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18 Cards in this Set

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type 1 diabetes is a metabolic disorder characterised by the absense of ...
insulin production and secretion from autoimmune destruction of the beta cells of the islets of Langerhans in the pancreas. Used to be called junvenile or insulin dependent diabetes. Now its IDDM.
a type one illnes that puts people into the hospital is diabetic keytonacidosis or DKA. what is this?
DKA is a type 1 problem that puts people into the hospital for not following their strict diabetic routine. Its keytone acidosis. makes them ill or makes an infection etc.
so type 1 diabetes is IDMM because its an insulin-dependant diabetes. what does this mean1
this Dx results from not having insulin so its insulin dependent
people don't inherit type 1 DM but ...
do inherit genetic predisposition toward developing it. People w/ HLA or certain human leukocyte antigens. most type 1 pts have HLA types DR3 or DR4. if someone has DR3 or DR4 they have a 10-20 times risk of getting DM.
regardless:
destruction of beta cells causes:
decreased insulin production
unchecked glucose production by the liver
fasting hyperglycemia
at what point does BG exceed the renal thresholds for glucose?
180-200 mg/dL
at this point glucose will start to show up in the urine. this is called glucosuria. this causes excess loss of fluids and electrolytes.
what is it called to loss fluids and electrolytes from the kidneys passing glucose into the urine?
osmotic diuresis.
insulin normally inhibits glycogenolysis. what is this?
glycogenolysis is breakdown of stored glucose. insulin also prevents / inhibits gluconeogensis, production of new glucose from amino acids etc
so what happens now when the body's insulin cannot now stop glycogenolysis and gluconeogensis from happening?
these process now happen in an uncontrolled fashion causing hyperglycemia.
what else horrible happens that even further contributes to hyperglycemia?
fat breakdown occurs w/ increases production of keytone bodiesm a byproduct of fat breakdown
well, type 1 guy has keytones flying around, an acid - base balance now out of whack, this results in DKA which causes:
pain, nausea, vomiting, hyperventilation, fruity breath, altered consciousness, coma, and death. what can be done now about this?
insulin Tx asap
along w/ fluids & electrolytes
is critical to Tx hyperglycemia and DKA to improve the metabolic abnormalities
DM has a huge economic cost. not only but social physical and emotional costs too. its the leading cause of blindness, non traumatic amputations, and $$$ dialysis from nephropathy, kidneys are always affected. what other problems does DM cause?
cardiovascular disease
myo cardio infarctin
strokes
etc related to DM
we are now seeing type 2 in kids now!

which situation causes the organ damage, low or high blood sugar?
higher blood sugar causes all the damage in organs and creates the long effects.
how does our body regulate BG
insulin absorbs BG
glucogon raises BG
******************************
know gluco neogenesis
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know glyco genolysis
gluco neogenesis = breakdown of stored glucose, production of new glucose from amino acids and other substrates. insulin normally prohibits this

glycogenolysis = breakdown of stored glucose. insulin normally inhibits this

but people w/ insulin defencicies, these both happen unrestrained & contribute to hyperglycemia! Also, fat breakdown results w/ making keytone bodies, an acid which disturbs the acid/base balance. This results in DKA & makes you vomit, nausea, hyperventilation, fuity breath, altered level of consciousness, coma, death.
how could your BG be high in the morning, a high fasting BG first thing in the morning, why? you haven't eaten anything?
the liver, after fasting for so long, the BG goes down after a few hours, the liver starts to releases stored glycogen. After 7-8 hours the liver will start to produce glucose from other sources.
what does ketones in the urine indicate
your body is breaking up fat.
you will see acidosis in type 1 and what is that
the accumilation of keytone bodies