Term
| What is the normal blood glucose a person should maintain? |
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Definition
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Term
| What are the 4 tissues that require a continuous source of glucose? |
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Definition
| brain, RBC, medulla of kidney, intestinal eipthelium |
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Term
| T/F Water is lost when there is an excess of sugar taken in? |
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Definition
| True...so you will then store it in the liver as glycogen by insulin (it may also be stored in fibroblasts, fat cells or muscle) |
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Term
| What are the 6 characteristics of diabetics when the blood glucose goes up unopposed? |
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Definition
1. polyuria
2. polydypsia
3. polyphagia
4. lose weight
5. Eat more
6. Becomes weak because glucose can not get into muscles as glycogen |
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Term
| T/F If glucose is too low then your body takes it from storage via glucagon? |
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Definition
| F...via glucagon and epinephrine from liver; glucagon and growth hormone from adipose and cortisol and glucagon from proteins |
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Term
| T/F High levels of glucose in blood favors growth of microorganisms? |
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Definition
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Term
| What is the fat problem associated with diabetes described by Bernstein? |
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Definition
| Without sugar entering adipose and being unavailable as energy source so then broken down fat enters into Kreb cycle as acetyl coA whic then can cause hypercholesterolemia, hyperlipidemia and ketosis |
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Term
| T/F Poor healing and greater risk of infection occurs as a result of protein problems of diabetes? |
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Definition
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Term
| For the areas of the body that don't need glucose, what is the alternative pathway used? |
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Definition
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Term
| T/F Peripheral neuropathy can occur as a result of sorbitol accumulation from the kreb cycle? |
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Definition
| F...all if true except it occurs from the polyol pathway |
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Term
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Definition
| True....just in small amounts |
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Term
| Why does microangiopathy occur? |
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Definition
1. Genetic/Weakened endothelium
2. Sorbitol pathway
3. Just having high blood glucose |
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Term
| What happens with there are high blood glucose levels? |
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Definition
| glucose combines with proteins and "glycosylates" them.... which then deposit into blood vessels |
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Term
| What are the effects of microangiopathy? |
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Definition
Kidneys: nodular glomerulosclerosis
Retina: blindness and glaucoma
Skin: rahses |
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Term
| T/F Type II diabetes is characterized by sudden failure of insulin? |
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Definition
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Term
| What are the 5 main causes to get type I diabetes? |
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Definition
Main: Genetic propensity and a trigger
Minor (could be trigger): susceptible HLA profile, viral infection, develop autoimmune dx |
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Term
| T/F Type I diabetes is the most common type? |
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Definition
| False...type II is 90% of cases...type I is only 10% |
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Term
| T/F Type II diabetic has insulin? |
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Definition
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Term
| Type II diabetics do not get ketosis like Type I but what are 7 other things that they could get? |
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Definition
1. Lots of infections
2. Poor healing
3. Severe coronary atherolsclerosis
4. Unexplained candidiasis
5. vision problems
6. Peripheral neuropathies
7. Kidney dx |
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Term
| Since Type II diabetics have insulin what is the reason they have diabetes? |
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Definition
| THey have insulin resistance due to not having enough receptors...#1 environmental factor is obesity while pregnancy, stress and infections can contribute |
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Term
| What are the 7 target organs that are changed in diabetics? |
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Definition
1. heart--> atherosclerosis
2. Brain
3. kidneys --> nodular glomerularsclerosis and necrotizing papillitis
4. blood vessels--> poor healing (legs "fall off")
5. eyes --> glaucoma, blindness
6. peripheral nerves (sorbitol)
7. skin --> xantholasmas, loss of gingival height, rapid bone loss and perio dx, uncontrolled candidiasis
sometimes pancreas |
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Term
| What are the 4 types of diabetics and COMA? |
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Definition
Insulin shock --> type I and brittle
Diabetic shock --> type I not taking insulin
Hyperosmolar COMA --> poorly controlled type II
Lactic acidosis --> General poor vascular perfusion |
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Term
| What are the 4 types of diabetes according to the ADA? |
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Definition
| Type 1, Type 2, Gestational and Secondary |
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Term
| T/F Type 2 diabetics are prone to ketosis? |
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Definition
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Term
| T/F In type 1 diabetes a prodromal phase of polyuria, polydypsia and weight loss may precede the development of ketoacidosis by a period of days or months? |
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Definition
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Term
| Is the genetic predisposition stronger with type 1 diabetes or type 2 diabetes? |
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Definition
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Term
| T/F Ongoing, autoimmune destruction of pancreatic beta cells may underlie type 1 diabetes? |
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Definition
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Term
| What are the 4 main diagnostic features of type 2 diabetes? |
