A

alters basement membrane of glomerulus, leading to glomerularsclerosis (thickening of glomerulus)

  • will decrease filtration
  • glucose toxicity
34
Q

how does polyol pathway lead to nephropathy

A

damages tubular cells

35
Q

how is the development of nephropathy slowed

A

ACE (angiotensin converting enzyme) inhibitors

control blood glucose

36
Q

macrovascular disease

A

includes:
coronary artery disease (CAD)
CVA
peripheral vascular disease (PVD)

37
Q

which type of diabetes is more common to have macrovascular disease

A

type II

38
Q

what is the most common cause of death in NIDDM, especially in women

A

Coronary artery disease

39
Q

what does your risk of stroke increase by if you have diabetes

A

2x (due to increased BP)

40
Q

what does peripheral vascular disease typically lead to?

A

amputation

41
Q

why do diabetics have increased risk of infection

A
  • impaired sensation
  • hypoxia (due to decreased BF and decreased release of O2 to tissue)
  • pathogens proliferate because of increased glucose
  • blood supply is decreased
  • WBCs have decreased chemotaxis

Pathophysiology (19 decks)

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