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Alpha cells excrete what?
Beta cells excrete what?
Insulin and amylin
What does amylin do?
Slows glucose absorption in small intestine
What does somatostatin do?
- Decreases GI activity
- Decreases glucagon secretion
- Decreases insulin secretion
Diabetic Ketoacidosis (DKA) signs and symptoms
- Measurable amounts of fat and amino acids in blood
- Fruity scent
- Presents with severe dehydration since kidneys are filtering out water with the glucose
- Very hungry since cells are not receiving glucose
- Respiratory compensation so you will see deep breathing
What is Diabetic Ketoacidosis (DKA)
State of inadequate insulin that results in accumulation of organic acids in addition to accumulation of blood glucose
What is the treatment for DKA?
- Fluid replacement - regular insulin with saline, deliver IV
- Give hypotonic solution since cells will be dehydrated, this will make cells swell
- Replace electrolytes
What is the Dawn Effect?
A rise in glucose between 5 am and 9 am related to abnormal Cortisol and Growth Hormone release
What is the metabolic syndrome
- Abdominal obesity
- Increased triglycerides
- Decreased HDL
- Increased blood pressure
- Fasting plasma glucose
What does the exocrine pancrease do?
What does the endocrine pancreas do?
- Insulin is secreted
- No digestive enzymes are secreted
- Only about 10% of the organ produces insulin
What does Amylin (IAPP) do?
Slows rate that glucose enters the bloodstream
How does a lack of insulin effect the blood?
- The pH will lower, glucose makes the blood acidic
- Blood amino acids will rise
- Blood glucose will rise
What does lack of insulin do to the cell?
- Intracellular fat will decrease
- Intracellular protein will decrease
- Cell growth will decrease
How is a diagnosis made through blood glucose levels?
- Casual/random check over 200 mg/dL
- Fasting blood glucose over 126 mg/dL
How is a diagnosis made through a tolerance test?
A two hour postload over 200 mg/dL
What is a risk for Hemoglobin A1C levels?
Type 1 diabetes is autoimmune
It destroys beta cells
Is DKA seen in type 1 or type 2 diabetes?
How does Glucophage work, a medication used to treat type 2 diabetes
It increases tissue sensitivity to glucose and tells the liver to stop making glucose
THE PRESENCE OF ENDOGENOUS INSULIN PREVENTS THE LARGE PROCUTION OF KETO ACIDS FROM ADIPOSE TISSUE
- In other words, when insulin is given as a medication, it will prevent the keto acids from being released.
- Keto acids are the product of fat breakdown
- Insulin prevents fat from being broken down to begin with
Two types of complications from diabetes is vascular and neuropathic
Vascular complications refer to vessel damage. What are some of these complications?
- ACS (acute coronary syndromes)
- MI (myocardial infarction)
Neuropathic complications are autonomic, what are some examples?
- GI problems
- Bladder dysfunction
- Postural hypertension
What are some chronic complications of diabetes?
- microcirculation of glucose in kidneys and eyes
- Somatic neuropathy - diminished perception
- Autonomic neuropathy - vagus nerve doesn't relay any pain
What insulins are rapid acting?
What insulins are intermediate acting?
What insulins are long acting?
What insulin can be given by IV
What insulin can be given by continuous infusion?
What would you like to do?
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