PTG 105-Exam 4-Pancreas 2
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What type of diabetes is associated with ketoacidosis?
What is ketoacidosis?
Accumulation of acidic ketone bodies in the blood due to lack of fatty acid utilization (as would normally be stimulated by insulin)
What I Hemoglobin A1c?
Sugar attached to hemoglobin
What does blood sugar in RBCs tell us?
Idea of how much sugar has been around during the last 3 months
What is the normal range for Hemoglobin A1c?
In poorly controlled diabetes, what level is normal for hemoglobin A1c?
8% or more
In well controlled diabetes, what level is normal for hemoglobin A1c?
Less than 7%
What measure is more stable than blood sugar?
What are signs of Ketoacidosis?
- Blood pH decrease
- Acetone breath
What is the major complication of Diabetic ketoacidosis?
What type of diabetes usually causes ketoacidosis?
What is the treatment of ketoacidosis?
- Immediate insulin
- IV Fluids
Why are the eyes, nerves and kidneys involved in diabetes?
What is Microangiopathy?
Thickening of the basement membrane of small vessels
Why is Microangiopathy an important feature of diabetes?
It is the cause of Nephropathy, retinopathy and neuropathy
What are major complications of Type I and II diabetes?
- Macrovascular disease
What is macrovascular disease?
- Accelerated atherosclerosis of large vessels, hypertension and stroke
- Causes diabetic foot
What is the cause of Diabetic foot?
What type of neuropathy is found with Microangiopathy?
What changes are seen in the kidney with Microangiopathy?
- Periglomerular fibrosis
- Kimmelstiel-Wilson (K/S) change in the glomerulus
- Tremendous protein loss
What type of retinopathy is common in diabetes?
- Small hemorrhages/microanuerysms in the eye
What is Diabetic foot?
- Macrovascular disease causes reduced circulation to the peripheries
- Allows for infection and gangrene to grow in the foot
What is Charcot foot?
Repeated unrecognized microtrauma due to neuropathy that reduces sensation of the foot
What is the leading cause of new cases of blindness in working adults?
What percent of lower extremity amputations are due to diabetes?
What percent of new cases of end state renal disease are due to diabetes?
What is the increase in risk for cardiovascular disease in individuals with Diabetes?
2 to 4 fold increase
What percent of ischemic heart disease deaths are attributed to diabetes?
Is cancer associated with diabetes?
What is the total annual cost of diabetes?
What is the per capita cost for healthcare of people with diabetes?
What is the per capita cost for healthcare of people without diabetes?
What is Metformin?
Type II diabetes drug that improves tolerance for glucose and improves insulin sensitivity
What is Sulfonylurea
A drug that enhances insulin secretion from the Beta cells
What is a surgical treatment for Diabetes?
What type of treatment differences are between type I and II diabetes?
- Type I is treated with insulin
- Type II is treated with insulin, diet, exercise, oral glucose lowing drugs
What is secondary Diabetes Mellitus?
Diabetes due to drugs or other diseases
What other diseases cause secondary diabetes mellitus?
- Cystic fibrosis
- Iron overload
- Surgical removal of pancreas
- Endocrine disorders (Acromegaly, Cushing’s)
What type of drugs cause secondary DM?
- Beta adrenergic agonists
- Thiazide diuretics
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