week 12 Flashcards
Exocrine
digestive enzymes
Endocrine
insulin production from the Islets of Langerhans
alpha cells =
beta cells =
delta and polypeptide cells
alpha cells =secrete glucagon,
beta cells = secrete insulin,
delta and polypeptide cells
if a patient is type 1 diabetic
insulin is secret beta cells.
ketones are seen in the
urine and blood
Diabetes Mellitus is
characterized by hyperglycemia due to defects in insulin secretion, insulin action, or both
Type 1 is IDDM
Presents in under 30 years of age Almost complete lack of insulin or severe lack of Autoimmune Cause? Patients commonly lean Could be genetically linked Sometimes triggered by Viral infection HYPERGLYCEMIC EVENT no insulin to little insulin is produced beta cells were destroyed by insulin
Gestational Diabetes-
glucose intolerance with onset during pregnancy
Type 2 is NIDDM the
Combination of decreased sensitivity to insulin (insulin resistance) and impaired beta cell function (decreased insulin production) 90–95% of person with diabetes
More common in persons over age 30 and in the obese
Slow, progressive glucose intolerance/decreased tissue sensitivity (ulcer) sensation decreased,
Treated initially with diet and exercise
Oral hypoglycemic agents/insulin may be required
The function for insulin is to
- Enable (sugar) glucose to enter cells to be metabolised for energy.
- Stimulates storage of glucose in the liver and muscle (as glycogen)
- Signals the liver to stop the release of glucose (monitor)
- Enhances storage of dietary fat in adipose tissue
- Accelerates transport of amino acids from dietary protein into cells
- Inhibits the breakdown of stored glucose, protein, and fat
“When carbohydrates, fats and proteins are eaten, insulin promotes cellular transport and storage of all these nutrients”
Classifications of Diabetes is
Prediabetes (impaired glucose intolerance)
Type 1 diabetes (IDDM)
Latent Autoimmune Diabetes of Adults (LADA)
Type 2 diabetes (NIDDM)
Gestational diabetes (during pregnancy) 2nd trimester
Diabetes associated with other conditions/syndromes
Pancreatic & hormonal disorders (diabetes insipidus)
Corticosteroid & hormone drug induced
What causes diabetes
Genetics
Lifestyle choices
What are the THREE P’s of Diabetes
polyuria- increased urine output (osmotic effect of glucose)
polydipsia- increased thirst (osmotic effect of glucose)
polyphagia- increased hunger from cellular malnourishment
Diagnostic Findings of diabetes are
Fasting blood glucose level (BGL) equal to or greater than 7.0 mmol/L (repeated)
Postprandial BGL equal to or greater than 11.0mmol/L (repeated)
Glycosylated haemoglobin (HbA1C)
-Equal to or greater than 6.5% (48mmol/mol) (repeated)
Type 1 & 2 - Management
Dietary
Prevent wide fluctuations of BGLs
Provide optimal nutrition/all essential food groups
Meet energy needs/maintain a reasonable weight
Low GI foods
Plan with diabetic nutritionist/dietician
Patient education/teaching is essential
Type 1s - insulin & diet must be “integrated”
Exercise
Planned and consistent
Lowers blood glucose & cardiovascular risk/aids in weight loss
If on insulin need to adjust accordingly/post exercise hypo
Monitor with BGLs regularly
