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34 Cards in this Set
- Front
- Back
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what characterizes diabetes mellitus?
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chronic hyperglycemia
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what are the four forms of diabetes mellitus?
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type 1, type 2, other, and gestational
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What causes type 1 DM?
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immune mediated diabetes, aka juvenile onset diabetes.
shows up as islet cell antibodies or autoantibodies to insulin |
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what is the rate of B cell destruction like in kids? whats their first DM type 1 manifestation
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it is rapid in children.
first sign is usually ketoacidosis |
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what is the rate of B cell destruction in adults with type 1 DM like? do they get ketoacidosis?
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this is a gradual loss
they usually do not have ketoacidosis |
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What is the onset age for type 1 DM?
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11-13, but usually before 30
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what are type 1 DM diabetics weight like?
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these are usually pts of normal weight
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What are the suspected causes of type 2 DM?
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genetics
being a fatty NO autoimmune component!! |
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What are the two main effects of type 2 DM?
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insulin resistance
a defect in insulin secretion w/insulin resistance |
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what is the weight of a type 2 DM pt like?
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they are typically obese, which leads to insulin resistance itself
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What is insulin secretion like in type 2 DM?
does ketosis occur? |
insulin is normal
ketosis doesnt normally occur |
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What does an impaired glucose tolerance test mean?
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this refers to a metabolic stage between normal and diabetes
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What is the definition of an impaired glucose tolerance test?
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blood glucose of >140mg/dl, but less than 199mg/dl upon oral glucose tolerance test
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what are the factors in metabolic syndrome?
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insulin resistance, hyperinsulinemia, abdominal obesity, high TAGs, low HDL, HTN
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What are the 3 diagnostic factors for diabetes?
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casual plasma glucose of >200mg/dl- and polydipsia, polyuria, weight loss.
FPG>126mg/dl OGCT >200mg/dl @ 2hour mark |
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What are the 3 clinical manifestations of type 1 DM?
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polydipsia
polyuria polyphagia |
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What is the treatment of type 1 DM?
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Insulin
exercise- (doesnt affect glycemic problems) |
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What are the 6 types of insulin delivery? what do they come from?
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rapid acting- synthetic
short acting- beef/pook, recomb intermediate acting- beef/pork, recomb long acting- recomb inhaled insulin insulin pill |
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What does lifestyle modification do for type 1 DM?
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delays CV problems
lipid redistribution tissues more sensitive to insulin (may lessen the dose of insulin needed) |
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What are the 4 complications from type 1 DM?
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hypoglycemia
diabetic ketoacidosis dawn phenomenon somogyi effect |
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What are the main causes of Hypogycemia (insulin shock) in type 1 DM?
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incorrect insulin dosing,
missed meal insulin clearance is reduced - leads to CNS function drop. |
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What causes diabetic ketoacidosis in type 1 DM?
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Low insulin, and high glucagon lead to-> Deceased glucose uptake, increased protein use, increased lipolysis.
-hyperglycemia- causes electrolye depletion/dehydration -increased plasma FFA's-> ketogenesis these both lead to dehydration and acidosis |
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What is the somogyi effect?
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this is hypoglycemia at night, followed by rebound hyperglycemia in the morning
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what causes the somogyi effect?
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hypoglycemia in the night triggers regulatory hormone release, which increases blood sugar
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what is the treatment of the somogyi effect?
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decreasing insulin requirement or changing time of administration
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What is the dawn phenomenon?
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early morning rise in blood glucose with no hypoglycemia at night.
may be cause by HGH |
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What are the clinical manifestations of type 2 DM?
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recurrent infections
gential pruritus (favors fungal and candidal infections) Visual changes paresthesia and fatigue |
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How does diet and exercise affect type 2 DM?
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this results in glycemic control, and a delay in CV problems and diabetes onset.
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What do sulfonylureas/meglitinides do? what are they for?
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These act on the pancreas, increase insulin secretion
they do so by closing ATP dependent K+ channels, depolarizing the cell. treats type 2 DM |
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What does Biguanides do?
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these act on liver and muscle.
suppresses liver glucose creation, and increase muscle glucose uptake |
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what do alpha-glucosidase inhbitors do?
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these act on the small intestine, and inhibit the absorption of CHO
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What do Thiazolidenediones do?
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these act on muscle, liver, and adipose tissue.
increase insulin sensitivity- by activating PPAR-gamma receptor |
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what do GLP analogues do?
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these act on pancreas to increase insulin secretion, (the incretin effect)
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What is the cause of inuslin resistance in type 2 diabetes?
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caused by a reduction in insulin receptor content. decreases tyrosine kinase activity.
reduced signal transduction |
