body tries to compensate by increasing the production of insulin
no ketones, rare
pts typically obese
pt has no islet antibodies
Type 1 diabetes is described as:
glucose derived from food cannot be stored in the liver and remains circulating in the blood, leading to postprandial hyperglycemia
desctruction of beta cells results in unchecked glucose production by the liver and fasting hyperglycemia
pt usually thin at Dx
pt needs insulin to preserve life
pt often has islet cell antibodies
onset can occur at any age
what is lipotrophy?
Lipotrophy is loss of subcutaneous fat and appears as a slight dimpling or more serious pitting of subcutaneous fat.
Clinical manifestations of HHNS?
leading cause of blindness in US in ages 20-74?
sensory neuropathy causes?
loss of sensation to pain and pressure
Autonomic neuropathy causes?
increased skin dryness
formation of skin fissures
Motor neuropathy causes?
how does peripheral vascualar disease affect the progression of a foot infection and ulcer formation?
inadequate and compromised lower extremity circulation interfers with ability to get nutrients to wound to promote healing and prevent gangrene.
how does hyperglycemia affect the spread of a foot infection?
hyperglycemia impairs leukocytes ability to destroy bacteria, thus lowering resistance to infection
explain how insulin regulation is altered in the diabetic state
insulin regulates the procution and storage of glucose: in diabetes the pancreas stops making insulin or the cells stop responding to it. hyperglycemia results and can lead to acute metabolic complications (DKA, HHNS)
Describe the pathophysiologic difference between type 1 and type 2
type 1: characterized by an absence of insulin production and secretion due to autoimmune destruction of the beta cells
type 2: characterized by deficiency of insulin production and decreased insulin action as well as insulin resistance
describes how much a given food increases the BG level compared with an equivalent amount of glucose