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Endocrine Patho 2

Diabetes Mellitus Review

Type 1 Diabetes Mellitus is caused by what? Pancreatic atrophy and specific loss of beta cells with small islets in type 1. Macrophages, T & B lymphocytes, and natural killer cells often present.
Incidence of Type 1 DM is for which group of individuals? Incidence and prevalence are higher for whites than nonwhites, highest rate found in Finland and lowest in Japan.
Is Type 1 DM genetically linked? Yes there is a correlation between 10%-13% of individuals have a first-degree relative (parent or sibling) with type 1 diabetes.
Most diagnosis of Type 1 DM occurs when? More cases reported in autumn and winter in the northern hemisphere, rare during first 9 months of life, peaks around 12 years of age.
Two distinct types of Type 1 DM? Immune and nonimmune
What are the distinguishing factors of immune-mediated type 1 DM? environmental-genetic factors thought to result in cell-mediated destruction of pancreatic beta cells Markers of immune destruction include autoantibodies to islet cells and/or insulin, glutamic acid decarboxylase(GAD65, protein tyrosine phosphatase IA-2
What are the distinguishing factors of nonimmune type 1 DM? Occurs secondary to other diseases ie, pancreatitis, idiopathic (type1B), and Autoimmune is called Type 1A
Genetic susceptibility to Type 1 DM? Strongest component- MHC (Major histocapatibility complex), (Histocompatibility leukocyte antigen) HLA class II alleles HLA-DQ and HLA-DR markers increases 5-8x when present.
Most common HLA markers for Type 1 DM? HLA-DR3 and HLA -DR4, the risk is 20-40 times higher than that of general population. HLA-DR2 associated with LOWEST risk.
Environmental, Viral infection, Factors for DM Type 1? Viral infections with autoimmune damage to beta cells, incl. cytomegaloviruses, mumps, and Epstein-Barr Virus, Reubella (40% develop later Type 1 DM)
Environmental, Nutritional Intake, factors for DM type 1? Bovine serum albumin (bovine milk), High levels of nitosamines
Environmental, Drugs and chemicals, factors for DM type 1? Alloxan, Streptozotocin, Pentamidine, Vacor (a rodenticide).
Clinical Manifestations type 1 Diabetes affects the metabolism of what? Fat, Protein, Carbohydrates
Diagnostic requirements for diabetes are: 1. more than 1 fasting plasma glucose level ≥ 126mg/dl 2.Plasma glucose value in 2-hr sample of tolerance test ≥ 200mg/dl confirmed on next day. 3. Random w/o regard to meals, plasma glucose level > 200mg/dl combined with classic symptoms.
What are the classic symptoms of diabetes mellitus? Polydipsia, polyphagia, polyuria
Early signs of hyperglycemia in diabetes include: * Increased thirst * Headaches * Difficulty concentrating * Blurred vision * Frequent urination * Fatigue (weak, tired feeling) * Weight loss * Blood sugar more than 180 mg/dL
What are symptoms of hypoglycemia? * nervousness, * sweating, * intense hunger, * trembling, * weakness, * palpitations, and * often have trouble speaking.
What is the Somogyi effect? Also known as “rebound hyperglycemia”, the Somogyi effect is a pattern of undetected hypoglycemia,followed by hyperglycemia Typically, this happens in the middle of the night, but can also occur when too much insulin is circulating in the system.
What causes Somogyi effect? It occurs when hypoglycemia stimulates glucose counterregulation(release of epi, GH, Cortisol, and glucagon) these hormones increase blood glucose through gluconeogenesis, mobilize fatty acids, and proteins while inhibiting peripheral glucose use.
What is the Dawn phenomenon? The dawn phenomenon: response to hormones released in the early AM. This occurs for everyone. When we sleep, hormones are released to maintain and restore cells within our bodies.
What causes the Dawn phenomenon? Counterregulatory hormones cause the glucose level to rise. People with diabetes do not have enough circulating insulin to keep this increase of glucose under control, the end result is a high glucose reading in the morning.
Created by: laceymonique