Podcast
Questions and Answers
What is a common symptom that individuals with untreated hyperglycemia may experience?
What is a common symptom that individuals with untreated hyperglycemia may experience?
Which factor is commonly noted in the pathophysiology of type 2 diabetes?
Which factor is commonly noted in the pathophysiology of type 2 diabetes?
What characterizes the onset of type 2 diabetes?
What characterizes the onset of type 2 diabetes?
What is the typical time frame for an individual with prediabetes to develop type 2 diabetes if no preventive measures are taken?
What is the typical time frame for an individual with prediabetes to develop type 2 diabetes if no preventive measures are taken?
Signup and view all the answers
Which medical condition is NOT typically associated with secondary diabetes?
Which medical condition is NOT typically associated with secondary diabetes?
Signup and view all the answers
What is a common result of insulin resistance in body tissues?
What is a common result of insulin resistance in body tissues?
Signup and view all the answers
Which laboratory test result indicates diabetes based on random plasma glucose levels?
Which laboratory test result indicates diabetes based on random plasma glucose levels?
Signup and view all the answers
Which of the following expresses a characteristic of adipokines in relation to diabetes?
Which of the following expresses a characteristic of adipokines in relation to diabetes?
Signup and view all the answers
What is the normal fasting plasma glucose value?
What is the normal fasting plasma glucose value?
Signup and view all the answers
What best describes the change in beta cells in type 2 diabetes?
What best describes the change in beta cells in type 2 diabetes?
Signup and view all the answers
What is a major complication often associated with diabetes?
What is a major complication often associated with diabetes?
Signup and view all the answers
Type 1 diabetes is primarily characterized by which of the following?
Type 1 diabetes is primarily characterized by which of the following?
Signup and view all the answers
Which hormone counterregulates insulin action by increasing blood glucose levels?
Which hormone counterregulates insulin action by increasing blood glucose levels?
Signup and view all the answers
What does prediabetes indicate?
What does prediabetes indicate?
Signup and view all the answers
Which body system is notably affected by insulin's action of promoting glucose transport?
Which body system is notably affected by insulin's action of promoting glucose transport?
Signup and view all the answers
Secondary diabetes can arise from conditions that involve which of the following?
Secondary diabetes can arise from conditions that involve which of the following?
Signup and view all the answers
What is the typical glucose range stabilized by normal insulin metabolism?
What is the typical glucose range stabilized by normal insulin metabolism?
Signup and view all the answers
Type 2 diabetes is mainly related to which issue in insulin function?
Type 2 diabetes is mainly related to which issue in insulin function?
Signup and view all the answers
Insulin not only transports glucose but also inhibits which process?
Insulin not only transports glucose but also inhibits which process?
Signup and view all the answers
Which statement about gestational diabetes is true?
Which statement about gestational diabetes is true?
Signup and view all the answers
What are the classic symptoms of Type 1 Diabetes Mellitus?
What are the classic symptoms of Type 1 Diabetes Mellitus?
Signup and view all the answers
Which of the following statements about Type 1 Diabetes is accurate?
Which of the following statements about Type 1 Diabetes is accurate?
Signup and view all the answers
At what age is the peak onset of Type 1 Diabetes commonly observed?
At what age is the peak onset of Type 1 Diabetes commonly observed?
Signup and view all the answers
What is the primary underlying issue in Type 2 Diabetes Mellitus?
What is the primary underlying issue in Type 2 Diabetes Mellitus?
Signup and view all the answers
Which group has the highest prevalence of diabetes in the world?
Which group has the highest prevalence of diabetes in the world?
Signup and view all the answers
What is a common physiological response when the pancreas can no longer produce insulin effectively in Type 1 Diabetes?
What is a common physiological response when the pancreas can no longer produce insulin effectively in Type 1 Diabetes?
Signup and view all the answers
What major factor significantly contributes to the development of Type 2 Diabetes?
What major factor significantly contributes to the development of Type 2 Diabetes?
Signup and view all the answers
Which of the following indicates a condition of prediabetes?
Which of the following indicates a condition of prediabetes?
Signup and view all the answers
Which hormone plays a role in opposing the effects of insulin?
Which hormone plays a role in opposing the effects of insulin?
Signup and view all the answers
What might happen during the long preclinical period of Type 1 Diabetes?
What might happen during the long preclinical period of Type 1 Diabetes?
