Lecture 11: Diabetes

Question 1

pancreatic alpha cells

Answer 1

produce glucagon (hormone) = increases blood sugar levels

Question 2

pancreatic beta cells

Answer 2

produces insulin = lower blood sugar levels by allowing cells to absorb glucose from blood

Question 3

rise of glucose triggers what when you eat

Answer 3

insulin

Question 4

what spikes after every meal to make levels go back to normal

Answer 4

insulin

Question 5

what is insulin

Answer 5

key hormone that promotes uptake of glucose

Question 6

what are counter-regulatory hormones

Answer 6

• 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

Question 7

what is prediabetes

Answer 7

• 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)

Question 8

prediabetes symptoms

Answer 8

• polyuria (increased urine)
• polyphagia (increased eating)
• polydipsia (excessive thirst)

Question 9

diagnosis of diabetes

Answer 9

• 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

Question 10

types of diabetes

Answer 10

type 1, and type 2
also gestational and prediabetes

Question 11

type 1 diabetes

Answer 11

“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

Question 12

when you have dangerously high blood glucose levels at the ER what do you show up with

Answer 12

ketoacidosis
- also weight loss, polydipsia, polyuria, polyphagia

Question 13

type 2 diabetes

Answer 13

• most prevalent type
• overweight
• genetic basis
• pancreas continues to produce some endogenous insulin. insulin produced is insufficient or is poorly utilized by tissues

Question 14

type 2 diabetes abnormalities

Answer 14

• insulin resistance: body tissues don’t respond to insulin
• pancreas decreases ability to produce insulin
• inappropriate glucose production from liver

Question 15

clinical manifestations of type 1 diabetes

Answer 15

• usually acute onset
• polyuria, polyphagia, polydipsia
• weight loss
• weakness, fatigue
• visual changes
• women-yeast infections

Question 16

type 2 diabetes clinical manifestations

Answer 16

• non-specific
• gradual onset
• fatigue
• poor wound healing
• recurrent infections
• visual acuity changes
• painful peripheral neuropathy in the feet

Question 17

type 1 diabetes diet

Answer 17

• balance meal plan
• insulin + exercise balance = good

Question 18

type 2 diabetes diet

Answer 18

• emphasis on achieving glucose, lipid, and bp goals
• calorie reduction and weight loss

Question 19

why is exercise important for diabetes

Answer 19

• increases insulin receptor sites
• lowers blood glucose levels
• contributes to weight loss

Question 20

administration of insulin

Answer 20

• SC injection for self-admin
• IV admin in care setting

Question 21

where is the fastest absorption for insulin therapy

Answer 21

abdomen, followed by arm, thigh, and buttock

rotate injections within one particular site

do not inject in site to be exercised

Question 22

no diabetes level

Answer 22

HbA1C : <5.7%

Question 23

hypoglycemia level

Answer 23

< 4 mmol/L

Question 24

insulin therapy problems

Answer 24

• hypoglycemia
• allergic reactions
• lipodystrophy
• somogyi effect
• dawn effect

Question 25

biguanides

Answer 25

(1st line for most type 2 diabetes)
- antihyperglycemics
ex: metformin

Question 26

sulphonylureas

Answer 26

-increase insulin production from pancreas
-increase risk of hypoglycemia
ex:Gliclazide and glyburide

Question 27

Non-sulfonylureas

Answer 27

-increase insulin production from pancreas
-takes 30 mins before meal
ex: Repaglinide

Question 28

Dipeptidyl peptidase-4 (DDP-4) Inhibitors

Answer 28

• increase and prolong incretin levels
• glucose dependent
• antihyperglycemics
  ex: sitagliptin