Endocrine pancreatic disease Flashcards
Symptoms diabetes
Polyphagia, polydypsia, polyuria, and complications like micro and macropathies
Diabetes: For its diagnosis, one of the following criteria is required
- FASTING BASAL GLYCEMIA > 126 mg/dL detected on two or more times
- Glycemia > 200 mg/dL at any daytime with symptoms
- Glycemia > 200 mg/dL 2 h after oral glucose overload test
- Glycosylated hemoglobin > 6,5%
DM type 1
autoimmune destruction of Langerhans islets
DM type 2
Relative insulin deficiency caused by a lower sensitivity of tissues to insulin action (insulin resistance).
Hormones that act as Glucagon and increase insulin resistance
Growth hormone
Glucocorticoids
Cathecholamines
Mechanisms that induce insulin resistance
- Insulin mutations
- Receptors RI mutations
- Receptors decrease
- Defective signal transduction for GLUT4
Situations favoring insulin resistance
- Obesity
- Sedentarism
- Polycystic ovarty
- Excess of GC (Glucocorticoids)
- Excess of GH
Diabetes MODY
Adult diabetes that begins at a young age: there is a dominant autosomal hereditary form of early onset (before 25) and with similar clinical features to DM type II
Diabetes due to increase of counterinsular hormones
GLUCOCORTICOIDS –> CUSHING ́S SYNDROME
CATHECHOLAMINES –> PHEOCHROMOCYTOMA
GROWTH HORMONE (GH) –> ACROMEGALY
GLUCAGON –> GLUCAGONOMA
Gestational diabetes: during pregnancy
Children of mothers with gestational diabetes are at increased risk of obesity and diabetes in adolescence and adulthood
Acute alterations!
Hypoglycemia
Ketoacidosis (DM 1)
Hyperglycemia or hyperosmolar coma (DM 1 & 2)
Chronic alteration!
Microangiopathy
- Neuropathy
- Nephropathy = main reason for kidney failure
- Retinopathy: Diabete = main cause of blindness
Macroangiopathy
- Ictus
- Cardiovascular events
- Peripheral vascular disease
- Diabetic foot
Hypoglycemic syndrome
Glucose levels <50 mg/dL
Reactive hypoglycemia (diet induced)
Fasting hypoglycemia
= adrenergic reaction and neuroglucopenia
