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What is relative deficiency of insulin? no specific amount of insulin - delay in release time
What is the effects of Caffeine in blood sugar? induces Cori Cycle -> increase blood glucose
What is the normal value for Hemo A1C? 3.5-5.6% <6.5% is desirable
What is Hemoglobin A1C Test of choice for diagnositic of Diabetes. measure degree of glycation (glycosylation) - glucose and protein Turnover rate for RBC is 100 days (3 months)
What is Type 1 DM? insulin dependent inflammatory, immune-mediated, absolute deficiency loss of all beta cells and insulin production
What are the characteristics of Type 1 DM? severe hyperglycemia decrease cognitive and fruity breath ketoacidosis tendency increase osmolarity in plasma - renal problem neovascularization - retina and iris effects more than type II
What is the result of neovascularization? goes into vitreous and pull on the root of blood vessels -> retinal detachment between photoreceptors and RPE
What is Kussmaul's Breathing? repid deep breathing - trying to push out Co2 to decrease acid from ketoacidosis Type I DM
What is the genetic implications of Type I DM? HLA antigens (chromosome 6) DR 3/4 DQw2/8
What is involvement of T cells and Beta Cells? T cells destroys beta cells - antibodies markers
Why is Type I more severe than Type II? C peptide proteins not made because insulin isnt produced. involves in neuropathy - maintain Node of Ranvier and integrity of node. reverse Na/K ATPase activity increase risk of Alzheimer's
Type I DM increase Severity of: proliferative retinopathy vitreous hemorrhage retinal detachment
What are the treatment of Type I Diabetes? self-monitoring blood glucose daily injections insulin pumps pancreatic + kidney transplant islet transplant - not effective after 2 years
What defines Type II DM? inadequate insulin secretory response to glucose resistance to insulin action sustained hyperglycemia
Type II DM secretory Pattern Phase 1: reduced or lost ->hyperinsulinemia Phase 2: significant decrease in titer of insulin
Explain Insulin Resistance body doesnt respond to insulin -> beta cells make more insulin -> exhausted post-receptor defects
What are the associated conditions of Type II DM? obesity hypertension hyperlipidemia hyperuricemia sedentary lifestyle - GLUT4
Obesity result in fat cells increase in diameter -> secrete endocrines inapproapriately secrete adipokines (inflammatory affects beta cells)
Mechanism of Hyperinsulinemia target cell not responding -> down regulation of receptors result: sodium retention (hypertension) increase VLDL and low HDL levels (dyslipidemia) increase endothelial & smooth muscle cell proliferation (artherosclerosis and thrombosis) insulin resis
Cause of Hypertension sodium retension sympathetic activation decrease NO increase endothelin (insulin stimulate endothelin -> increase BP
Created by: prinny916