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ILE I > ILE I U2 D1 > Flashcards

ILE I U2 D1 Flashcards

1
Q

Type 1

A

Insulin deficient

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2
Q

Type 2

A

Insulin resistant

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3
Q

The American Diabetes Association Diabetes Expert Committee recommends a diagnosis of diabetes when one of three criteria is met

A
  1. Random plasma glucose of ≥ 200 mg/dL, + polydipsia, polyuria, unexplained weight loss
  2. Fasting plasma glucose of ≥ 126 mg/dL on AT LEAST 2 occasions
  3. Fasting plasma glucose of < 126 mg/dL, but a 75g 2 hr oral glucose tolerance test plasma glucose of ≥ 200 mg/dL
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4
Q

normoglycemia

A

appropriate glycemic control based on the patient’s comorbidities

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5
Q

BP control in diabetic patients reduces risk for

A
  1. retinopathy
  2. nephropathy
  3. cardiovascular risk
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6
Q

significant reductions in macrovascular complications may take

A

5-15 years

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7
Q

Short term reductions time-frame

A

<5 years

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8
Q

T1D therapy

A

Insulin

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9
Q

T2D therapy

A

Insulin (or other injectable anti-hyperglycemics) and metformin.
Multiple therapeutic agents required for T2D

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10
Q

thiazolidinediones (TZDs) MoA

A

Reduce (not stop) decline of beta cell function

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11
Q

Aggressive management of cadiovascular risk is required for patients with which type?

A

T2D

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12
Q

How do you prevent T1D?

A

Unknown

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13
Q

Alcohol consideration in D

A

Less than one drink per day for women
Less than two drinks per day for men
A drink = 12 oz beer, 5 oz glass wine, 1.5 oz distilled spirits

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14
Q

Na consideration for D

A

<2300 mg/day

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15
Q

consideration for sweeteners for D

A

non nutritional sweeteners “May be an acceptable substitute for nutritive sweetners”

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16
Q

Carb consideration for D

A

Type 1 diabetes: carbohydrate counting to dose insulin

▪ Type 2 diabetes: portion measurement to improve glycemic control

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17
Q

For diabetic patients, do you want a high or low glycemic index?

A

High!

18
Q

Proteins consideration for D

A

15-30% of diet

19
Q

Fat consideration for D

A 
Limit calories from fat
▪ Polysaturated fats—”good fats”
▪ Monounsaturated fats—”good fats”
▪ Saturated fats---limit/avoid if/when possible
▪ Trans fats---AVOID if/when possible
20
Q

The PLATE method is used when treating patients with which type of diabetes?

A

T2D

21
Q

What are the 2 “bad” fats? Provide examples of each

A
  1. Saturated (lard, poultry skin, coconut oil, high fat meat)
  2. Trans (French fries, shortening, crackers, chips)
22
Q

What are the 2 “good” fats? Provide examples of each

A
  1. Monounsaturated (Avocado, canola oil, nuts, peanut butter)
  2. Polyunsaturated (Salad dressing, corn oil, pumpkin seeds)
23
Q

Diabetes definition

A

Group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both

24
Q

Long-term hyperglycemia is associated with what?

A

damage, dysfunction, and failure of the eyes, kidneys, nerves, heart, and blood vessels.

25
Q

What causes T1D?

A

body’s immune system destroys pancreatic

beta cells, the only cells that make the insulin that regulates blood glucose

26
Q

Risk factors for developing type I diabetes

A

autoimmune, genetic, or environmental

27
Q

Types of T1D

A
  1. Immune-mediated (90%)

2. Idiopathic (10%)

28
Q

Immune-mediated T1D

A

Auto-antibodies, Patients prone to other autoimmune disorders i.e. Graves disease,
Hashimotos thyroiditis, Addison, vitiligo, pernicious anemia.

29
Q

Idiopathic T1D

A

No anti-bodies, no evidence of pancreatic beta cell autoimmunity

30
Q

Symptoms of T1D

A

Symptoms of polyuria, polydipsia, rapid weight loss, ketonuria, keto-acidosis

31
Q

T1D treatment

A

Healthy (eucaloric) diet and insulin

32
Q

Islet cells can develop antibodies to (5)

This leads to T_D

A
  1. Insulin: decreases release and overall insulin expression 2. Proinsulin
  2. Glutamic acid decarboxylase
  3. Ganglioside antigens
  4. Tyrosine phosphatase
    Leads to T1D
33
Q

4 other disease states that lead to pancreatic cell destruction

A

a. Mumps virus
b. Coxsackievirus B4
c. Pancreatitis
d. Destructive cytotoxins and antibodies form sensitized immunocytes

34
Q

Environmental toxins that lead to T1D

A

nitrosamines (R-N=O)

35
Q

Food/drugs that lead to T1D

A

Early exposure to cow milk, immunosuppressive drugs

36
Q

Polydipsia

A

Increased thirst

37
Q

Polyuria

A

Increased urination

38
Q

Macrophages release what in terms of beta cell death?

A

Cytokines and free radicals

39
Q

T and B cells release what in terms of beta cell death?

A

Auto-antibodies

40
Q

“Hallmarks” of T1D

A
  1. Auto-bodies

2. Beta cell destruction

41
Q

Formerly IDDM

A

T1D

ILE I (18 decks)

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