Pancreatic Gland Disorders Flashcards
what kind of gland in the pancreas?
endocrine and exocrine
alpha cells prodce
glucagon
glucagon does what?
increase the blood glucose levels by stimulating the level and other cells to release stored glucose (glycogenolysis)
beta cells produce
insulin
insulin does what?
lowers blood glucose levels by facilitating the entrance of glucose into the cells for metabolism
delta cells produce
somatostatin
somatostatin does what?
regulate the release of insulin and glucagon
what is diabetes?
defect in the secretion of insulin or action of insulin
Chronic hyperglycemia is associated with
long term damage and dysfunction and impairment of tissues organs - eyes kidneys, nerves heart and BVs
how do kidneys try to restore glucose blood levels?
excreting excess glucose
DM1 pathophysiology
autoantibodies are specific to beta cells
what are some characteristics of DM1
decreased utilization of glucose, increased fat mobilization, and impaired protein utilization
DM2 pathophysiology
endogenous insulin produce but have difficulty with effective insulin action at the cellular level
characteristics of DM2
normal to elevated insulin levels, insulin produced is ineffective because cells are resistance to attachment
action of insulin
transports glucose into the cell for use as energy and storage as glycogen – turns food into energy;
glucose levels elevated – beta cells increase secretion of insulin to transport/dispose glucose into peripheral tissue – lowers blood glucose levels and reestablishes homeostasis
DM1 also known as
insulin - dependent diabetes
DM1 autoimmune -
destroyed beta cells - defects in the production/secretion of insulin
DM2 also known as
non-insulin dependent DM
onset of DM2
adult - resistance to insulin action an inadequate compensatory insulin secretory response
characteristics of DM2
- no drop in insulin levels at first
- failure to express enough glucose transporters in skeletal muscles
- oral durgs help
- beta cells become exhausted and eventually will require insulin
- controlled with diet, exercise, and oral hypoglycemic med
how does insulin work?
transports glucose to cells; glucose absorbed into blood and is detected by pancreas which then secretes insulin that helps initiate transport to muscles
Type 2 - lots of glucose in blood stream becaus:
insulin doesn’t work at the skeletal muscle level …. insulin still binds to insulin receptor but it’s not able to signal GLUT4 protein to go to cellular surface and merge with cell membrane to produce a channel for glucose to allow the glucose to come into the muscle
Fasting Plasma Glucose
diabetes: >126
pre-diabetes: >100 and < 126
normal: <100
2 hour OGTT
diabetes: > 200
pre-diabetes: >140 and < 140
s/s of type 1 diabetes
polyuria, polydipsia, polyphagia, weight loss, extreme fatigue and irritability
s/s of type 2
polyuria, polydipsia, polyphagia, weight loss, extreme fatigue and irritability +
infections, blurred vision, slow to heal, paresthesis
medical management of of diabetes
- diet modification (2)
- oral medication (2)
- IM insulin injection (1 and prolonged 2)
- Insulin pump (2)
complication of diabetes
ketoacidosis (500-700 mg/dL) --> fruity breath skin lesions infection neuropathy CAD, stroke, PVD MS problems (CTS, duputytrens, trigger finger, OP) Kidney failure (nephropathy) Vision impairment (retinopathy)
PT implications of diabetes
monitor glucose levels - exercise can cause hypo
Hypoglycemia PT implications
no exercise <70
s/s: sweating, hunger, trembling, anxiety, blurred vision and confusion
Hyperglycemia PT implications
no exercise >300
s/s: increased thirst, fatigue, blurred vision
contraindications to exercise
poor control of glucose levels, poorly controlled retinopathy, HTN, neuropathy, nephropathy, dehydration, extreme environment temperatures
Exercise does what to insulin?
increase insulin sensitivity, thus lowering blood glucose levels = allows body to utilize blood glucose
exercise does what with metabolism?
increase carb metabolism (lowers glucose levels), increases HDL, decreases triglycerides, BP, stress and Tension
s/s of hypoglycemia of <70
nausea, hunger, nervous, cold/clammy, tachycardia, paresthesias, trembling
s/s of hypoglycemia of <55
anxiety, confusion, blurred vision/dizziness/HA, weakness, poor coordination, slurred speech
s/s of hypoglycemia if <35
seizure, LOC
if hypoglycemic, follow what rule:
15:15
HbA1c
glucose can attach to hemoglobin and have glycosilated hemoglobin
HbA1c is an indication of what?
average amount of BG from previous 3 months
Excellent control (HbA1c)
less than or equal to 6; BG < 115
good control (HbA1c)
7-8; BG 150-180
Action suggested (HbA1c)
level of 0-14; BG 215-380
muscle contraction does 2 things:
- encourage the up-take of glucose
2. getting GLUT4 to surface w/o help of insulin
