S2 - Diabetes Flashcards
What is diabetes mellitus?
A condition in which blood sugar is highly elevated.
What are the two main types of diabetes mellitus?
Which is more common in the U.S.?
Type 1 and type 2
Type 2 (90-95% of cases)
Is the pancreas an endocrine or exocrine organ?
Both
What are the primary endocrine secretions of the pancreas?
What are the clusters of endocrine cells called?
Insulin and glucagon secretion
Islets of Langerhans
Which pancreatic cells secrete insulin?
Which pancreatic cells secrete glucagon?
Beta cells
Alpha cells
What are the primary functions of insulin?
Decrease blood glucose by:
Increasing glucose transport into adipose and skeletal muscle tissues through GLUT-4 transporters
Increasing glycogenesis
Decreasing gluconeogenesis
Decreasing lipolysis
What are the primary functions of glucagon?
Increase blood glucose by:
Increasing glycogenolysis (Glycogen breakdown)
Increasing gluconeogenesis (Protein breakdown)
Increasing lipolysis (Fat breakdown)
What is the primary dysfunction in T1DM?
Insulin deficiency due to autoimmune destruction of pancreatic beta cells
What is the primary dysfunction in T2DM?
Insulin insensitivity
What is a hemoglobin A1c measurement?
What is it used for?
A measure of how much glucose has gotten ‘stuck’ on hemoglobin for the past 120 days (The lifespan of an RBC).
Used as a measure of long-term blood glucose control.
What are the normal, pre-diabetic, and diabetic A1c readings?
Normal < 5.7%
Pre-Diabetic 5.7 - 6.4%
Diabetic > 6.4%
Define hyperglycemia.
Elevated blood sugar
What is a fasting plasma glucose (FPG) reading?
A measurement of an individual’s blood glucose levels during a fasting state
What are the normal, pre-diabetic, and diabetic FPG readings?
Normal < 100 mg/dl
Pre-Diabetic 100 - 125 mg/dl
Diabetic > 125 mg/dl
At what age does T1DM usually manifest?
At what age does T2DM usually manifest?
Early. Often between 12 and 18 Later in life
Usually after 35 or 40
What are the cardinal signs and symptoms of diabetes? (Remember the 3 P’s)
Polyphagia (Excessive hunger)
Polydipsia (Excessive thirst)
Polyuria (Excessive urine production)
Besides the 3 P’s, what are some other signs and symptoms of diabetes?
There are many systemic effects, including, but not limited to:
Peripheral neuropathy
Diabetic retinopathy
Infection and gangrene
Acanthosis nigricans
Weight loss (Mainly in T1DM)
Renal damage
What is the extreme and life-threatening effect of T1DM?
Diabetic ketoacidosis (DKA)
What is the extreme and life-threatening effect of T2DM?
Hyperosmolar Hyperglycemic Non-Ketotic Coma (HHNC)
How is T1DM typically treated?
Insulin administration and diet adjustment
How is T2DM typically treated?
Diet and weight loss; oral hypoglycemic medications as needed (E.g. metformin)
What is the leading cause of death among individuals with T1DM?
Renal failure
What is the leading cause of death among individuals with T2DM?
Heart failure
Where does diabetes mellitus fall in as a leading cause of death in the U.S.?
7
What geographic region in the U.S. has the highest prevalence of diabetes mellitus and in what racial group?
The Southeastern United States
(The obesity/stroke/diabetes belt)
African-Americans are at increased risk over other racial groups
Which type of diabetes mellitus holds a stronger genetic disposition, type 1 or 2?
Type 2
What factors can greatly increase one’s chances of developing T2DM?
Obesity, metabolic syndrome, high-sugar and high-fat diet, family history
What effect have gastric bypass surgeries been shown to have on obese patients with T2DM?
A complete cure of some patients’ T2DM (As well as an average of 2/3 excess weight lost)
What is diabetic ketoacidosis (DKA)?
Usually seen only in T1DM, glucose is unable to make it into the cells, the cells begin to starve, and lipids are broken down at a quick rate for energy production. Lipid breakdown leads to the production of ketone bodies that are acidic to normal blood pH. Blood pH drops and the individual enters a coma.
What are the ketone bodies produced during DKA?
Beta-hydroxybutyrate and acetoacetate
Define hypoglycemia.
What is a danger of extended periods of hypoglycemia?
Low blood sugar (< 70 mg/dl)
Brain damage
What are the ABCs of diabetes control (After an individual has already been diagnosed)?
A1c < 7%
Blood pressure < 130 / 85
Cholesterol
LDL < 100 mg/dl
HDL > 50 mg/dl (Women) > 40 mg/dl (Men)
At what BMI should most Americans start being screened for diabetes?
Who else should be screened?
BMI ≥ 25 (Overweight)
≥ 45 years of age
Family history of T2DM
History of gestational DM
What is the BMI at which members of the Asian population should be screened for diabetes?
23
(Screen at 23)
What is the technical term for glucose production through the breakdown of fat and protein?
Gluconeogenesis (glucose-new-production)
(Promoted by glucagon; inhibited by insulin)
What is the technical term for fat breakdown?
Lipolysis
(Promoted by glucagon; inhibited by insulin)
What is the technical term for glucose breakdown to pyruvate?
Glycolysis
(Inhibited by glucagon; promoted by insulin)
What is the storage form of glucose?
Where is it found?
Glycogen
Liver and skeletal muscle tissue
What is the technical term for glycogen synthesis?
Glycogenesis
(Inhibited by glucagon; promoted by insulin)
What is the technical term for glycogen breakdown (producing glucose)?
Glycogenolysis
(Promoted by glucagon; inhibited by insulin)
