What is DM Flashcards
Diabetes has become an epidemic
Diabetes itself is a Chronic metabolic disease resulting from either a deficiency in insulin secretion (not making any insulin or secreting any), resistance of insulin action at the cellular level or both - impossible for body to regulate BG - leads to chronic comps with it
Leading cause of disability specifically blindness, end stage kidney disease and foot/leg amputations
Seventh leading cause of death in the US
Affects 25.8 million people (8.3%) of the population - large number
DM
Resulting in hyperglycemia and inability to regulate blood glucose
Diabetes itself is a Chronic metabolic disease resulting from either a deficiency in insulin secretion (not making any insulin or secreting any), resistance of insulin action at the cellular level or both - impossible for body to regulate BG - leads to chronic comps with it
Pancreas and liver all work together to get glucose released which need for CNS and body to work
Insulin Physiology
Insulin is the key that moves glucose into cells - glucose what need for cells in body to work
Have Decreased insulin causes increased glucose in blood instead being moved into cells (hyperglycemia)
The cells don’t have the glucose they need and so they are starving
Body reacts to that and breaks down other things for sources for energy (specifically fats and protein - form ketones - classic sign of diabetes is ketone formation and becuase trying break down fatty acids and ketones are an acid; body breaking down other sources of energy and causing byproducts of that that causes further probs)
Counterregulatory (other) hormones levels increased (glucagon, epinephrine, growth hormone, cortisol) - attempts to get BG from other sources: released from liver etc
What happens in the absence of insulin? - happens don’t have it
Polyuria
Polydipsia
Polyphagia
Metabolic acidosis
Kussmaul respirations
Dehydration and Electrolyte imbalance
Symptoms of DM
frequent and excessive urination
Classic sign of DM
Increased urination - extra BG in bloodstream and peeing lot more because osmotic diuresis; BG causing kidneys get rid more fluid
Caused by osmotic diuresis secondary to excess glucose
Polyuria
excessive thirst
Thirsty because losing fluid
Classic sign of DM
Caused by dehydration
Polydipsia-
excessive eating
Eating lot more because even tho lots BG in bloodstream - not in cells and cells starving and need something to eat so want to eat all time because not getting nutrients into cells
Classic sign of DM
Caused by cell starvation
Polyphagia-
Because body not get glucose by norm means insulin not moving glucose into cells; starts breaking down fats and proteins that are converted to ketone bodies which results in metabolic acidosis
Caused by breakdown of fats and protein releasing fatty acids then converted to ketone bodies (small acids)
Metabolic acidosis
RR tries to compensate for metabolic acidosis and way does that is getting rid CO2 (acid resp sys can control) - trying blow off CO2; lungs trying get rid more CO2 to get body back into balance pH wise; resp sys tries to compensate by decreasing CO2 levels in bloodstream via Kussmaul respirations
Related to acidosis and Kussmaul respirations also releasing acetone bodies and have fruity odor from acetone
Increased respiration rate and depth of breathing (respiratory system trying to fix acidosis)
Kussmaul respirations
Urinating and getting osmotic diuresis so getting rid lots fluid and also get rid electrolytes when doing that; electrolytes big issue in diabetes because vary sig in what going on in body
Caused by excessive diuresis
Dehydration and Electrolyte imbalance
Type 1
Type 2
Gestational
Classifications of DM
No insulin is being produced
Autoimmune disorder
Beta cells of the pancreas from islet cells are not functioning anymore and are destroyed by antibodies (why autoimmune - destroys beta cells of pancreas)
Onset usually occurs <30 years of age; now see in older pats; more onset in youth
Abrupt onset
Classic signs: Polydipsia, polyuria, polyphagia, and weight loss
Always Requires insulin
Could be viral in etiology/nature that causes autoimmune disorder but unknown
Type 1
Reduction of the cells to respond to insulin (insulin resistance) and decreased secretion of insulin from beta cells - become more resistant to insulin: primary - there and may be there less but cells not responding to it
Sometimes require insulin
Predisposing factors are obesity, physical inactivity and genetics (big part)
Imp for edu: weight loss, increase phys activity, diet
Onset usually occurs >50 years of age - older
Could have no symptoms or classic signs: polydipsia, fatigue, blurred vision, vascular and neural complications; no severe symps and abruptly
Accounts for 90% of diabetic patients - increase incidence of diabetes because 90% on T2DM where causes by obesity, physical inactivity
Type 2
Glucose intolerance during pregnancy - does not mean after pregnant still be T2DM but lot higher incidence of having diabetes later on; always tested for it while pregnant
Gestational
