DM Part 1 Flashcards
diabetes mellitus is a group of metabolic diseases characterized by prolonged ________ resulting from defects in insulin secretion, insulin action, or both.
hyperglycemia
_________ is associated with long term damage and dysfunction of tissues & organs including eyes, kidneys, nerves, and blood vessels.
chronic hyperglycemia
____% of the population have diabetes and prevalence is increasing. Diabetes is the _____ leading cause of death in the U.S. and ___ million people are prediabetic
11.3%
7th
88 million
clinical classes of diabetes include
type 1
type 2
due to other causes such as
___________
___________
and gestational diabetes
diseases of the pancreas
drug induced (corticosteroids)
type 1 DM is due to __________, which usually leads to absolute insulin deficiency and cells are ___________ and depend on _________ for survival
beta cell deficiency
unable to use glucose for energy
exogenous insulin
Type 1 diabetes typically has a _____ onset. It can occur at any age but most cases are diagnosed younger than age _____. Type 1 accounts for ___% of DM cases in the U.S.
rapid
30
5%
genetic predisposition and unidentified environmental factors appear to contribute to development of DM1 so it is _______
idiopathic
hypothesis for Type 1 DM is that ______, ________, or _______ may trigger autoimmune response
viral infections
toxic chemicals
other diseases
when glucose cannot enter the cells…
- plasma glucose levels _____ (______)
- Glucose lost in ____ and _____ increases in an attempt to rid the body of excess sugar (____)
- Dehydration occurs and _______ becomes disrupted
rise (hyperglycemia)
urine, urination (polyuria)
electrolyte balance
when glucose cannot enter the cells, the cells begin to ______ and the body breaks down ____, _____ are formed, and ________ develops.
exception being __________________ because glucose can diffuse across these membranes without insulin
starve
fat
ketones
metabolic acidosis
brain, lens of eye, and renal medulla
Type 2 DM accounts for ____% of all cases in the U.S. It is characterized by _______ and _________
90-95%
insulin resistance
progressive loss if B cell failure
insulin resistance cause ?
What occurs ?
cell receptor defect
insulin produced, but cells are resistant
pancreas produces more insulin
liver produces glucose
over time pancreas loses ability to keep up
risk factors for Type 2 DM?
pre-diabetes
obesity
increased age (≥45)
1st degree relative with DM
Physical inactivity
Race/ethnicity
why does increased age higher risk for DM
insulin receptors change, body comp changes, less insulin synthesis
which races have greater risk of DM
african American
hispanic or latino
American Indian
alaska native
pacific islanders
asian Americans
More risk factors for type 2 DM
CVD
HTN
Dyslipidemia
PCOS
condition associated with insulin resistance (acanthuses nigricans)
history of gestational diabetes
smoking
what is acanthuses nigracans
result of high insulin
skin propagation that thickens skin and makes it darker
pre diabetes is when _______ is higher than normal, but not high enough to diagnose diabetes
blood glucose
diagnosis criteria for prediabetes
fasting plasma glucose (FPG) @ 100-125 mg/dL
OR
2hr plasma glucose during the 75 g oral glucose tolerance test (OGTT) @ 140-199
OR
A1C @ 5.7%-6.4%
when should you test for pre diabetes
adults with BMI ≥25 with ≥ risk factors
Asian American ≥23
including:
HDL chol <35 or TG >250
for all other adults, when they turn 35, repeat 3 yrs
test for __________ if the patient has pre diabetes
type 2 DM a year following
Treatment for pre diabetes
7% weight loss
increase physical activity to 150 minutes/week
metformin if someone needs drugs
