Exam 3: Diabetes basics Flashcards

1
Q

Define T1DM

A

pancreatic beta cell destruction and eventually absolute insulin deficiency (production or secretion). Considered autoimmune. Not preventable

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2
Q

T1DM etiology

A

idiopathic autoimmunity

circulating autoantibodies

immune mediated

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3
Q

T1DM Pathophysiology

A

Autoimmune disease in which body attacks the beta cells of the pancrease resulting in the lack of insulin production. Without insulin it won’t act as a key to open up cells to uptake blood glucose causing hyperglycemia

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4
Q

T1DM Complications

A

Ketoacidosis
Macrovascular diseases
* Coronary heart disease
* Peripheral vascular disease
* Cerebrovascular disease Microvascular diseases
* Retinopathy
* Nephropathy Neuropathy

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5
Q

explain why Ketoacidosis (DKA)
occur

A

Ketoacidosis in type 1 diabetes (T1DM) occurs because of a severe insulin deficiency, which prevents glucose from entering cells for energy. As a result, the body starts breaking down fat for fuel, producing ketones as a byproduct. When ketones accumulate in the blood faster than they can be used or eliminated, they cause the blood to become acidic, leading to diabetic ketoacidosis (DKA). This condition is often triggered by factors like infection, insufficient insulin administration, or stress, and is a medical emergency requiring prompt treatment

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6
Q

T1DM symptoms

A

hyperglycemia (insulin deficiency)

polydipsia (excessive thirst)

polyuria (frequent urination)

polyphagia (excessive hunger)

weight loss

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7
Q

Why does hyperglycemia occur in T1DM

A

absolute lack of insulin, a hormone that is essential for helping glucose enter cells for energy. Without enough insulin, glucose builds up in the bloodstream instead of being utilized by the body’s cells, resulting in high blood sugar levels.

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8
Q

Why does polyuria occur in T1DM

A

occurs due to the body’s attempt to excrete excess glucose through urine. When blood sugar levels become very high (hyperglycemia), the kidneys are unable to reabsorb all the glucose, leading to glucose spilling into the urine. The presence of glucose in the urine increases the osmotic pressure, drawing more water into the urine, which results in frequent urination

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9
Q

Why does polyphagia occur in T1DM

A

due to the body’s inability to effectively use glucose for energy. In T1DM, insulin production is either absent or insufficient, which means glucose cannot enter cells to be used as fuel. As a result, the body begins to break down fat and muscle for energy, leading to increased hunger as the body signals that it needs more fuel to meet its energy demands

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10
Q

Why does polydipsia occur in T1DM

A

body’s attempt to dilute the excess glucose in the bloodstream. When blood sugar levels rise significantly, the kidneys filter out the excess glucose into the urine, which increases urine volume (polyuria). This causes dehydration, and as a result, the body triggers the sensation of thirst to compensate for the fluid loss and restore proper hydration levels

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11
Q

Why does weightloss occur in T1DM

A

body cannot properly use glucose for fuel and instead starts breaking down fat and muscle tissue for energy, leading to weight loss. Additionally, excessive glucose in the bloodstream is excreted in the urine (polyuria), which causes fluid loss and contributes to dehydration, further exacerbating weight loss. This weight loss can occur even though the individual may be eating more (polyphagia), as the calories from food are not being utilized effectively.

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12
Q

Diabetes diagnostic criteria: FPG

A

Fasting Plasma Glucose FPG: ≥126mg/dL

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13
Q

Diabetes diagnostic criteria: CPG

A

Casual Plasma Glucose CPG: ≥ 200 mg/dL (random)

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14
Q

Diabetes diagnostic criteria: 2hPG

A

2hPG ≥ 200 mg/dL (2h after oral gluc tolerance)

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15
Q

Diabetes diagnostic criteria: A1c

A

A1C greater than or equal to 6.5% (long term blood sugar control)

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16
Q

Define A1c

A

glycosylated hemoglobin amount of glucose attached to the hemoglobin protein in RBC

as blood glucose inc amount of gluc attached to hemo inc estimate 3m time frame

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17
Q

Define T2DM

A

insulin resistance and insulin deficiency. Preventable

18
Q

Etiology T2DM

A

genetic factors

intake of excessive calories

risk factors

physical inactivity

environmental factors

19
Q

T2DM risk factors

A

obesity (modifiable)
physical inactivity
prediabetes
metabolic syndrome

older age
ethnicity
gestational diabetes

20
Q

Pathophysiology T2DM

A

Insulin resistance by peripheral tissues (muscle and fat cells), impaired insulin secretion, Increased hepatic glucose, Increased lipolysis and elevated free fatty acids, worsening insulin resistance.
Chronic inflammation, renal glucose reabsorption,

21
Q

T2DM complication

A

CVD
dyslipidemia
hypertension

22
Q

T2DM symptoms

A

hyperglycemia
* Abnormal patterns of insulin secretion and action
* Decreased cellular uptake of glucose
increased postprandial glucose
* Increased release of glucose by liver (gluconeogenesis) resulting in fasting hyperglycemia
* Central obesity
Weight gain

23
Q

define GDM

A

occurs during pregnancy and is characterized by elevated blood glucose levels that are not due to pre-existing diabetes.

24
Q

GDM risk factors

A

obesity
Family history DM PCOS-impaired lifestyle factors

Advanced maternal age prior history of GM ethnic groups

25
Q

GDM complications

A

Preterm Birth
Inc risk for T2DM for mom and bb

Higher birth weight- more glucose to baby and baby produce more insulin promote fat store and and protein synthesis

neonatal hypoglycemia difficult delivery or C-section

26
Q

GDM behavioral mod management

A

exercise

27
Q

GDM medications

A

insulin analogs
metformin

28
Q

GDM screening timeframe postpartum

A
  • screening for DM 4-12 weeks postpartum and at least every 3 years
29
Q

GDM diagnosis

A

OGTT

30
Q

GDM diagnosis OGTT time frame

A

24-28wks

31
Q

GDM diagnosis OGTT value

A

1-hour oral glucose tolerance test value ≥ 180 mg/dL

32
Q

GDM how many kcal from CHO

A

40%

33
Q

GDM nutrition management

A

SFM
- one CHO svg at breakfast - no milk, fruit or dry cereal
- avoid added sugars and fruit juices
- limit refined cHO white bread, pasta…
- avoid sacchrain

34
Q

GDM breastfeeding yes or no, why?

A

breastfeeind reduce risk developing T2 in both

35
Q

PreDM complications

A

Higher risk for Type 2(asymptomatic)

36
Q

PreDM diagnosis

A

Impaired glucose tolerance use 2hPG Impaired Fasting Glucose use PG or A1c

37
Q

PreDM diagnosis 2hPG

A

140 - 199mg/dL

38
Q

PreDM diagnosis FPG

A

100 - 125 mg/dL

39
Q

PreDM diagnosis A1c

A

5.7% to 6.4%

40
Q

PreDM management

A

7 - 10% weight loss is typically sufficient for a individual with prediabetes