Endocrine Flashcards
Normal changes
delayed and insufficient release of insulin by the beta cells of the Islet cells of langerhans.
glucose metabolism is reduced, causing higher and more prolonged levels of hyperglycemia, which is why it’s not unusual to see high blood glucose levels among nondiabetic older people.
thyroid gland gradually atrophies & thyroid gland activity decreases, resulting in:
- lower basal metabolic rate
- reduced radioactive iodine uptake
- less secretion of thyrotropin
- thyroid function will remain adequate to meet daily needs
release of the adrenocorticotropic hormone decreases, leading to:
- reduced activity of the adrenal gland
- reduced secretion of estrogen, progesterone, androgen, 17-ketosteroids & glucocorticoids
volume of the pituitary decreases
insulin secretion by the beta cells in the pancreas is also affected:
- reduced tissue sensitivity to the insulin
- reduced ability to metabolize glucose
- reduced receptor sensitivity to glucose
- this can increase the risk of hyperglycemia
Dupuytren’s contracture
fixed flexion of hands due to a thickening of the fibrous tissue under the skin of the palm and fingers, a risk for persons with DM
Goiter
nonmalignant swelling of the thyroid
Metabolic syndrome
group of conditions (high triglycerides, low HDL, elevated fasting sugar, elevated bp, & central obesity) occurring together that increase the risk of diabetes, stroke & coronary artery disease
major classes of hormones
- steroids (lipid-soluble)
- thyronines (lipid-soluble)
- polypeptides (water-soluble)
- catecholamines (water-soluble)
pre-diabetes
-blood glucose levels are high, but is not consistent and high enough to be diagnosed as diabetes
gestational diabetes
- DM that develops during pregnancy
- Increased risk of type 2 DM on the mother AND child
Secondary DM
-caused by another disease affecting the function of the pancreas (pancreatitis or cystic fibrosis)
3 p’s of DM
- Polyuria: excessive urination
- Polydipsia: excessive fluid intake
- Polyphagia: excessive eating
3’ “pathy’s” of DM
- Neuropathy
- Retinopathy
- Nephropathy
Administering insulin
- insulin is administered via sub q injections (back of the arm, anterior lateral area of the thigh
- needle size for sub q (25-27 gauge; 3/8-5/8 in needle)
- NPH is cloudy
- Long acting insulin can’t be mixed
Medications
- Biguanides (metformin): decreases hepatic glucose production and increases glucose uptake/insulin sensitivity
- used as the 1st line of treatment because it has a low risk for causing adverse effects
Onset
when the insulin first begins to act in the body
Peak
the time when insulin is exerting maximum action
Duration
the time the insulin remains in effect