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49 Cards in this Set
- Front
- Back
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The pancreas is located...
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w/in the mesentary of the duodenum
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Estimated annual morbidity rate of DM in the US
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13 million
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Annual US mortality rate for DM
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35,000 deaths/year
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Percent of pancreas involved in secretion of hormones
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15%
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Name to cells w/in pancreas that secrete the hormones involved in DM
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islets of Langerhan cells
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DM carries an annual cost of _____ for the US
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Over 100 billion dollars
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3 similarities between Type 1 and Type 2
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1) both are not single disease processes, but groups of disorders that decrease body's insulin response.
2) DM is condition in which pancreas doesn't produce enough insulin or cells stop responding 3) thought to have genetic factors |
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3 differences between Type 1 and Type 2
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1) DM1 is deficiency in insulin secretion due to destruction of Beta cells, DM2 is combination of resistance and inadequate compensatory response
2) Type 2 is associated with obesity and inactivity 3) Type 1 commonly develops in childhood |
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A 58 year old man has DM that has been poorly controlled for years. As a consequence, he has had nonenzymatic glycosylation of free amino groups of proteins in his body. This process is best illustrated by finding:
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accelerated atheroma formation
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3 Measures used to control DM
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Have accurate and current knowledge-test blood glucose levels frequently
2) Therapies that help pt.s insulin work better 3) Replace insulin via exogenous sources |
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Most of the chronic pathology seen with DM can be attributed to:
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damage of the blood vessels
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Chronic eye problems
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All 3: DM 1A, 1B, and 2
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Amyloid deposits in pancreas
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Type 2
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Decreased insuling and NO anti islet cell antibodies
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Type 1B
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Blood vessel damage
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All 3: DM 1A, 1B, and 2
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Low blood insulin
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Type 1A and 1B
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Highest occurrence in twins
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Type 2
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Normal blood insulin
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Type 2
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Hyperglycemia
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All 3: DM 1A, 1B, and 2
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Peripheral insulin resistance
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Type 2
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Virus may be involved in etiology
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Type 1A
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Diagnosed in juveniles
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All 3: DM 1A, 1B, and 2
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Oral glucose tolerance test:
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1) low insulin levels one hour after test confirm DM
2) Preclinical DM can be diagnosed 3) in people with DM blood glucose can remain high for several hours post test |
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Pathology of Atherosclerosis
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Nonenzymatic glycosylation
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Pathology of Peripheral Neuropathy
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Osmotic swelling
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Pathology of Cataracts
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Osmotic swelling
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Pathology of Gangrene
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Nonenzymatic glycosylation
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Pathology of Myocardial Infarctions
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Nonenzymatic glycosylation
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Pathology of loss of autonomic nervous system function (such as bladder control or erectile dysfunction)
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Osmotic swelling
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Nonenzymatic glycosylation
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excess glucose attaches to proteins in the body
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Clinical signs of DM
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Polyuria, Polydipsia, Polyphagia
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Polyuria with DM
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extra glucose & ketones in kidney filtrate causing osmotic pull of water from blood to urine... which leads to polydipsia due to dehydration
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Polyphagia with DM
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catabolism of proteins & fats for energy activates brain hunger centers
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#9 What are the chronic effects of DM
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Nonenzymatic glycolysation > irreversible AGEs > form on collagen of blood vessels leading to ARTERIOSCLEROSIS > damage capillaries > bind to cell receptors & cause inflammatory like response
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#11 Clincal feature DM has in common
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hyperglycemia
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#13 Difference b/t DM types
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1A: immune system destroys Beta cells
1B) idiopathic destruction of Beta cells 2) decreased ability of peripheral tissues to respond to insulin, or Beta cell dysfunction manifested as inadequate insulin secretion in fave of insulin resistance |
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#14 Tests used for diagnosing DM
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1) urine glucose
2) urine ketones 3) plasma glucose 4)blood pH |
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Parent - Offspring Conflict
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fetus secretes Human Placental Lactogen [hPL] that ties up mothers insulin to elevate glucose levels providing more for fetus. Mother counters by secreting more insulin and the fetus more hPL and so on.
-if the mother is deficient > gestational diabetes -possibly fatal to mother |
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#20 How is glucose stored?
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-glucose is used for immediate ATP production
- then used to restore liver's supply of glycogen - then chemically converted to fat & stored in adipocytes long-term |
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#4 Ketones in urine are indicative of what process?
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When cells can't get the glucose they need they send hormones to fat cells & cause them to release fatty acids & their metabolites--some are called KETONES.
Ketnones are acids which drop blood pH.... this leads to ketoacidosis |
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#19 What is glucagon & how does it effect the body?
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glucagon releases glucose from the liver
-acuses breakdown of stored glycogen -break down fat for glucose - breaks down protein [muscle] for glucose |
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#42 What protein is secreted by Beta cells that can damage them in response to high blood glucose levels?
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Amylin: sets up like cement around Beta cells & is directly toxic to them
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#26 What hormones are secreted by the Islets of Langerhaans?
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alpha cells: glucagon
beta cells: insulin delta cells: somatostatin |
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How many people in US does DM affect?
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18 million
[13 million diagnosed 5 million undiagnosed] |
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What is DM?
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Not a single disease process, but a group of disorders that decrease insulin response.
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Annual mortality rate of DM?
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74,000
-5th leading cause |
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#22 Pancreas functions
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endocrine & exocrine organ
exocrine: digestive enzymes in duodenum via pancreatic duct endocrine: islets of langerhan |
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#22 What does the pancreas function in?
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functions in the production of insulin, amylin, somatostatin, & glucagon
Also Pancreatic Polypeptide [PP] stimulate secretion of gastric enzymes |
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What takes up glucose w/o insulin?
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liver, kidney, & brain
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