Lecture 11: Diabetes Flashcards
pancreatic alpha cells
produce glucagon (hormone) = increases blood sugar levels
pancreatic beta cells
produces insulin = lower blood sugar levels by allowing cells to absorb glucose from blood
rise of glucose triggers what when you eat
insulin
what spikes after every meal to make levels go back to normal
insulin
what is insulin
key hormone that promotes uptake of glucose
what are counter-regulatory hormones
- oppose effect of insulin
- stim glucose production and output by liver
- decrease movement of glucose into the cells
- ex: glucagon, epinephrine, growth hormone, and cortisol
what is prediabetes
- ppl at risk for diabetes
- blood glucose high but not high enough to have diabetes
- long term damage alr occuring
- impaired fasting glucose (6.1-6.9 mmol/L)
- impaired glucose tolerance (2 hour plasma glucose levels between 7.1 and 11 mmol/L)
prediabetes symptoms
- polyuria (increased urine)
- polyphagia (increased eating)
- polydipsia (excessive thirst)
diagnosis of diabetes
- fasting glucose greater or equal to 7 mmol/L
- A1C greater or equal 6.5%
- 2 hr plasma glucose in a 75g oral glucose
- random PG greater or equal to 11.1 mmol/L + sympt
types of diabetes
type 1, and type 2
also gestational and prediabetes
type 1 diabetes
“insulin dependent diabetes”
- progression destruction of beta cells
- antibodies present for months to years before sympt occur
- sympt come when ur pancreas can no longer produce insulin
when you have dangerously high blood glucose levels at the ER what do you show up with
ketoacidosis
- also weight loss, polydipsia, polyuria, polyphagia
type 2 diabetes
- most prevalent type
- overweight
- genetic basis
- pancreas continues to produce some endogenous insulin. insulin produced is insufficient or is poorly utilized by tissues
type 2 diabetes abnormalities
- insulin resistance: body tissues don’t respond to insulin
- pancreas decreases ability to produce insulin
- inappropriate glucose production from liver
clinical manifestations of type 1 diabetes
- usually acute onset
- polyuria, polyphagia, polydipsia
- weight loss
- weakness, fatigue
- visual changes
- women-yeast infections
type 2 diabetes clinical manifestations
- non-specific
- gradual onset
- fatigue
- poor wound healing
- recurrent infections
- visual acuity changes
- painful peripheral neuropathy in the feet
type 1 diabetes diet
- balance meal plan
- insulin + exercise balance = good
type 2 diabetes diet
- emphasis on achieving glucose, lipid, and bp goals
- calorie reduction and weight loss
why is exercise important for diabetes
- increases insulin receptor sites
- lowers blood glucose levels
- contributes to weight loss
administration of insulin
- SC injection for self-admin
- IV admin in care setting
where is the fastest absorption for insulin therapy
abdomen, followed by arm, thigh, and buttock
rotate injections within one particular site
do not inject in site to be exercised
no diabetes level
HbA1C : <5.7%
hypoglycemia level
< 4 mmol/L
insulin therapy problems
- hypoglycemia
- allergic reactions
- lipodystrophy
- somogyi effect
- dawn effect
biguanides
(1st line for most type 2 diabetes)
- antihyperglycemics
ex: metformin
sulphonylureas
-increase insulin production from pancreas
-increase risk of hypoglycemia
ex:Gliclazide and glyburide
Non-sulfonylureas
-increase insulin production from pancreas
-takes 30 mins before meal
ex: Repaglinide
Dipeptidyl peptidase-4 (DDP-4) Inhibitors
- increase and prolong incretin levels
- glucose dependent
- antihyperglycemics
ex: sitagliptin