Signup and view all the answers
Study Notes
Insulin Resistance
- Body tissues do not respond to insulin
- Insulin receptors either unresponsive or insufficient in number
- Results in hyperglycemia
Pancreas ↓ ability to produce insulin
- β cells fatigued from compensating
- β -cell mass lost
Inappropriate glucose production from liver
- Liver’s response of release of glucose is haphazard
- Does not correspond to body’s needs
- Not considered a primary factor in development of type 2 diabetes
Alteration in production of hormones and adipose tissue (adipokines)
- Adipokines play a role in glucose & fat metabolism
- Contribute to pathophysiology of type 2 diabetes
Type 2 - Onset of Disease
- Gradual onset
- Person may go many years with undetected hyperglycemia
- Osmotic fluid/electrolyte loss from hyperglycemia may become severe
- Resulting in hyperosmolar coma
Prediabetes
- Individual is at increased risk for developing diabetes
- Blood glucose levels are not high enough for diabetes diagnosis
- Increased risk for developing type 2 diabetes
- If no preventive measure taken, diabetes usually develops within 10 years
- Long-term damage already occurring
- Heart, blood vessels - see a cardiologist
- Usually present with no symptoms
- Monitor for diabetes symptoms
- Polyuria
- Polyphagia
- Polydipsia
- Maintaining healthy weight, regular exercise, and a healthy diet reduces the risk of developing diabetes
Secondary Diabetes
- Results from another medical condition
- Cushing syndrome
- Hyperthyroidism
- Pancreatitis
- Parenteral nutrition
- Cystic fibrosis
- Hematochromatosis
- Treatment of medical condition that causes abnormal blood glucose level
- Corticosteroids (Prednisone)
- Thiazides
- Phenytoin (Dilantin)
- Atypical antipsychotics (clozapine)
- Usually resolves when underlying condition treated
Diagnostic Studies
-
Random plasma glucose
- Normal 70-120 mg/dL
- Diabetes ≥200 mg/dL
-
Fasting plasma glucose (no caloric intake for 8 hours)
- Normal 70-100 mg/dL
- Prediabetes 100-125 mg/dL
- Diabetes ≥126 mg/dL
Type 1 Diabetes Mellitus
- Formerly known as “juvenile onset” or “insulin dependent” diabetes
- Most often occurs in people under 30 years of age
- Peak onset between ages 11 and 13
- 5-10% of all diabetics
- Now occurring in younger children
Type 1- Etiology and Pathophysiology
- End result of long-standing process where body compensates for a long time
- Immune-mediated disease
- Body’s own T cells attack & destroy pancreatic beta (β)-cells, which are the source of insulin
- Autoantibodies to the islet cells cause a reduction of 80% to 90% of normal cell function before hyperglycemia manifestations occur
- Causes
- Genetic predisposition
- Related to human leukocyte antigens (HLAs)
- Exposure to a virus
- Idiopathic diabetes – not related to autoimmunity but strongly inherited
- Genetic predisposition
Type 1- Onset of Disease
- Long preclinical period before any symptoms
- Antibodies for βcell destruction present for months to years before symptoms occur
- Manifestations develop when pancreas can no longer produce insulin
- Rapid onset of symptoms
- Patient often presents at ER with ketoacidosis
- History of recent, sudden, weight loss
- Classic symptoms
- Polydipsia – excessive thirst
- Polyuria – production of abnormally large amounts of urine
- Polyphagia – Increased appetite
- Will require exogenous insulin to sustain life
Type 1 - Clinical Manifestations
- Classic symptoms
- Polyuria (frequent urination)
- Polydipsia (excessive thirst)
- Polyphagia (excessive hunger)
- Weight loss – body cannot get glucose and uses other energy sources such as fat
- Weakness & fatigue – body cells lack needed energy from glucose
- Nonspecific symptoms
- May have classic symptoms of type 2
- Fatigue 3 lethargic
- Recurrent infections
- Recurrent vaginal yeast infections
- Prolonged wound healing
- Visual changes
Type 2 Diabetes Mellitus
- Most prevalent type of diabetes - over 90% of patients with diabetes
- Usually occurs in people over 35 years of age
- 80% to 90% of patients are overweight
- Prevalence increases with age
- Genetic basis
- Greater in some ethnic populations
- African Americans, Asian Americans, Hispanic Americans, and Native Americans
- Native Americans and Alaskan Natives: Highest rate of diabetes in the world
Etiology and Pathophysiology
- 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
Etiology and Pathophysiology
- Four major metabolic abnormalities
- Insulin resistance
- Decreased insulin secretion
- Increased hepatic glucose production
- Altered lipid metabolism
Diabetes Definition
- Chronic multisystem disease related to
- Abnormal insulin production
- Impaired insulin utilization
- Or both
- The long-term complications of diabetes make it a devastating disease. Diabetes is the leading cause of:
- Adult blindness
- End-stage renal disease
- Nontraumatic lower limb amputations
- Major contributing factor
- Heart disease
- Stroke
Etiology and Pathophysiology
- Two most common types
- Type 1
- Type 2
- Other types
- Gestational
- Prediabetes
- Secondary diabetes
Etiology and Pathophysiology
- Normal insulin metabolism
- Produced by the B cells (beta cells)
- Islets of Langerhans of the pancreas
- Released continuously into bloodstream in small increments with larger amounts released after food intake
- Stabilizes glucose range to 70 to 120 mg/dl
- Produced by the B cells (beta cells)
- Insulin
- Promotes glucose transport from bloodstream across cell membrane to cytoplasm of cell
- Decreases glucose in the bloodstream
Etiology and Pathophysiology
- Insulin involvement of many body systems
- Increased Insulin 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
- Increased protein synthesis
Counterregulatory hormones
- Increase blood glucose levels by stimulating glucose production & output by the liver, & by decreasing the movement of glucose into the cells.
- Examples:
- Glucagon
- Epinephrine
- Growth hormone
- Cortisol
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz explores critical aspects of Type 2 Diabetes, including insulin resistance, the role of the pancreas, and factors influencing glucose metabolism. It covers the gradual onset of the disease and discusses prediabetes as a risk factor for diabetes development. Test your knowledge on these vital concepts related to diabetes pathology.
