DM Questions From The Endocrine Pancreas Lectures Flashcards
What does diabetes mellitus (DM) stand for and why?
“Flow” and “Sweet”
Patients urinate large volumes of sweet urine
What is type 1 diabetes also known as?
Insulin dependant DM
What % of diabetic patients have type 1?
10%
What is the pathological cause of type 1 DM?
Autoimmune destruction of the pancreatic B-cells which destroy’s bodies ability to make insulin = compromised ability to absorb glucose from blood
What can untreated type 1 DM lead to?
Complex changes and death
Treatment for type 1 DM?
Daily insulin injections
Why is insulin injected?
Peptide hormones cannot be taken orally
Why are type 1 diabetics in ketoacidosis?
Even though body has glucose in blood - it cannot use it so acts as if it is starving so uses FFA’s and ketones instead
But a lack of insulin depresses ketone body intake causing ketoacidosis
What is type 2 diabetes known as?
Non-insulin dependent DM
What is type 2 associated with?
Obesity
High fat and sugar diets
What is the pathology behind type 2?
Peripheral tissues like muscle and fat become insensitive to insulin leading to resistance
What is behind the insulin sensitivity?
Abnormal response from insulin receptors
Reduction in insulin receptor numbers
What happens to B-cells in type 2 ?
Remain normal and intact
May even be hyperinsulinaemia
Type 2 initial treatment?
Restore insulin sensitivity with exercise and diet changes
What treatment is used if lifestyle changes fails?
Oral hypoglycemic drugs - metformin is first line
How does metformin work?
Increases insulin sensitivity of cells
Antagonises action of glucagon and inhibits gluconeogenesis
What are sulphonylureas?
A class of drug which closes the K-ATP channels in B-cells = Ca2+ entry and insulin secretion
Why can sulphonylureas not be used in type 1 DM?
Needs functioning B-cells to increase insulin in blood
What do many type 2 patients eventually end up taking to avoid hyperglycaemia?
Insulin in very pharmacological doses
What does a glucose tolerence test show?
If patient has hyperglycemia
How does the test work?
Patient eats a glucose load after fasting and BG levels will be measured
After an hour BG levels should return to fasting levels
If still elevated after 2 hours indicated diabetes
Does the glucose-tolerance-test distinguish between type 1 and type 2 ? How/why?
No since it only shows a patient is hypoglycemic?
How do you convert mg/dl to mM?
Divide by 18
Complications from hyperglycaemia?
Retinopathy
Neuropathy
Nephropathy
Cardiovascular disease
Staging of hypoglycemia ?
- 6 mM - inhibition of insulin secretion
- 8 - glucagon, adrenaline and GH secretion
- 2 - cortisol secreted
- 8 - cognitive function
- 2 - lethargy
- 7 - coma
- 1 - convulsions
- 6 - brain damage and death
