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Pathophysiology Exam 5 (Diabetes, Endocrine)

Terms in this set (51)

_____:broken down carbohydrates for energy; sugar
Glucose
_____:hormone produced by alpha cells of pancreas. Stimulates glycogenolysis and gluconeogenesis in liver
Glucagon
______:carbohydrate consists of glucose produced in muscle and liver from stored glucose
Glycogen
______:hormone produced by beta cells of pancreas.
-Energy metabolism stimulates the diffusion of glucose into adipose and muscle tissue and inhibits the production of glucose by the liver
Insulin
_____:breakdown of sugar so cells can use
Glycolysis
_____:production of glucose from breakdown of glycogen in liver and muscle tissue
Glycogenolysis
_____:production of glycogen from glucose in liver in muscle tissue
Glycogenesis
_________:production of glucose from amino acids in liver
Gluconeogenesis
Fed state
-dominated by insulin

-After eating, rise in blood glucose and insulin
-Presence of insulin stimulates glucose diffusion into adipose and muscle tissue and inhibits production of glucose by liver
-Glycolysis -energy use for cell
-Glycogenesis-glycogen production muscle/liver
Fasting state
-dominated by glucagon
-Glucose is produced:
+by glycogenolysis (breakdown of stored glycogen) in liver and muscles
+by gluconeogenesis (production of glucose in liver)
-Glucagon-responsible for 75% of glucose production
-Lipolysis is primary source of energy to muscles
Exercise:
-After _____minutes, glucose use by muscles increase 7 to 20 times
-Muscle contraction increases insulin sensitivity for up to ___ hours

Stress:
-Injury, illness, pain and stress hormones:
-All increase production of _____
-Take more ___ when more stress
-10-40
-16

-glucose
-insulin
Diabetes Mellitus (DM):
1. Normal Blood Glucose level
FPG _____ mg/dl (this varies per resource)

2. Diagnosing Pre-Diabetes
-Impaired fasting glucose tolerance test
FPG ______ mg/dl
-Impaired glucose tolerance test
2 hours post glucose ingestion ________mg/dl

3. Diagnosing DM
-Fasting Plasma Glucose (FPG) >___
OR
Symptoms of hyperglycemia or random >_____
OR
2-hour plasma glucose during an Oral Glucose Tolerance Test (OGTT) after drinking _____ sugar
1. 70-110
2. 100-125; 140-200
3. 126; 200; 75g
Type 1 Diabetes Mellitus
-Immune-mediated: result of autoimmune attack on the beta cells of the pancreas
-Absolute insulin deficiency- Loss of beta cells
-Overproduction of glucagon by pancreatic alpha cells
-(breakdown of protein or a diet) Ketone bodies in urine which causes osmotic fluid loss
-Decreased:(Bicarbonate ions, Sodium, Magnesium, Phosphorus,
Total body water (hypovolemia))-->
Leads to increased (K, H&H, protein, creatinine, lactic acid)
-Diabetic Ketoacidosis (DKA) occurs(S&S Kussmaul respirations (have fruity breath) this is a GOOD thing we want them to breath fast;Kussmaul respiration to correct metabolic acidosis
-Hyperkalemia due to excretion of fluid
-Lactic acid
-Hypovolemic shock
-Polydipsia, Polyuria, Polyphagia
-Diagnosed at young age, Caucasian, very thin bc of impaired glucose, fat metabolism; insulin dependent their entire life
Type 2 Diabetes Mellitus
-Risk factors: Obese, sedentary lifestyle, abdominal adipose, 3 P's
-insulin resistance/insufficient insulin- beta cell dysfunction
-decreased number of insulin receptors
-Impaired glycogen syntheses
-Impaired production of insulin by pancreas
-Typically don't make acidosis so pt wont develop any kind of acidosis

-DKA uncommon
-Polydipsia, Polyuria, Polyphagia
-NHHC- Nonketotic hyperglycemic hyperosmolar coma
-Severe hyperglycemia and dehydration W/O ketones
-Type 2 usually non caucasion, older 40-50 diagnosed, overweight, can convert from type 2 to type 1
-Oral antidiabetic agents or Insulin
NHHC- Nonketotic hyperglycemic hyperosmolar coma
>600 mg/dL glucose
No urine ketones
normal pH
low, normal or high Na+, K+
High hematocrit, hemoglobin, WBC, creatinine, BUN, serum osmality
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