Exam 5: Chapter 25 Flashcards
Risk factors for DM
45 years and older, gestational diabetes, high weight, low activity level, HLD, HTN,
What is glycogenesis?
process of glycogen formation which is stored in cells
What is glycogenolysis?
the breakdown of stored glycogen to yield glucose; this is stimulated by the pancreas and adrenal glands
What is gluconeogenesis?
the formation of glucose from stored fats and proteins
What is a normal fasting glucose levek?
70mg/dL-100mg/dL
What is a hypoglycemic glucose level?
blood glucose less than 70mg/dL`
What is a hemoglobin A1c level in diabetes?
greater than 6.5
What is a positive dx of DM?
two or more fasting glucose levels of 126mg/dL
What are the Isles of Langerhans?
endocrine cells that secrete insulin and glucagon
What is the pathophysiology of type 1 DM?
autoimmune destruction of the pancreatic beta cells
Sx of type 1 DM
hyperglycemia with initial rapid onset, polyuria, polydipsia, polyphagia, glucosuria, ketonuria, dehydration, weight loss, and fatigue
What is the pathophysiology of type 2 DM?
cells are insulin resistant and pancreatic production decreases over time
What are the risk factors for type 2 DM?
obesity, increasing age, native American, Hispanic, African-American, sedentary lifestyle, gestational diabetes
Sx of type 2 DM
gradual “silent” onset, polyuria, polydipsia, polyphagia, fatigue, prolonged wound healing, recurrent infections, vision changes
What are the acute complications of DM?
hypoglycemia with is present in both type 1 and 2, diabetic ketoacidosis which is mainly present in type 1, and hyperglycemia hyperosmolar syndrome which is present in type 2`
Causes of hypoglycemia
excess insulin, inadequate food intake, stress, extreme physical activity, infection, alcohol use, surgery, excess oral hypoglycemic druvs
What is insulin “shock”?
excess insulin in circulation because of glucose deficit in the blood and can cause damage to the brain if left untreated
Sx of hypoglycemia
headache, hunger, confusion, dizziness, inability to concentrate, shaky, diaphoretic, palpitations, irritability, seizures, loss of consciousness, hypotensive, tachycardic
What are the compensatory mechanisms of hypoglycemia?
release of epinephrine, glucagon, SNS
What is the pathophysiology of diabetic ketoacidosis (DKA)?
starts with hyperglycemia due to there not being enough insulin which leads to the burning of fatty acids for energy which leads to the production of ketones
Sx of DKA
dehydration, thirst, dry and rough oral mucosa, warm and dry skin, hypotension and tachycardia, rapid and deep respirations (kussmaul), acetone breath (fruity), lethargy, decreased responsiveness, electrolyte imbalance, abdominal cramps, nausea, vomiting, weakness
What is hyperglycemic hyperosmolar non-ketonic COMA?
occurs in type 2 DM and results in severe dehydration and electrolyte imbalance
What is the pathophysiology of hyperglycemia hyperosmolar syndrome?
starts with hyperglycemia which leads to severe cellular dehydration (osmotic pressure causes fluids to be pulled from cells and into extracellular compartments). As a result there is polyuria which causes hypovolemia
Microvascular diabetic complications
(endothelial damage)retinopathy, nephropathy, neuropathy
