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N130 Diabetes Exam 1

N130 Diabetes Exam 1 OLOL

Diabetes Mellitus A group of metabolic diseases characterized by elevated levels of glucose in the blood (hyperglycemia) resulting from defects in insulin secretion, insulin action, or both
What are sources of glucose in the blood? Ingested food in the gastrointestinal (GI) tract, formation of glucose by the liver from food substances
What is the normal serum glucose level? 70-100 mg/dl
Hyperglycemia may result in Diabetic ketoacidosis (DKA, Diabetic coma) and Hyperglycemia hyperosmolar nonketonic syndrome (HHNS)
What are some long term effects of Hyperglycemia? Macrovascular complications( CAD, CV disease, PVD), Microvascular complications (kidney and eye disease), and Neuropathic complications (diseases of the nerves)
How many people have diabetes in the US? about 17 million people
How many new cases of diabetes are diagnosed each year in the US? 800,000
50% of people over the age of ___ suffer some degree of glucose intolerance. 65
A hormone produced by the pancreas Insulin
What is secreted by the beta cells in the islets of langerhans? Insulin
Insulin controls the level of glucose in the blood by regulating the production and storage of glucose.
What are the two things that happen in a diabetic state? The cells may stop responding to insulin or the pancreas may stop producing insulin entirely.
After eating a meal, insulin secretion increases and moves glucose fro the blood into muscle, liver, and fat cells.
In muscle, liver, and fat cells insulin does these things Transports and metabolizes glucose for energy, stimulates storage of glucose in the liver and muscle ( in the form of glycogen), signals the liver to stop the release of glucose, enhances storage of dietary fat in adipose tissue, acc. transp. of aminoacid
What inhibits the breakdown of stored glucose, protein, and fat? Insulin
During fasting the pancreas continously releases a small amount of insulin( basal insulin) and glucagon
basal insulin is a small amount of insulin
glucagon is secreted by the alpha cells of the islets of Langerhans
Insulin and glucagon together maintain a constant level of glucose in the blood by stimulating the release of glucose from the liver.
Conversion of glycogen into glucose in the liver and muscles. glycogenolysis
The formation of glucose from excess amino acids, fats, or other noncarbohydrate sources. gluconeogenesis
What are risk factors for diabetes? family hx of diabetes, obesity, race, ethnicity, age >45, hypertension, HDL cholesterol level < or = 35 mg, hx of gestational diabetes
which races/ethnicities have a great risk of having diabetes? African Americans, Hispanic Americans, Native Americans, Asian Americans, and Pacific Islanders
What are two goals when treating diabetes? Control blood glucose levels and prevent acute and long term complications
Previously refered to as insulin-dependant diabetes Mellitus (IDDM) Type 1 diabetes
previously refered to as non insulin dependant diabetes mellitus (NIDDM) Type 2 diabetes
Type 1 is what % of people with diabetes? About 5%to 10%
What happens in type 1 diabetes? beta cells produce little or no insulin
What happens when beta cells are destroyed by an autoimmune process? A person can be diagnosed with type 1 diabetes
What are three ways a person can get type 1 diabetes? genetic predispostion, immunologic, and enviromental ( viral and or toxins)
Type 1 diabetes usually has an ____ onset acute
Type 1 diabetes usually is dx'ed before age ___. 30
What are three characteristics of Type 1 diabetes? decreased insulin production, unchecked glucose production by the liver, and fasting hyperglycemia.
What contributes to postprandial (after meals) hyperglycemia? Glucose derived from food that cannot be stored in teh liver but instead remains in the bloodstream.
postprandial after meals
What is the renal threshold? usually 180 to 200 mg/dl.
If concentration of glucose in the blood exceeds renal threshold ( usually 180-200 mg/dl) what happens? Glucosuria
What results in osmotic diuresis? Glucosuria
Insulin normally inhibits _________and ________. glycogenolysis and gluconeogenesis
When fat breakdown occurs in type 1 diabetics it results in increased production of ketone bodies ( byproducts of fat breakdown)
Ketone bodies are _______. acid
What disturbs the acid-base ballance of the body? Type 1 diabetes
In type 1 diabetes, a person has no insuliin to use or store _________. glucose
In type 1 diabetes the liver does not know to stop releaseing __________. glucose
In type 1 diabetes glycogenolysis is ___ _______. not inhibited
In type 1 diabetes, gluconeogenesis is _______ _________. not inhibited
In type 1 diabetes, fat breakdown occurs and results in ________ __________. diabetic ketoacidosis (DKA)
What are s & s of diabetic ketoacidosis DKA? abdominal pain, nausea, vomiting, hyperventilation, a fruity breath odor, and if left untreated, altered LOC, coma and death
What is DKA? A diabetic coma
What is the treatment for DKA? insulin, fluid & electrolytes as needed.
90 to 95% of people have this type of diabetes Type 2
Type 2 diabetes results from a decreased sensitivity to insulin ( called insulin resistence), impaired beta cell functioning resulting in decreased insulin production.
Type 2 diabetes occurs among people who are greater than 30 years old
Type 2 diabetes has a _____ glucose intolerance slower ( it happens over years)
What does typically not occur in type 2 diabetes? DKA, because there is enough insulin to prevent the breakdown of fat
Uncontrolled type 2 diabetes may lead to hyperglycemic hyperosmlar nonketonic syndrome (HHNS) sometimes seen as HHNK
What type of diabetes may go undetected for many years? Type 2
What are s & s of type 2 diabetes? fatigue, irritability, polyuria, polydypsia, skin wounds that heal poorly, vaginal infections, or blurred vision.
What is the primary treatment for type 2 diabetes? weight loss ( if obese)
What enhances the effectiveness of insulin? Exercise
What may be added for a type 2 diabetic if exercise and diet are not successful? Oral antidiabetic agents or insulin thearpy
Type two diabetics may need insulin during periods of stress (illness and surgery)
Any degree of glucose intolerance with its onset during pregnancy is gestational diabetes
What do secretions of placental hormones that cause insulin resistance in gestational diabetes result in? Hyperglycemia
When is screening for diabetes in preg. women done? Between the 24th and 28th weeks of gestation.
Who is screen during pregnancy for gestational diabetes? women age greater than 25, younger if obese, family hx of diabetes, member of an ethnic/ racial group with high prevalence of diabetes
Gestational diabetes occurs in ____ % of preg. women 14
If a preg woman has gestational diabetes it increase the risk for hypertensive disorders
To treat gestastional diabetes a woman modifiys her diet and monitors her blood glucose levels. If hyperglycemia persist, insulin is prescribed.
What should not be used during pregnacy by the woman with gestational diabetes? Oral antidiabetic agents
What is the goal of a woman with gestational diabetes blood sugar before meals? 105mg/dl or less
What is a goal of the preg. womans blood sugar level two hours after a meal? 120 mg/dl or less
When a woman has gestational diabetes...after the baby is delivered what happens? blood glucose levels should return to normal and the woman has an increased risk for developing type 2 diabetes later in life.
What are s & s of diabetes? Fatigue, weakness , sudden vision change tingling or numbness in hand or feet, dry skin, lesions or wounds that are slow to heal.
Excessive Urine Polyuria
Excessive thirst Polydypsia
Extreme hunger polyphagia
Created by: 4LSUFootball