Disorders of the Endocrine Pancreas: Diabetes Mellitus

Question 1

Discuss the pathophysiology of diabete mellitus

Answer 1

when there is a lack of production of insulin from the beta cells (type 1) or resistance to the effects of insulin (type 2)

Question 2

describe the role of insulin in the body

Answer 2

Most tissues are at least partially dependent on insulin which regulates high blood glucose from a meal (stimulates glycogen formation and glucose uptake from blood)

Question 3

briefly explain hyperglycemia in diabetes mellitus

Answer 3

lack of cellular uptake -> hyperglycemia -> cells complain -> glycogenolysis and gluconeogenesis

Question 4

Diagnosis of diabetes mellitus

Answer 4

PU/PD: excretion of excess sugar

weight loss despite a good appetite: many cells are starving -> hunger

Dx is made by hx, CS and fasting hyperglycemia

Question 5

treatment for type 1 DM is __ while type 2 is partly __, managing the diet, __ and __

Answer 5

replacing the insulin

replacing insulin, medications and promoting exercise

Question 6

regular insulin is __ acting and used in __ situations

Answer 6

short, emergency

Question 7

intermediate or long acting insulins are used for __ and usually __

Answer 7

maintenance, BID

Question 8

what 3 things can you use to evaluate long term DM management?

Answer 8

clinical signs
glucose curves
fructosamine (avg glucose over 3 wks)

Question 9

somogyi response

Answer 9

rebound hyperglycemia situation in which the body responds to a rapid drop in glucose due to an overdose of insulin by secreting glucagon and catecholamines

Question 10

what is the best way to avoid the somogyi response?

Answer 10

glucose curve with BG measurements every 2 hours throughout the day to make sure the glucose is not dropping too low

Question 11

diabetic ketoacidosis (DKA)

Answer 11

complication of untreated or poorly regulated diabetes where the body breaks down fatty acid stores into ketones to use as an energy source leading to metabolic acidosis

Question 12

ketones are __

Answer 12

acids

Question 13

how does the treatment of DKA differ from regular diabetes mellitus?

Answer 13

• both are treated with insulin therapy
• with DM, the goal is regulate blood glucose
• in DKA, insulin is given repeatedly to stop the formation of ketones blood glucose is monitored and when it becomes low, dextrose is supplemented to prevent hypoglycemia and insulin therapy continues until the animal is no longer in DKA

Question 14

the goal in treating DKA is to convert them back to __ by getting rid of the __

Answer 14

diabetes mellitus, ketones