Exam Two - endocrine three Flashcards
diabetes mellitus
chronic condition with no cure resulting in elevated blood glucose levels
type one
autoimmune reaction attaching pancreas beta cells - insulin production is impaired
type two
insulin resistance at the cellular level - insulin function is impaired
gestational diabetes
- 2-10% of pregnancies
- develops w.o history of diabetes
- usually goes away after birth
- increases future risk of type 2 diabetes by 50%!
- baby at increased risk to develop obesity as a child/teen and to develop type 2 diabetes later in life
diabetes insipidus
- rare
- not related to mellitus
- blood sugar levels are normal
- kidneys cannot concentrate urine
- etiology: impaired vasopressin (ADH) production
prediabetes
- blood glucose levels are higher than normal but not high enough for type 2 diabetes diagnoses
t or f? prediabetes can be reversed with lifestyle changes
t
A1C ranges
> 6.5% = diabetes
5.7-6.4 = prediabetes
<5.7% = normal
____ of people have diabetes
11.3% 37.3 million people
____ of people have prediabetes
29% 96 million
t or f? diabetes is considered an age related disease
true
diabetes prevalence varies with?
- race/ethnicity (native american, then black is most, white is least)
- socio/economic status
- education level
type one risk factors
family history
age (can develop at any age, but it usually develops in children, teens, or young adults)
type two risk factors
- have prediabetes
- overweight
- over 45 years old
- family history
- physically active less than 3x a week
- history of gestational diabetes
- high risk in specific ethnic groups
- non-alcoholic fatty liver
how to prevent type 2 diabetes?
weight loss, heathy diet, exercise, quit smoking
what are two categories of diabetes complications?
- comorbidities
- complications
comorbidities definition
coexisting health condition
examples of diabetes comorbidities
- CVD
- obesity
- metabolic disease
complications definition
disease caused by primary disease
complications of diabetes
- diabetic neuropathy
- diabetic nephropathy
- diabetic retinopathy
diabetic retinopathy
- excess glucose clogs capillaries in eyes, causes edema, damages retina
- a leading cause of blindness
diabetic nephropathy
- kidney disease
- leading causes of chronic kidney disease and end-stage renal disease
(issue with blood vessels because excess glucose in blood)
diabetic neuropathy
nerve damage, often in extremities
diabetes symptoms
- feeling more thirsty than usual
- urinating often
- losing weight without trying
- presence of ketones in urine
- feeling tired and weak
- feeling irritable or having other mood changes
- blurry vision
- slow-healing sores
- high frequency of infections
types one diabetes diagnoses
- often start suddenly and are often the reason for checking blood sugar levels
ADA screening guidelines for diabetes
- bmi>25 (>23 for asians)
- age> 35
- women who had gestational diabetes
- diagnosed with prediabetes
- HIV+
What are different diagnostic tests for type one and two?
- A1C test (>6.5 diabetes, <5.7 normal)
- random blood sugar test (no matter fasting state, blood sugar above 200 suggests diabetes)
- fasting blood sugar test
- glucose tolerance test
fasting blood sugar test
- overnight fast
<100 normal
100-125 prediabetes
>126 2x tests is diabetes
glucose tolerance test
- GOLD STANDARD
- overnight fast, then drink sugary beverage
- blood sugar tested regularly for 2 hours
after 2 hrs:
<140 normal
141-199 prediabetes
> 200 dibetes
type one tests
- ketone abundance in blood
- autoantibody tests
autoimmune disease?
type one
in type one, immune system destroyes
beta cells
with no ______ in blood stream, _______ is left to build up in damaging numbers
insulin, glucose
no _______, equals no glucose in cells which means death
insulin
type _____ diabetics have to constantly measure their blood glucose and inject the right amount of insulin
one
insulin pump
- type one
- constantly measures blood glucose and automatically puts the right amount of insulin into the body
insulin resistance
type two
in type two cells gradually become insulin
resistant
insulin is _______ but cells (do/do not) respond
present, do not
exact cause of type two is unknown. t or f?
true
What are strong life style links to diabetes?
- excess body fat around the waist
- inactivity
- poor dietary habits
type two is a _________ and can take years, often without symptoms to develop into type 2 diabetes
gradual process
- starts with insulin resistance and over time can move on to insulin dependance as the beta-cells :burn out” and reduce or eliminate insulin production
insulin secreting pathway with low levels of glucose in blood
1 - low glucose in blood
2 - metabolism slows
3 - ATP decreases
4 - Katp channels open adn K leaks out of cell
5 - cell at resting membrane potential. no insulin is released (coltage gated ca channel stays closed)
insulin secreting pathway for high blood glucose
1 - high levels of glucose in blood
2 - metabolism increases
3 - atp increases
4 - Katp channels close
5 - cell depolarizes and ca channels open
6 - ca entry acts as an intracellular signal
7 - ca signal triggeres exocystosis and insulin is secreted
diabetes complications
- CVD
- atherosclerosis
- hypertension
- peripheral neuropathies
- other nerve damage
- kidney disease
- retinopathy and eye damage
- skin conditions
- slow healing and foot ulcers
- amputations
- hearing impairement
- sleep apnea
- dementia
treatment for all types of diabetes
- healthy eating
- physical activity
- quit smoking
treatment for type one diabetes
- insulin injections
- insulin pump
- frequent blood sugar checks
- carb counting
- pancreas transplant or islet cell transplant
treatment for type two diabetes
- mostly lifestyle changes
- monitoring blood sugar
- oral diabetes drugs, insulin, or both
