N130 Diabetes Exam 1 OLOL
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| 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
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| What are sources of glucose in the blood? | Ingested food in the gastrointestinal (GI) tract, formation of glucose by the liver from food substances
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| What is the normal serum glucose level? | 70-100 mg/dl
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| Hyperglycemia may result in | Diabetic ketoacidosis (DKA, Diabetic coma) and Hyperglycemia hyperosmolar nonketonic syndrome (HHNS)
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| 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)
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| How many people have diabetes in the US? | about 17 million people
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| How many new cases of diabetes are diagnosed each year in the US? | 800,000
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| 50% of people over the age of ___ suffer some degree of glucose intolerance. | 65
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| A hormone produced by the pancreas | Insulin
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| What is secreted by the beta cells in the islets of langerhans? | Insulin
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| Insulin controls the level of glucose in the blood by | regulating the production and storage of glucose.
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| 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.
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| After eating a meal, insulin secretion increases and moves glucose fro the blood into | muscle, liver, and fat cells.
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| 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
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| What inhibits the breakdown of stored glucose, protein, and fat? | Insulin
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| During fasting the pancreas continously releases | a small amount of insulin( basal insulin) and glucagon
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| basal insulin is | a small amount of insulin
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| glucagon is secreted by | the alpha cells of the islets of Langerhans
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| Insulin and glucagon together maintain a constant level of glucose in the blood by | stimulating the release of glucose from the liver.
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| Conversion of glycogen into glucose in the liver and muscles. | glycogenolysis
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| The formation of glucose from excess amino acids, fats, or other noncarbohydrate sources. | gluconeogenesis
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| 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
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| which races/ethnicities have a great risk of having diabetes? | African Americans, Hispanic Americans, Native Americans, Asian Americans, and Pacific Islanders
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| What are two goals when treating diabetes? | Control blood glucose levels and prevent acute and long term complications
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| Previously refered to as insulin-dependant diabetes Mellitus (IDDM) | Type 1 diabetes
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| previously refered to as non insulin dependant diabetes mellitus (NIDDM) | Type 2 diabetes
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| Type 1 is what % of people with diabetes? | About 5%to 10%
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| What happens in type 1 diabetes? | beta cells produce little or no insulin
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| What happens when beta cells are destroyed by an autoimmune process? | A person can be diagnosed with type 1 diabetes
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| What are three ways a person can get type 1 diabetes? | genetic predispostion, immunologic, and enviromental ( viral and or toxins)
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| Type 1 diabetes usually has an ____ onset | acute
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| Type 1 diabetes usually is dx'ed before age ___. | 30
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| What are three characteristics of Type 1 diabetes? | decreased insulin production, unchecked glucose production by the liver, and fasting hyperglycemia.
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| What contributes to postprandial (after meals) hyperglycemia? | Glucose derived from food that cannot be stored in teh liver but instead remains in the bloodstream.
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| postprandial | after meals
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| What is the renal threshold? | usually 180 to 200 mg/dl.
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| If concentration of glucose in the blood exceeds renal threshold ( usually 180-200 mg/dl) what happens? | Glucosuria
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| What results in osmotic diuresis? | Glucosuria
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| Insulin normally inhibits _________and ________. | glycogenolysis and gluconeogenesis
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| When fat breakdown occurs in type 1 diabetics it results in increased production of | ketone bodies ( byproducts of fat breakdown)
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| Ketone bodies are _______. | acid
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| What disturbs the acid-base ballance of the body? | Type 1 diabetes
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| In type 1 diabetes, a person has no insuliin to use or store _________. | glucose
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| In type 1 diabetes the liver does not know to stop releaseing __________. | glucose
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| In type 1 diabetes glycogenolysis is ___ _______. | not inhibited
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| In type 1 diabetes, gluconeogenesis is _______ _________. | not inhibited
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| In type 1 diabetes, fat breakdown occurs and results in ________ __________. | diabetic ketoacidosis (DKA)
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| 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
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| What is DKA? | A diabetic coma
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| What is the treatment for DKA? | insulin, fluid & electrolytes as needed.
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| 90 to 95% of people have this type of diabetes | Type 2
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| Type 2 diabetes results from | a decreased sensitivity to insulin ( called insulin resistence), impaired beta cell functioning resulting in decreased insulin production.
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| Type 2 diabetes occurs among people who are greater than | 30 years old
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| Type 2 diabetes has a _____ glucose intolerance | slower ( it happens over years)
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| What does typically not occur in type 2 diabetes? | DKA, because there is enough insulin to prevent the breakdown of fat
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| Uncontrolled type 2 diabetes may lead to | hyperglycemic hyperosmlar nonketonic syndrome (HHNS) sometimes seen as HHNK
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| What type of diabetes may go undetected for many years? | Type 2
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| What are s & s of type 2 diabetes? | fatigue, irritability, polyuria, polydypsia, skin wounds that heal poorly, vaginal infections, or blurred vision.
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| What is the primary treatment for type 2 diabetes? | weight loss ( if obese)
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| What enhances the effectiveness of insulin? | Exercise
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| What may be added for a type 2 diabetic if exercise and diet are not successful? | Oral antidiabetic agents or insulin thearpy
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| Type two diabetics may need insulin during periods of | stress (illness and surgery)
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| Any degree of glucose intolerance with its onset during pregnancy is | gestational diabetes
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| What do secretions of placental hormones that cause insulin resistance in gestational diabetes result in? | Hyperglycemia
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| When is screening for diabetes in preg. women done? | Between the 24th and 28th weeks of gestation.
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| 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
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| Gestational diabetes occurs in ____ % of preg. women | 14
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| If a preg woman has gestational diabetes it increase the risk for | hypertensive disorders
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| To treat gestastional diabetes a woman | modifiys her diet and monitors her blood glucose levels. If hyperglycemia persist, insulin is prescribed.
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| What should not be used during pregnacy by the woman with gestational diabetes? | Oral antidiabetic agents
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| What is the goal of a woman with gestational diabetes blood sugar before meals? | 105mg/dl or less
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| What is a goal of the preg. womans blood sugar level two hours after a meal? | 120 mg/dl or less
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| 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.
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| 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.
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| Excessive Urine | Polyuria
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| Excessive thirst | Polydypsia
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| Extreme hunger | polyphagia
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