Define diabetes mellitus
A syndrome (group of symptoms) Chronic hyperglycemia Absolute or relative insulin deficiency Disturbances of carbohydrate, protein and fat metabolism A whole body disease that can effect the brain, eyes, heart, pancreas, kidneys, and blood vessels
Normal reulation of serum glucose
We eat >>serum glucose rises Pancreas responds with >> insulin Beta cells release insulin into >> plasma Cells have insulin receptors on membranes Insulin binds with >> receptor sites Intracellular activation mechanism responds. Glucose enters the cells >> serum glucose levels drop. Pancreas senses drop in serum glucose >> stops secreting insulin When serum glucose drops, alpha cells secrete >> glucagon into plasma Glucagon travels to the liver and >> stimulates release of stored glucose into serum Liver releases >> glucose Serum glucose >> increases **(Summary)** Dietary glucose>>Increase serum glucose>>insulin>>decreased serum glucose>>glucagon>>increase serum glucose **Normal (fasting) glucose range is 70-100 mg/dl**
What unlocks the cells so glucose can get back in?
insulin
Body makes little or no insulin. Usually occurs in children or young adultspancreas -> no insulin
Type 1 diabetes
Body makes too little insulin. Or body prevents insulin from workin gproperly. More common in overweight older adults.
Type 2 diabetes
What are some common clinical manifestations of hyperglycemia in types 1 and 2?
Polydipsia : increase in thirst, secondary to cellular dehydrationPolyuria : increase in urination, secondary to hyperglycemia acting as a osmotic diuretic.Polyphagia : increase in hunger, secondary to cellular starvationWeight loss : secondary to diuresis and loss of body tissue as fats and proteins are used for energy.Fatigue : secondary to metabolic changesVision changes Skin problems - dry/itchy, frequent infections
Symptoms generally have a rapid onset with ______
type 1
Polydipsia
increase in thirst, secondary to cellular dehydration
Polyuria
increase in urination, secondary to hyperglycemia acting as a osmotic diuretic.
Polyphagia
increase in hunger, secondary to cellular starvation
What is weight loss secondary to?
Diuresis and loss of body tissue as fats and proteins are used for energy
What is fatigue secondary to?
Metabolic changes
Type 1 diabetics must have ______
insulin
Type 2 diabetics can be controlled with ____ and ____
Diet and exercise (and sometimes insulin)
Who does type 2 primarily affect?
People over 40 age and oesity are the 2 greatest risk factors symptoms are generally vague and devop gradually
Hypoglycemia
a drop in serum glucose levels to less than 70mg/dl
What are 4 chronic complications of DM?
Diabetic neuropathies Microvascular diesase Macrovascular diesase Infection
Somogyi effect
Hypoglycemia followed by rebound hyperglycemia
Dawn phenomenon
Rise in blood sugar early in AM although patient has not eaten for several hours
What is Diabetes Mellitus?
Syndrome of chronic hyperglycemia with absolute or relative insuline deficiency. Caused by altered beta cell function in pancreas Primarily affects people over 40 Risk factors include - obesity, ethnic minority, and family history
This complication occurs when there is too much insulin, too little food intake and too much exercise.
Hypoglycemia
Symptoms of hypoglycemia are:
Symptoms may include tachycardia, palpitations, diaphoresis, and tremors.
A chronic complication of DM which may put the client at high risk for lesion, ulcers, and gangrene secondary to cocclusions of the small arteries.
Peripheral vascular disease (Macrovascular disease)
What are the MOST common clinical manifestations of hyperglycemia?
Polydipsia Polyuria Polyphagia
Often affects young people around the age of puberty
Type I Diabetes
A serious complication r/t a deficiency of insulin and an increase in counter-regulatory hormones (catecholamines, cortisol, glucagon, growth hormone)
Diabetic Ketoacidosis
A type of Microvascular disease
Diabetic Nephropathy
A condition that is generally treated with a oral rapid acting carbohydrate, such as: glucose tablets, glucose gel, juice, milk, or graham crackers.
hypoglycemia
True or false:True False
False
True or False:True False
false - you either are diabetic or you're not. It is a lifelong disease that may be manages by diet and exercise, but you still have the condition
Absolute insulin deficiency means:
NO action of insulin
What is the pathophysiology of diabetes?
The immune system mistakenly destorys insulin producing Beta cells
What is the goal of treatment for Type 2 Diabetes?
Restoration of euglycemia (normal BG levels) and correction of relatd metabolic disorders
What are 4 types of severe hyperglycemia?
DKA HHNKS Somogyi effect Sawn phenomenon
DKA is what type of a complication?
acute
What are some characteristics of DKA?
serum glucose level >400mg/dl symptoms : fatigue, sleepiness, warmth/flushing, feeling full/anorexic, fruity breathcan lead to coma and death mainly seen in type 1
What is a classic symptom of DKA?
fruity breath
DKA is mainly seen in which type of diabetes?
Type 1
HHNKS is mainly seen in which type of diabetes?
Type 2
This syndrome is an uncommon complication of Type 2 diabetes with a high mortality rate. Glucose leves are >500mg/dl
HHNKS
What is the most common complication of diabetes?
Diabetic neuropathies
Diabetic retinopathy and nephropathy are examples of what type of disease?
Microvascular disease
Coronary artery disease
Macrovascular disease
