Lecture 16: Insulin & Diabetes Flashcards
What is type 1 diabetes?
An autoimmune disorder where the pancreas produces little or no insulin
What is type 2 diabetes?
Occurs when the body is in an insulin resistant state and pancreatic beta cells cannot release sifficient insulin to compensate. Largely a result of lifestyle; obesity, lack of excersise, diet
Compare Type 1 and type 2 diabetes (5)
- T1 young onset, T2 older onset
- T1 rapid onset of symptoms, T2 no obvious symptoms in the early stage
- T1 not related to obesity, T2 obese
- T1 body cant produce insulin, T2 body cells are resistant to insulin
- T1 managed by insulin injections, diet and excersise, T2 managed by oral medication or insulin injection, diet and excersise
What is gestational diabetes?
Affects up to 25% of women during pregnancy. Usually develops in 2nd trimester and disappears after the child in born. Cause not clear but thought to be due to various hormonal changes that occur during pregnancy, many of which can block the action of insulin
What are the three tests for diagnosis of diabetes?
- Fasting glucose test/ random glucose test
- Glucose tolerance test
- Hba1c
What is the fasting glucose test?
Patient doesnt eat or drink for 8-10 hours then a blood test is done to check values for plasma glucose levels
What is a random glucose test?
Regardless of when a person last ate, a random plasma glucose value of 11.1 mmol/l indicates diabetes
What is the oral glucose tolerance test?
Patient must fast for atleast 8 hours. Plasma glucose is measured immediately before and 2 hours after drinking 75g glucose dissolved in water
What is the HbA1c test?
HbA1c levels give a measure of the average blood glucose levels over the previous 3-4 months.
How is diabetes diagnosed?
Diagnosis is made by classic acute symptoms of hyperglycaemia and an abnormal blood test
How is diabetes diagnosed in patients with no classical symptoms?
Two abnormal blood tests of separate days
What are the acute symptoms of diabetes?
- Dehydration
- Nausea and vomitting
- Increased fatigue
- Increased thirst
- Increased urination
- Increased appetite
- weight loss
- infections
- poor wound healing
- blurry vision
What causes tiredness and extreme hunger?
Cells do not get energy they need as glucose is not taken up
What causes unexplained weight loss?
Fat stores are broken down and used to supply energy
What causes blurry vision?
Lens of eye becomes dry due to dehydration and glucose build up
What causes poor healing?
Damage to blood vessels limits flow of oxygen and nutrients needed for repair
What causes genital itch/ thrush?
High glucose in blood/urine (support yeast growth)
What is diabetic ketoacidosis?
Lack of insulin limits the use of glucose as an energy source. Absence of insulin enhances free fatty acids (FFA) release from adipocytes. FFAs converted to ketone bodies by the liver (acetoacetate and b-hydroxybutyrate), which can serve as an energy source. Ketones cause the pH of the blood to become acidic
What are the early signs of diabetic ketoacidosis?
- feeling very thirsty
- urinating often
- high blood glucose levels
- high ketone levels in urine
What are the later/ extreme signs of diabetic ketoacidosis?
- feeling weak or constantly sleepy
- dry/ flushed skin
- nausea, vomitting, pain in the abdomen
- difficulty breathing
- fruit flavoured breath
What is the treatment for diabetic ketoacidosis?
- Fluid replacement
- Insulin
- Mineral replacement
When does diabetic ketoacidosis usually develop?
- At the time of diagnosis of diabtetes
- During illness
- During growth spurt/ puberty
- When insulin has not been taken correctly
What are the chronic complications of diabetes?
- Stroke
- CVD
- Diabetic retinopathy: leading cause of blindness in adults. Caused by damage to vessels in eye
- Diaetic nephropathy: leading cause of end stage renal disease. Caused by damage to small blood vessels in kidney
- Diabetic neuropathy: leading cause of non traumatic lower extremity amputation. Causes sensory loss and impotence
What is diabetic foot?
Nerve damage or poor blood flow to feet increases risk of various complications. Cuts and blisters can become serious infections, which often heal poorly and may ultimately need amputated.
What are the pregnancy complications of diabetes?
- increased risk of miscarriage, stillbirth and birth defects when diabetes not well-controlled
- for mother, diabetes increases risk of DKA, retinopathy, pregnancy induced high blood pressure and pre-eclampsia
