Exam 2 Study Guide Diabetes Flashcards
What is Diabetes?
Relative or absolute deficiency of insulin causing glucose intolerance.
Fasting sugar >126 mg/dL
75gm glucose tolerance test: >200mg/dL after 2 hours
hb1Ac >6.5%
What are diabetes statistics?
8-9% of US population
73000 die per year
about 50% undiagnosed
14% of population is prediabetic
What are the functions of insulin?
Promote glucose and amino acids through membrane of all muscle cells, fibroblasts, FAT cells.
*anabolic hormone
Insulin doesn’t affect glucose reuptake in…
neurons
kidney
RBC’s
insulin and C-peptide are secreted from B cells in pancreas in response to …
Glucose
Consequences of Diabetes….
- Increased lipolysis = blood ketosis and increase triglycerides
- Increased glycogenolysis and gluconeogenesis
- anabolic effect (Muscle wasting)
Type 1 diabetes is found in
in young patients who lose islet beta cells
Characteristics of Type 1 Diabetes…
No insulin
loss of beta cells from autoimmunity (virus)
Ketoacidosis
Characteristics of Type 2 Diabetes
Insulin resistant Excessive Visceral fat Older (starting to see more younger) minimal ketoacidosis but high glucose Indians, hispanics, and african-americans = higher risk
Type II diabetes is also known as a …
Metabolic Syndrome (X)
(a group of risk factors that increase chance of heart disease, diabetes, and stroke
What is the pathogenesis of Type II Diabetes?
Visceral fat
impaired glucose metabolism and insulin sensitivity
Hepatic inflammation and cirrhosis
Major metabolic complications of Type II…
Very high glucose
Hyperosmolar consequences (Coma)
Brain Swelling
What is Gestational Diabetes?
diabetes in pregnant women due to dress of pregnancy
3-10%
Consequences of Gestational Diabetes…
- insufficient placental function
- abnormally large babies w/ excessive insulin secretion and early hypoglycemia causing malformations.
- can become Type II later in life
What are the 4 oral problems of diabetics?
Gingivitis and Periodontitis
Poor wound healing
Abnormal infections (Candidiasis)
Xerostomia
*make sure patients avoid hypoglycemia.
What treatment is used for Type 1 and advanced Type II?
Insulin replacement therapy
try to replicate natural insulin patterns
What is the most common dose of Insulin?
U-100
Insulin can be obtained by which 2 ways?
Genetically modified e-coli. (Humulin)
or cow and pigs for special cases
What are the different types of insulin?
Rapid acting Short acting NPH (natural protein hagedorn) Insulin Glargine Insulin determir
What is characteristic of Rapid acting insulin?
- Rapid onset, early peak onset, 4 hour duration
- Taken immediately before a meal
What is an example of Rapid acting insulin?
Lispro (Humalog)
What is characteristic of Short acting insulin?
- Crystalline zinc helps to delay onset and lengthen duration
- 30 min onset, peaks 2-3 hours, lasts 5-8 hours
What is characteristic of NPH insulin?
- immediate acting
- delayed absorption and onset (linked peptide protamine)
- Onset 2-5 hours
- Duration 4-12 hours
- often mixed with other insulins for immediate and sustained needs
What is characteristic of glargine insulin?
Long acting sustained insulin
good background insulin
