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BYU - Health 619 > S2 - Diabetes > Flashcards

S2 - Diabetes Flashcards

1
Q

What is diabetes mellitus?

A

A condition in which blood sugar is highly elevated.

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2
Q

What are the two main types of diabetes mellitus?

Which is more common in the U.S.?

A

Type 1 and type 2

Type 2 (90-95% of cases)

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3
Q

Is the pancreas an endocrine or exocrine organ?

A

Both

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4
Q

What are the primary endocrine secretions of the pancreas?

What are the clusters of endocrine cells called?

A

Insulin and glucagon secretion

Islets of Langerhans

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5
Q

Which pancreatic cells secrete insulin?

Which pancreatic cells secrete glucagon?

A

Beta cells

Alpha cells

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6
Q

What are the primary functions of insulin?

A

Decrease blood glucose by:

Increasing glucose transport into adipose and skeletal muscle tissues through GLUT-4 transporters

Increasing glycogenesis

Decreasing gluconeogenesis

Decreasing lipolysis

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7
Q

What are the primary functions of glucagon?

A

Increase blood glucose by:

Increasing glycogenolysis (Glycogen breakdown)

Increasing gluconeogenesis (Protein breakdown)

Increasing lipolysis (Fat breakdown)

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8
Q

What is the primary dysfunction in T1DM?

A

Insulin deficiency due to autoimmune destruction of pancreatic beta cells

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9
Q

What is the primary dysfunction in T2DM?

A

Insulin insensitivity

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10
Q

What is a hemoglobin A1c measurement?

What is it used for?

A

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.

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11
Q

What are the normal, pre-diabetic, and diabetic A1c readings?

A

Normal < 5.7%

Pre-Diabetic 5.7 - 6.4%

Diabetic > 6.4%

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12
Q

Define hyperglycemia.

A

Elevated blood sugar

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13
Q

What is a fasting plasma glucose (FPG) reading?

A

A measurement of an individual’s blood glucose levels during a fasting state

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14
Q

What are the normal, pre-diabetic, and diabetic FPG readings?

A

Normal < 100 mg/dl

Pre-Diabetic 100 - 125 mg/dl

Diabetic > 125 mg/dl

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15
Q

At what age does T1DM usually manifest?

At what age does T2DM usually manifest?

A

Early. Often between 12 and 18 Later in life

Usually after 35 or 40

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16
Q

What are the cardinal signs and symptoms of diabetes? (Remember the 3 P’s)

A

Polyphagia (Excessive hunger)

Polydipsia (Excessive thirst)

Polyuria (Excessive urine production)

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17
Q

Besides the 3 P’s, what are some other signs and symptoms of diabetes?

A

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

18
Q

What is the extreme and life-threatening effect of T1DM?

A

Diabetic ketoacidosis (DKA)

19
Q

What is the extreme and life-threatening effect of T2DM?

A

Hyperosmolar Hyperglycemic Non-Ketotic Coma (HHNC)

20
Q

How is T1DM typically treated?

A

Insulin administration and diet adjustment

21
Q

How is T2DM typically treated?

A

Diet and weight loss; oral hypoglycemic medications as needed (E.g. metformin)

22
Q

What is the leading cause of death among individuals with T1DM?

A

Renal failure

23
Q

What is the leading cause of death among individuals with T2DM?

A

Heart failure

24
Q

Where does diabetes mellitus fall in as a leading cause of death in the U.S.?

A

7

25
Q

What geographic region in the U.S. has the highest prevalence of diabetes mellitus and in what racial group?

A

The Southeastern United States

(The obesity/stroke/diabetes belt)

African-Americans are at increased risk over other racial groups

26
Q

Which type of diabetes mellitus holds a stronger genetic disposition, type 1 or 2?

A

Type 2

27
Q

What factors can greatly increase one’s chances of developing T2DM?

A

Obesity, metabolic syndrome, high-sugar and high-fat diet, family history

28
Q

What effect have gastric bypass surgeries been shown to have on obese patients with T2DM?

A

A complete cure of some patients’ T2DM (As well as an average of 2/3 excess weight lost)

29
Q

What is diabetic ketoacidosis (DKA)?

A

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.

30
Q

What are the ketone bodies produced during DKA?

A

Beta-hydroxybutyrate and acetoacetate

31
Q

Define hypoglycemia.

What is a danger of extended periods of hypoglycemia?

A

Low blood sugar (< 70 mg/dl)

Brain damage

32
Q

What are the ABCs of diabetes control (After an individual has already been diagnosed)?

A

A1c < 7%

Blood pressure < 130 / 85

Cholesterol

LDL < 100 mg/dl

HDL > 50 mg/dl (Women) > 40 mg/dl (Men)

33
Q

At what BMI should most Americans start being screened for diabetes?

Who else should be screened?

A

BMI ≥ 25 (Overweight)

≥ 45 years of age

Family history of T2DM

History of gestational DM

34
Q

What is the BMI at which members of the Asian population should be screened for diabetes?

A

23

(Screen at 23)

35
Q

What is the technical term for glucose production through the breakdown of fat and protein?

A

Gluconeogenesis (glucose-new-production)

(Promoted by glucagon; inhibited by insulin)

36
Q

What is the technical term for fat breakdown?

A

Lipolysis

(Promoted by glucagon; inhibited by insulin)

37
Q

What is the technical term for glucose breakdown to pyruvate?

A

Glycolysis

(Inhibited by glucagon; promoted by insulin)

38
Q

What is the storage form of glucose?

Where is it found?

A

Glycogen

Liver and skeletal muscle tissue

39
Q

What is the technical term for glycogen synthesis?

A

Glycogenesis

(Inhibited by glucagon; promoted by insulin)

40
Q

What is the technical term for glycogen breakdown (producing glucose)?

A

Glycogenolysis

(Promoted by glucagon; inhibited by insulin)

BYU - Health 619 (24 decks)

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