Intro to Diabetes Flashcards
Preventative strategies for reducing the onset of T2DM
Lifestyle change
Dietary intake
Weight control
Exercise level
Epidemiology of DM
~37 million in the U.S. have DM
1 in 10
1 in 5 don’t know
~96 million cases of Pre-Diabetes
1 in 3 adults
Additional factors (besides glucose) that can stimulate insulin release from the β-cell
- Hormones: GLP-1, CCK, Glucagon
- Neurotransmitters: Acetylcholine, epi-/norepinephrine, somatostatin
- Glucose synergizes with these mediators
& enhances the secretory response of the
β-cell to these factors.
_____ Allows glucose transportation into the cell for metabolism
Insulin
Digestion also stimulates ____ release
insulin
Activation of the insulin receptor causes activation of _____
phosphatidylinositol 3-kinase
What triggers the liver to do gluconeogenesis?
Glucagon
____ separate C-peptide from insulin
Converting enzymes
_____ is characterized by β cell destruction (pancreas) and virtually absent circulating insulin
DM1
Pathophysiology of DM1
Mostly seen in children before school age & again around puberty
Rate of B cell destruction is variable
_____ is characterized by sufficient circulating endogenous insulin, & ↑ insulin resistance (↓ tissue sensitivity)
DM2
What happens with circulating glucagon in DM1?
Elevated
In this state, almost no carbohydrates are metabolized & all energy comes from fat
metabolism.
Ketoacidosis
Explain how ketoacidosis occurs
ADD
What are “Kussmaul” respirations?
slower, deeper & labored breathing
_____ + _____ = high serum osmolarity & metabolic acidosis
Hyperglycemia + osmotic diuresis
The lethality of ketoacidosis lies in ______
the changes to key ions like potassium
Diagnostic criteria of DM1
Increased Urination
Increased Appetite
Increased Thirst
Blurred Vision
Weight Loss
Hypotension ↓ blood volume from urination, K+ loss
Paresthesias (abormal sensations, tingling)
Diagnostic Criteria for DM2
↑ Urination & Thirst
Glycosuria or hyperglycemia
Neuropathies
Cardiovascular problems
Chronic skin infections
Generalized Pruritus
Vaginitis
Chronic Candidal vulvovaginitis
Marcosomia (large (>9lb) babies)
Balanoposthitis
Overweight or obese
↑ waist circumference
Acanthosis Nigricans
Eruptive xanthomas
Hypertrigliceridemia
Laboratory findings for Diabetes
- Urine Glucose
- Urine & Blood Ketones
- Plasma or Serum Glucose: ≥ 126 mg/dL on two separate occasions with at least 8 hours of
fasting is diagnostic for Diabetes Mellitus
≥ ____mg/dL on two separate occasions with at least 8 hours of fasting is diagnostic for Diabetes Mellitus
126
Normal vs. Fasting glucose laboratory testing
Normal: if 0 minute is < 100mg/dL & 120 minute is < 140 mg/dL
Fasting: >126 mg/dL or 120 minute is over > 200 mg/dL = DM
How is HgbA1c weighted?
HgbA1c is weighted to the most recent month & expressed as %
Correlates to glucose concentration over the last 8-12 weeks
Check this in all types of diabetics every 3-4 months
~5.7-6.4% HgbA1c indicates ______
higher risk (prediabetes or insulin resistance)
Compare & contrast DM1 and DM2
See slide 35
How are eyes affected by DM?
Diabetic retinopathy
Cataracts
How are the kidneys affected by DM?
Glomerulosclerosis
Infection
Pyelonephritis
Renal Tubular Necrosis (RTN)
How is the nervous system affected by DM?
Peripheral neuropathy: sensory & motor
Foot or wrist drop
Cranial Neuropathy
Postural Hypotension
Loss of sweating
Gastroparesis
Urinary Bladder atony
How is the skin affected by DM?
Skin spots
Candidiasis
Foot & leg ulcers
Ischemic
How is the cardiovascular system affected by DM?
Heart disease
Myocardial Infarction
Cardiomyopathy
Peripheral vascular disease
Ischemic ulcers
How is the musculoskeletal system affected by DM?
Diabetic Characteropathy
Dupuytren contracture
Charcot joint
Osteomyelitis
Unusual infections that occur due to DM?
Necrotizing Fasciitis
Necrotizing Myositis
Emphysematous Cholecystitis
Malignant otitis media
