L12 - Diabetes Flashcards
Symptoms of diabetes?
- Weight loss 0r gain
- Fatigue
- Excessive thirst and hunger
- Freq urination
- Irritability
- Blurred vision
- Slow healing wounds
- Nausea
How would you diagnose for diabetes?
- Urine analysis for glc
- Measure blood insulin
- Blood glcvalues
- OGTT - Gold standard
- HbA1c - glycosylated Hb
What is type 1 diabetes?
ABSOLUTE INSULIN DEFICIENCY
- Insulin dependent
- Onset typically <40 years but can present at any age
- Usually normal weight or slim
- Fam history less common
- KETONES PRESENT
What is type 2 diabetes?
RELATIVE INSULIN DEFICIENCY
- Non insulin dependent
- Onset typically >40 years (now getting younger)
- Genetic predisposition
- Ass with obesity
- NO KETONES
How could you control type 1 diabetes?
- Lifestyle
- Insulin
How could you control type 2 diabetes?
- Lifestyle
- Red insulin resistance
- Inc glc excretion
- Inc insulin
What are the different types of insulin?
- Meal time insulin
- Soluble
- Rapid acting - Longer acting insulin
- Zinc insulin
- Long acting
What medication other than insulin could you take to lower glc?
- Tablets
- Insulin sensitisers
- Insulin secretogogues
- Gut abs
- Glc excretion
- Incretion breakdown inhib - Injections
- Incretin mimetic
What are some complications of diabetes to the eye?
- High blood glc
- High BP can dmg BV
- Diabetic retinopathy
- Cataracts
- Glaucoma
What are some complications of diabetes to the kidney?
- High BP dmg small BV
- Excess bglc overwork kidneys –> neuropathy
What are some complications of diabetes to the neuropathy?
Hyperglycemia dmg nerves in PNS
- Pain and/ or numbness
- Feet wounds undetected –> infection –> gangrene
What are some complications of diabetes to the brain?
- Inc risk of stroke
- Inc risk of cerebrovascular disease
- Inc transient ischaemic heart attack
- Cognitive impairment
What are some complications of diabetes to the heart?
- High BP and insulin resistance result in inc risk of CHD
What are some complications of diabetes to the extremities?
- Narrowing of BV –> peripheral vascular disease
- Inc risk for reduced or lack of blood flow to legs
- Feet wounds likely to heal slowly contributing to gangrene
What are some complications in diabetes to the liver?
- Non-alcoholic fatty liver disease
build up of fat
What is diabetic neuropathy?
Sensory, motor and autonomic nerves can all be damaged
- Longest nerves often get dmged first
Cause of type 2 diabetes?
- Insulin resistance mainly in the skeletal muscle and liver
- Beta cell dysfunction leading to a relative reduced insulin secretion
LEADING TO HIGH GLC LEVELS
Cause of type 1 diabetes?
AI disorder (insulitis) - Destroy beta cells of pancreas
What medication could you take to control blood pressure in diabetes?
- ACE (angiotensin converting enzymes) inhibitors - Enalapril
- Beta blockers - Atenolol
- Calcium channel blockers - Amlodipine
- Diuretics - Furosemide
What medication could you take to control lipids in diabetes?
- Statins - Simvastatin
2. Fibrates - Fenofibrate
What effect does diabetes have on platelets?
- Inc platelet reactivity
-
What is insulin?
An anabolic hormone
- Maintains supply of glc to tissues
- Promotes protein synthesis
- Inhibits breakdown of fat
- Regulates met in muscle
- Glc –> glycogen for storage in liver and skeletal muscle
- DEC BGLC
Why are there ketones in T1D?
Triglycerides break down into fatty acids and gylcerol
- Ketones build up when body uses fat for energy
- Without enough insulin, glc can’t enter cells therefore builds up in blood –> DKA –> coma –> death