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Definition
1. Most patients are >40 y.o. and obese
2. Polyuria and polydypsia. Ketonuria and weight loss are usually uncommon at time of diagnosis. Candidal vaginitis in women. While some have no symptoms
3. Plasma glucose of 126 mg/dL or higher after an overnight fast on more than one occasion. After 75 gms oral glucose, diagnostic values are 200 mg/dL or more 2 hrs after the oral glucose and at least once between 0 and 2 hours
4. Hypertension, hyperlipidemia, and atherosclerosis |
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Term
| What is the more important cause of insulin resistance in type 2 diabetes? |
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Definition
| the failure of postreceptor coupling and of intracellular insulin action |
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Term
| What syndrome of insulin resistance has been proposed to explain the frequent association of hypertension, carb intolerance, abdominal obesity, hyperlipidemia and accelerated atherosclerosis of type 2 diabetes? |
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Definition
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Term
| Mild to marked obesity is present in approximately what percentage of type 2 diabetics? |
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Definition
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Term
| Most patients with type 2 diabetes are diagnosed after what age? |
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Definition
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Term
| T/F In MODY an autosomal dominant inheritance has been established? |
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Definition
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Term
| T/F Carbohydrate intolerance of gestational diabetes during pregnancy usually resolves after delivery? |
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Definition
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Term
| T/F Those that had gestational diabetes are at a greater risk (by 30-50%) for developing type 2 diabetes? |
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Definition
| False...the percentage is 40-60 |
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Term
| What are the 7 secondary causes of diabetes? |
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Definition
1. Genetic defect of beta cell function
2. Genetic defects in insulin action
3. Diseases of the exocrine pancreas
4. Endocrineopathies
5. Drug or chemical induced
6. Infections
7. Other genetic syndromes sometimes associated with diabetes (Down's, Klinefelter's, Turner's, Wolfran's, Friedreich's atxia, Huntington's chorea) |
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Term
| T/F Pre-diabetes puts a person at a 60% greater likelihood of having a heart attack or stroke? |
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Definition
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Term
| What 2 kind of people should screening for pre-diabetes be done for? |
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Definition
1. Patients >45 years of age with a BMI >25
2. Younger individuals with BMI >25 who have one or more of the following risk factors: a family hx of diabetes, have had gestational diabetes or a baby weighing >9 lbs, are not Caucasian, have dyslipidemia, or have hypertension |
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Term
| What are the signs and symptoms for type 1 diabetes? |
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Definition
| Increased urination, weight loss, lowered plasma volume with postural hypotension, paresthesias, ketoacidosis (w/ fruity breath), loss of subcutaneous fat and muscle wasting |
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Term
| What are the signs and symptoms of type 2 diabetes? |
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Definition
| Increased urination and thirst, hyperglycemia, some with neuropathic or CV complications, chronic skin infections, pruritus, vaginitis, obese diabetes may have any variety of fat distribution, mild hypertension |
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Term
| What lab findings are there for urinalysis in diabetics? |
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Definition
| Glucosuria and Ketonuria (make sure to look over blood testing procedures as well) |
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Term
| What are the 3 criteria for the diagnosis of diabetes mellitus? |
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Definition
1. Symptoms of diabetes plus casual plasma glucose concentrations >200 mg/dL
2. Fasting plasma glucose >126 mg/dL
3. 2 hours plasma glucose >200 mg/dL during an oral GTT |
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Term
| What are some of the acute complications of diabetes? |
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Definition
Hyperglycemia
Hypoglycemia
Diabetic ketoacidosis
Hyperosmolar, hyperglycemic, nonketotic coma |
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Term
| What are some chronic complications of diabetes? |
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Definition
1. Atherosclerotic: hypercholesterolemia, atherosclerosis, stroke
2. Ocular: cataracts, retinopathy, glaucoma
3. Nephropathy: persistent albuminuria, microalbuminuria,hypertension
4. Ulceration and gangrene of feet
5. Neuropathy: peripheral (distal symmetric polyneuropathy, isolated peripheral neuropathy, painful diabetic neuropathy) and autonomic
6. Skin and Mucous Membrane complications: chronic pyogenic infections (eruptive xanthomas, necrobiosis lipoidica diabeticorum), candidal infection
7. Increased risk for infections
8. Oral: xerostomia, bacterial, viral and fungal infections, poor wound healing, increased caries, gingivitis, perio dx, perioapical abcesses and burning mouth sx |
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Term
| What are the short term and long term goals for diabetic treatments? |
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Definition
Short term: 1. restore metabolic control to as close to normal as possible 2. improve sense of well-being
Long term: 1. Minimize risk of diabetic complications including: accelerated atherosclerosis, microangiopathy |
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Term
| What kinds of insulin are there? |
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Definition
| Bovine, HUman, Procine,Inhaled, Pump |
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Term
| What type of treatments are used for type 2 diabetes? |
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Definition
a. diet and exercise
b. oral hypoglycemic drugs (sulfonylureas, metformin, thiazolinediones, benzoic acid derivatives, alpha-glucosidase inhibitors)
c. insulin |
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Term
| What ASA category is the following diabetic: frequent problems with ketoacidosis and hypoglycemia? |
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Definition
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Term
| What ASA category is the following diabetic: fasting blood glucose of 200-230 mg/dL? |
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Definition
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