Dr. Winter - DMT1 Flashcards
What are deep and increased respiratory rate called?
Kousmall breathing
How do define mild, moderate and severe weight loss?
5% = mild
10% = moderate
15% = severe
What are the desirable glucose values?
Fasting < 100 (65-100)
Random < 200
When a patient has been vomiting what should we think of their glucose numbers?
We should be looking for fasting numbers (65-99) they are essentially fasting due to vomit.
What causes hyperglycemia?
insulin action = [insulin] x insulin sensitivity of responding tissue.
Insulin works on insulin receptors of what tissues?
Adipose, Muscle, Liver
What cells of the body produce insulin?
Beta cells of the liver release insulin via endocrine secretion.
What other ways can hyperglycemia occur?
The elevation of counterregulatory hormones responsible for the increase of blood glucose can also cause hyperglycemia. These are glucagon and epinephrine.
How does the cell respond to “perceived” low glucose levels?
When insulin repsonse is poor either DMT1 and DMT2 the cell thinks it is starving and tells the body to release glucagon and make glucose. This increases the level of glucose in the blood.
What is the process of making glucose from glycogen?
Glycogenolysis
What is the process of making glucose from precursors?
Gluconeogenesis
In what circumstances does signaling for glucose happen?
Increased glucagon and decreased insulin
What are the percentages of T1 and T2 DM?
90% is T2
10% is T1
What are some of the acute symptoms of DM?
Polyuria, polydipsia, dehydration, infection, nocturia, weight loss.
What are some of the chronic conditions of DM?
Macrovascular disease
Microvascular disease
Neuropathy
How many hormones lower blood sugar and mitigate hyperglycemia?
1 - insulin
How many hormones signal for glucose release?
(4)
Epinephrine
Glucagon
Cortisol
Growth Hormone
Why do we need to tightly regulate blood glucose?
Hypo:
Impaired CNS, decreased mentation,Seizure, coma, death
Hyper:
Peripheral Vascular Disease
Carotid Artery Disease
Coronary Artery Disease
Blindness
Renal Failure
Why is there increased urination in DM?
Glucose levels in the filtrate exceed the capacity of the Na+ / Glucose transporter proteins in the kidney and glucose is not entirely reabsorbed into the extracellular fluid. Glucose is a solute that draws water with it - this increases urine output.
What is the progression of dehydration in DM?
Hyperglycemia –> glucose in filtrate exceed kidney –>glycosuria –> Osmotic diuresis –>fluid loss