Endocrine Dysfunction Flashcards
what is diabetes
sugar in blood level is high
classified into Type1 and Type2 diabetes
type1 - insulin secretion problem; ie no insulin present because pancreas unable to produce insulin
type2 - insulin resistance problem; presence of insulin in blood but body is unable to respond appropriately
complications of diabetes
stroke heart attack peripheral artery disease diabetic retinopathy cataracts glaucoma diabetic foot diabetic nephropathy peripheral neuropathy
complications of obesity
metabolic:
- stroke
- coronary heart disease
- fatty liver
- gall bladder disease
- pancreatitis
- cancers
- gynecologic abnormalities
- gout
mechanical:
- pulmonary disease
- gastroesophageal reflux disease
- osteoarthritis
- phlebitis
definition of obesity
obesity is defined by WHO as abnormal or excessive fat accumulation that may impair health
BMI= weight in kg / (height in m)^2
BMI cut off for asians
lower BMI cut off by 2.5kg/m^2
18.5-22.9 - low risk
23.0-27.4 - moderate risk
>27.5 - high risk
why is there a lower BMI cut off for asians
diabetes increase as BMI increases
asians develop diabetes at lower BMI compared to westerners
at any BMI, asians have
- higher body fat, visceral fat and waistline
- lower muscle mass
- higher insulin resistance
- worse lipid profile
- increased risk of diabetes and heart disease
benefits of weight loss with lifestyle intervention
- delay progression from pre-diabetes to T2DM
- positive impact on treatment of T2DM
- improves mobility, physical functioning and health-related quality of life
how does the VLCD work?
carb is the preferred source of energy
limiting carb intake promotes gluconeogenesis (breaking glycerol into glucose
first 3 days, appetite will increase
VLCDs are designed to promote ketosis (byproduct of burning fat is ketones)
ketones suppress appetite
how does exercise lower glucose level
exercise has an insulin-like effect
it stimulates glucose transport and metabolism
increases blood flow to exercising muscle
more glucose enters the muscle to be burnt up for energy
what is the exercise recommendation
> 150 minutes per week of moderate-intensity physical activity OR
75 minutes per week of vigorous-intensity physical activity
with no more than 2 consecutive days without exercise
what is the physical examination done on patient to diagnose diabetes
height, weight, BMI BP skin examination (for acanthosis nigricans and insulin injection sites) comprehensive foot examination - inspection - palpation of pedal pulses - sensation
what is the aim of treatment for diabetes
- to relieve symptoms related to hyperglycemia, including achieving good metabolic control (short-term)
- to prevent diabetes-related complications, microvascular and macrovascular (long-term)
what are the 2 diabetic emergencies
- diabetic ketoacidosis
- hyperglycemic hyperosmolar syndrome
what are the clinical features of DKA
- excessive thirst
- frequent urination
- nausea and vomiting
- abdominal pain
- weakness or fatigue
- SOB
- fruity-scented breath
- confusion
what are the clinical features of HHS
- excessive thirst
- increased urination
- capillary glucose “HI” or >33.3mmol/L
- drowsiness, confusion
- dry mouth
- fever
- hallucinations
