Week 23 - Diabetes Type 1 and 2 and all complications! Flashcards
what is type one diabetes
where the pancreas stops being able to produce adequate insulin.
what is the result of not having insulin
the cells of the body cannot absorb glucose from the blood and use it as fuel.
therefore the cells think there is no glucose available, meanwhile the glucose level in the blood keeps rising causing hyperglycaemia
what is the classic triad of symptoms seen in type one diabetes (hyperglycaemia)
- polyuria (excessive urine)
- polydipsia (excessive thirst)
- weight loss (mainly through dehydration)
how else may patients present
with ketoacidosis
the body ideally wants to keep blood glucose concentration at what range
The body ideally wants to keep blood glucose concentration between 4.4 – 6.1 mmol/L.
where is insulin produced and what cell
the beta cells in the islets of langerhans in the pancreas
what are the two ways that insulin acts on the blood sugar levels
Firstly, it causes cells in the body to absorb glucose from the blood and use it as fuel. Secondly, it causes muscle and liver cells to absorb glucose from the blood and store it as glycogen in a process called glycogenesis. Firstly, it causes cells in the body to absorb glucose from the blood and use it as fuel.
Secondly, it causes muscle and liver cells to absorb glucose from the blood and store it as glycogen in a process called glycogenesis.
what is glucagon and what is its role in glucose metabolism
Glucagon is a hormone produced by the alpha cells in the Islets of Langerhans in the pancreas.
It is released in response to low blood sugar levels and stress and works to increase blood sugar levels. It tells the liver to break down stored glycogen and release it into the blood as glucose in a process called glycogenolysis. It also tells the liver to convert proteins and fats into glucose in a process called gluconeogenesis.
when does ketogenesis occur
when there is insufficient glucose supply and glycogen stores are exhausted, such as in prolonged fasting
what is converted to ketones and by what
fatty acids are converted to ketones by the liver
what is the characteristic about ketosis
acetone smell to their breath
what is diabetic ketoacidosis
The kidneys buffer ketone acids (ketones) in healthy people, so the blood does not become acidotic. When type 1 diabetes causes extreme hyperglycaemic ketosis, this results in a life-threatening metabolic acidosis. This is called diabetic ketoacidosis.
when does diabetic ketoacidosis occur
as a consequence of inadequate insulin
what are the three key features of diabetic ketoacidosis
ketoacidosis
dehydration
potassium imbalance
what happens in dehydration
high blood glucose levels overwhelm the kidneys, and glucose leaks into the urine. the glucose in the urine draws water out by osmotic diuresis. this causes increased urine production and resulting in severe dehydration
what does dehydration result in
polydipsia - excessive thirst
what does insulin normally do to potassium
normally drives potassium into cells.
what happens with insulin to potassium and what does this mean for the potassium imbalance
without insulin, potassium is not added to and stored in cells.
the serum potassium can be high or normal as the kidneys balance blood potassium with the potassium excreted into the urine
why is total body potassium low
because no potassium is stored in the cells
what call happen to the potassium imbalance when patients are treated with insulin
patients can develop severe hypokalaemia very quickly leading to severe arrhythmias
what are the symptoms of diabetic ketoacidosis
Polyuria
Polydipsia
Nausea and vomiting
Acetone smell to their breath
Dehydration
Weight loss
Hypotension (low blood pressure)
Altered consciousness
what may diabetic ketoacidosis be triggered by
an underlying infection.
what does a diagnosis of diabetic ketoacidosis require
Hyperglycaemia (e.g., blood glucose above 11 mmol/L)
Ketosis (e.g., blood ketones above 3 mmol/L)
Acidosis (e.g., pH below 7.3)
what is the priority treatment in diabetic ketoacidosis
fluid resuscitation to correct dehydration, electrolyte imbalance and acodisosi