Chapter 25 Diabetes

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Chapter 25 Diabetes
2012-06-03 20:47:29
Chapter 25 Diabetes

Chapter 25 Diabetes
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  1. Formerly known as IDDM(Insulin Dependent Diabetes Mellitus)

    10% of all diabetics

    Diagnosis peaks at age 12
    Diabetes 1
  2. Fromely known as NIDDM
    more common
    increases with age
    Becoming more common in obese children and teens
    Diabetes 2
  3. What is the inital patho common to both diabetes
    insulin deficancy results in decreased transport and use if glucose in the body

    • Hyperglycemia
    • glucosuria
  4. What are the 3 P's that are the most common signs and symptoms in diabetes
    • Polyuria-Excessive urination
    • Polydipsia-Excessive thirst
    • Polyphagia-excessive appettite
  5. What causes polyuria
    Glucose acts as a diuretic
  6. What causes polydipsia
    water loss from polyuria causes dehydration
  7. What causes polyphagia
    lack of nutrients entering cells
  8. What are the progressive effects of diabetes
    Seen more commonly with diabetes 1
    • Catabloism of protein & fat
    • Leads to ketoacids
    • leads to ketoacidosis
    • ketones bind with serum bicarbonate
    • pH decreases
    • ketonuria
    • dehydration=reduced GFR
    • leads to decrease in ketoneacid excreation
    • metabolic acidosis
  9. What is the etiology of diabetes 1
    • idiopathic
    • autoimmune
  10. What antibodies are detected in the blood in a patient with diabetes 1
    islet cell antibodies against beta cells of pancreas(cells that produce insulin)
  11. What is the patho of diabetes 1
    • islets of langerhans deplete beta cells
    • cells are replaced by CT
    • suggest autoimmune reaction to viral infection
  12. What happens due to a loss of beta cells
    absolute insulin deficit and glucose uptake and metabolism is compromised
  13. In which diabetes are the beta cells damaged
    diabetes 1
  14. Which diabetes has increased insulin resistance
    impaired insulin release from pancreas
    increased glucose production from the liver
    diabetes 2
  15. What is the etiology for diabetes 2
    genetic susceptability
  16. What are the key defects in diabetes 2
    • insulin resistance
    • obesity
    • impaired insulin release from pancreas
    • increased glucose production from the liver
  17. Where is glucose reabsorbed and how
    • PCT
    • active transport via protein pump
  18. What are normal blood glucose fasting levels
  19. What are renal threshold levels
    • 180/200mg/dl
    • glucose above this amount gets secreated because no more glucose can move into the blood
  20. What are the signs and symptoms for diabetes 2
    • polyuria
    • polydipsia
    • polyphagia
    • fatigue
    • obese
    • nocturia
  21. What causes fatigue in patients with diabetes
    poor use of food resulting from metabolic changes
  22. What are the signs and symptoms for diabetes 1
    • polyuria
    • polydipsia
    • polyphagia
    • weight loss
  23. What are the diagnostic test used to diagnose diabetes
    • urinalysis-glycosuria, ketonuria
    • FBS-70-110mg/dl
    • GTT
    • A1C/glycosylated hemoglobin
  24. Catabolism of what results in ketones
  25. What are normal FBS levels
    70-110 mg/dl
  26. A person with 2 consecutive test reading above ----- would be diagnoised with diabetes
  27. What is A1C testing for
    • RBC when released from bone marrow dont have glucose
    • during RBC cycle glucose binds to cell(glycosylated)
    • glucose will not disassociate/permanent
  28. What are normal blood glucose levels
    below 6%
  29. What are acute complications of diabetes
    • Hypoglycemia/low blood sugar/Shock
    • Diabetic ketoacidosis(DKA)
    • hyperosmolar hyperglycemic nonketotic coma
  30. What are hypoglycemic levels of glucose
  31. What can cause hypoglycemia and which diabetes is it normally associated with
    • exercise
    • insulin dosage
    • vomiting
    • not eating after taking insulin
    • diabetes 1
  32. What will quickly be effected by a lack of glucose
    neuron- they don't store glucose & can't use fats or proteins for energy
  33. What are some signs of impaired neurological function due to hypoglycemia
    • poor concentration
    • slurred speech
    • lack of coordiantion
    • staggering gait
    • Stimulates SNS and causes:
    • increase pulse
    • pale, moist skin
    • anxiety
    • tremors
    • seizures,coma
  34. What is the treatment for hypoglycemia
    • concentrated carbs
    • glucose or glycogne intravenous
    • epinephrine
  35. What is DKA and what diabetes is it specific to
    ketoacodosis & dehydration cause below normal pH in the blood
  36. What triggers DKA in a patient with diabetes
    physical or emotional stress
  37. What can an accumulation of ketones bodies in the blood cause
    • nausea
    • vomiting
    • fruity acetone smelling breath
    • coma
  38. What is the treatment for DKA
    • insulin
    • bicarbonate administered to reverse acidosis
    • reslove inital cause