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HFF - Exam 3 > Test 3 - Quiz 7 - Diabetes > Flashcards

Test 3 - Quiz 7 - Diabetes Flashcards

1
Q

What is type I diabetes?

A

Insulin-dependent diabetes mellitus

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2
Q

What are the immunological symptoms of type I diabetes?

A

Autoimmune disease - loss of beta-cells producing insulin

Genetically linked

Juvenile onset

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3
Q

What is type II diabetes?

A

Non-insulin-dependent diabetes mellitus

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4
Q

What are the characteristics of type II diabetes?

A

Insensitivity to insulin

Lifestyle and genetics

Adult onset, though becoming more prevalent in juveniles

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5
Q

What is gestational diabetes?

A

Develops during pregnancy - fetus induces changes in metabolism

*Chances of getting type II diabetes greatly increases for later in life

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6
Q

Diabetes dysregulates what?

A

Balanced insulin and glucagon signaling

  • Alpha - glucagon
  • Beta - insulin
  • Delta - somatostatin
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7
Q

Type I and II have different causes, but the symptoms of uncontrolled disease are _____________.

A

SIMILAR

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8
Q

What are some key characteristics of type I diabetes?

A

Circulating insulin is absent

Target tissues fail to properly absorb nutrients

*This leads to a dysregulated metabolic state of extreme fasting and starvation

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9
Q

The autoimmune disorder is caused by what?

A

95% immune-mediated

5% idiopathic (spontaneous and cause unknown)

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10
Q

Because insulin cannot get to the target tissues, what ensues?

A

Body is in “starvation,” and starts beta-oxidation for energy. This results in increased ketone body formation, and ketoacidosis will soon follow.

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11
Q

Prolonged fasting does what to ACTH, leptin, corticosterone, insulin, and glucagon?

A

Increased ACTH, corticosterone, and glucagon

Decreased leptin and insulin

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12
Q

What are the 3 ketone bodies?

A

Acetoacetate
Acetone
D-beta-hydroxybutyrate

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13
Q

Insulin deficiency leads to what?

A

Reduced glucose uptake.

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14
Q

Reduced glucose uptake leads to what?

A

Cellular energy deficiency

Elevated blood glucose

Fatty acid oxidation

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15
Q

Elevated blood glucose leads to what?

A

Osmotic diuresis (excessive urination)

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16
Q

FA oxidation leads to what?

A

Liver gluconeogenesis

Liver ketone bodies

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17
Q

Liver ketone bodies lead to what?

A

Elevated blood ketones

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18
Q

Elevated blood ketones lead to what?

A

Increased blood acidity

Osmotic diuresis

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19
Q

Osmotic diuresis leads to ____________, which then leads to reduced blood volume, and electrolyte imbalance.

A

Dehydration

20
Q

Reduced blood volume can lead to what?

A

Tachycardia

Coma

*It also feeds forward to elevate blood glucose, elevate blood ketones, and increase blood acidity

21
Q

What are the 3 coordinated interventions for type I diabetes?

A

Insulin administration

Glucose monitoring

Diet

22
Q

What is the desired target range that diabetics want for fasting blood glucose?

A

80-140 mg/dl

23
Q

What are the two current approaches to insulin administration?

A

Injections
-Several per day
-Two types: basal and bolus
—Basal - insulin maintains low-level systemic insulin
—Bolus - insulin given when food is consumed
This is scaled to carb consumption

Pump

  • Dose given when food consumed
  • Scaled to consumption and activity
24
Q

Generally, what is type II diabetes?

A

Progressive increase in fasting glucose due to reduced insulin sensitivity followed by a degeneration of insulin production

25
Q

What are the 5 things that type II diabetes is tied to?

A

Heterogeneous disorder and most prominent form of diabetes

Closely tied to obesity and visceral adiposity

Lifestyle factors play a role in development

Strong genetic link

High incidence in developed countries

26
Q

What are 3 possible mechanisms of insulin insensitivity?

A

Adipokine signaling

Ectopic lipid storage and free FAs

Inflammatory signaling

27
Q

___________ ____________ may drive type II diabetes insulin insensitivity.

A

Adipose signaling

28
Q

__________ fill adipocytes until enlarged. Once enlarged, adipocytes produce _________ ___________ _________.

A

Triglycerides

Macrophage chemotaxis protein (MCP-1)

29
Q

What infiltrates adipose tissue in response to MCP-1?

A

Macrophages

30
Q

Macrophages produce what in adipose tissue that favors export of fatty acids?

A

TNF-alpha

31
Q

Adipocytes export FA to ____________, where what forms?

A

Muscle

Ectopic lipid deposits

32
Q

Ectopic lipid interferes with ________ movement, and that produces what?

A

GLUT4

Insulin resistance

33
Q

What are three ways that type II diabetes is managed?

A

Lifestyle

  • Reduced carb consumption
  • Prevent glucose swings
  • Increase physical activity
  • Maintain healthy body weight

Oral Hypoglycemics

  • Increase insulin secretion
  • Increase insulin sensitivity
  • Decrease carbohydrate absorption

Insulin
-Required when beta-cell mass degenerates (Once the disease progresses to that point

34
Q

What do sulfonylureases do?

A

Increase beta-cell insulin secretion

35
Q

What do metformins do?

A

Uncouples oxidative phosphorylation

*This reduces liver gluconeogenesis and lipogenesis

36
Q

What do peroxisome proliferator-activated receptor agonists (PPARs) do?

A

Increase glucose transporter expression

37
Q

What do alpha-glucosidase inhibitors do?

A

Prevent carbohydrate absorption

38
Q

What are the 5 primary methods for detecting diabetes?

A

Urinalysis

Glucose monitoring

HBA1c

Glucose tolerance test

C-peptide test

39
Q

*TEST - If a patient fails the urinalysis (glucose present in urine), fails glucose monitoring, and passes the C-peptide test, what do they have?

A

Type II.

Insulin is still being produced because C-peptide is present, but excess glucose is present in the urine.

40
Q

What are the neuroglycopenic symptoms of hypoglycemia? (8)

A 
Exhaustion
Loss of lucidity
Irritability
Blurred vision
Dizziness
Headache
Loss of speech
Coma and death
41
Q

What are the autonomic symptoms of hypoglycemia? (5)

A 
Increased heart rate
Sweating
Trembling
Nausea
Hunger
42
Q

What are the causes of hypoglycemia? (4)

A

Excess insulin
Activity
Insufficient food
Illness

43
Q

What are treatment options for hypoglycemia? (5)

A 
Sugar
Test blood sugar
Test again
Call 911, if necessary
GLUCAGON
-This would increase gluconeogenesis resulting in more glucose being put into the blood
44
Q

What are the signs of hyperglycemia? (6)

A 
Headache
Nausea
Thirst, dry mouth
Excessive urination
Ketones
Blurred vision
45
Q

What are the causes of hyperglycemia? (5)

A 
High blood sugar
Lack of insulin
Inactivity
Excess food
Illness
46
Q

What are the treatment options for hyperglycemia? (4)

A

Insulin
Oral hypoglycemic
Activity
Diet

47
Q

What are 5 long-term diabetic complications?

A 
Cardiovascular disorders
Blindness
Kidney disease
Neurologic complications
-Neuropathy
-ED
Impaired wound healing/amputation

HFF - Exam 3 (19 decks)

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