Diabetes definition - Answer Chronic multisystem disease related to
- Abnormal insulin production
- Impaired insulin utilization
- Or both
Long term effects of diabetes - Answer Diabetes is the leading cause of:
- Adult blindness
- End-stage renal disease
- Nontraumatic lower limb amputations
Major contributing factor
- Heart disease
- Stroke
Types of diabetes - Answer Type 1
Type 2
Gestational
Prediabetes
Normal insulin metabolism - Answer - Produced by the b cells
- Islets of Langerhans of the pancreas
- Released consistently into bloodstream in small amounts with larger quantities
released after food consumption
- Stabilizes glucose range to 70 to 120 mg/dl
,Insulin - Answer - Facilitates transportation of glucose across the cell membrane from
the blood stream into the cytoplasm of the cell
- Lowers glucose in the blood
Insulin post meals - Answer - increases after a meal
- Stimulates storage of glucose as glycogen in liver and muscle
- Inhibits gluconeogenesis-the process of synthesizing glucose in the body from
non-carbohydrate sources
- Enhances fat deposition
↑ Protein synthesis
Counterregulatory hormones - Answer - Increase blood sugar level by stimulating
glucose production & output by the liver, & by reducing the entry of glucose into the
cells.
- Act against the action of insulin
- Increase blood glucose
- Release glucose in a controlled manner to provide energy
- Involved in maintaining blood sugar within a narrow range
Type 1 diabetes age - Response - Also named as "juvenile onset" or "insulin dependent"
diabetes
- Commonly, individuals affected are below 30 years of age
- Peak onset between ages 11 and 13
- 5-10% of all diabetics
,- Now occurring in younger children
Etiology and Pathophysiology of type 1 diabetes - Answer - End result of long-standing
process
- Immune- mediated disease
- Body's own T cells attack & destroy pancreatic beta (β)- cells, which are the source of
insulin.
- Auto antibodies to the islet cells cause a reduction of 80% to 90% of normal b cell
function before hyperglycemia manifestations occur
Causes:
Genetic predisposition
Associated with human leukocyte antigens
Exposure to virus
Idiopathic diabetes - unrelated to autoimmunity but strongly inbred
Onset of type 1 diabetes -Answer- Long preclinical period
Antibodies for β-cell destruction present months to years prior to the onset of
symptoms
Manifestations develop when pancreas can no longer produce insulin
Onset of symptoms is very abrupt
Patients usually present at the ER with ketoacidosis
History of recent, sudden, weight loss
- will require exogenous insulin to sustain life
Classic symptoms of type 1 diabetes -Answer Polydipsia - increase in thirst
Polyuria - passage of extraordinarily large volumes of urine
, Polyphagia - Increased appetite
Nonspecific symptoms of type 1 diabetes -Answer Fatigue
Recurrent infections
Recurrent vaginal yeast infections
Poor healing of cuts
Blurred vision
Recent sudden weight loss
Type 2 Diabetes-Answer • Most common form of diabetes-more than 90% of patients
with diabetes • Generally begins after age 35 years • 80% to 90% of patients are
overweight • Prevalence rises progressive with age • Has a genetic origin/tendency •
More common among certain ethnic groups: • African Americans • Asian Americans •
Hispanic Americans • Native Americans • Native Americans and Alaskan Natives:
highest incidence of diabetes in the world
Etiology and Pathophysiology of type 2 diabetes - Answer • Pancreas continues to
produce some endogenous (self-made) insulin
• Insulin produced is either insufficient or poorly utilized by tissues or both
• Obesity (abdominal/visceral)
- Most powerful risk factor
• Genetic mutations
- Lead to insulin resistance
- Increased risk for obesity
Major metabolic abnormalities of type 2 diabetes - Answer 1. Insulin resistance
2. Pancreas ↓ ability to produce insulin
3. Inappropriate glucose production from liver
4. Alteration in production of hormones and adipose tissue (adipokines)
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