Diabetes Mellitus Review
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each of the black spaces below before clicking
on it to display the answer.
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| 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.
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| 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.
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| 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.
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| 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.
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| Two distinct types of Type 1 DM? | Immune and nonimmune
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| 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
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| 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
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| 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.
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| 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.
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| 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)
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| Environmental, Nutritional Intake, factors for DM type 1? | Bovine serum albumin (bovine milk), High levels of nitosamines
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| Environmental, Drugs and chemicals, factors for DM type 1? | Alloxan, Streptozotocin, Pentamidine, Vacor (a rodenticide).
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| Clinical Manifestations type 1 Diabetes affects the metabolism of what? | Fat, Protein, Carbohydrates
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| 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.
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| What are the classic symptoms of diabetes mellitus? | Polydipsia, polyphagia, polyuria
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| 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
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| What are symptoms of hypoglycemia? | * nervousness,
* sweating,
* intense hunger,
* trembling,
* weakness,
* palpitations, and
* often have trouble speaking.
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| 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.
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| 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.
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| 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.
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| 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.
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