Diabetes Mellitus

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created 7 years ago by jenkarmata
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Nursing 122 Spring 2014 CAC
updated 7 years ago by jenkarmata
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1

Diabetes Mellitus:

Is a chronic metabolic disease that requires lifelong behavioral and lifestyle changes.
The disease is classified by the underlying problem causing LACK of insulin & the severity of the insulin deficiency.

2

Name this patho:
For all types of______ the main feature is chronic hyperglycemia (high blood glucose level) resulting from problems w/insulin secretion, insulin action, or both.

Diabetes Mellitus (DM)

3

Which conditions are a complications of DM?

1. Hypertension
2. Hyperlipidemia

4

What organ mostly has the exocrine functions that are related to blood glucose control.

Pancreas

5

The endocrine portion of the pancreas has 1 million small glands, the 'islets of Langerhans,' scattered through the organ. The 2 types of islet cells important to glucose control are called what?

1. alpha cells
2. beta cells

6

Glucagon is secreted by which cells?

alpha cells

7

beta cells produce

insulin and amylin.

8

Name this hormone:
A 'counterregulatory' hormone that has actions opposite those of insulin.

Glucagon

* counterregulatory*

9

Glucagon

prevents hypoglycemia (low blood glucose levels) by triggering the release of glucose from cell storage sites.

10

Which hormone triggers the release of glucose from cell storage cites?

Glucagon

11

Name this hormone:
_______ is a protein made up of 51 amino acids. It is initially produced as inactive proinsulin, a prohormone that contains an additional amino acid chain (the C-peptide chain).

Active insulin

12

____ is converted into active insulin by removal of the C-peptide.

Proinsulin

13

About __ to __ units of insulin is secreted daily directly into liver circulation in a 2 step manner.

40-50

14

2 step manner in which insulin is secreted into liver circulation:

It is secreted at low levels during fasting (basal insulin secretion) AND at increased levels after eating (prandial).
An early burst of insulin secretion occurs w/in 10mins of eating. This is followed by an increasing release that lasts until the blood glucose level is normal.

15

What is the process where secretion of low levels of insulin during fasting called?

Basal insulin secretion

16

Increased levels of insulin secretion after eating is called?

Prandial

17

Fact about glucose:

Glucose is the main fuel for CNS cells. Because the brain cannot produce or store much glucose, it needs a continuous supply from circulation to prevent neuronal dysfunction & cell death

18

_____ is the main fuel for CNS cells.

Glucose

19

Why is glucose the main fuel for the CNS system?

Because the brain cannot produce or store much glucose, it needs a continuous supply from circulation to prevent neuronal dysfunction & cell death.

20

Where is glucose stored?

Inside cells as glycogen in the liver & muscles & free fatty acids are stored as triglyceride in fat cells.

21

Glucose is stored inside cells as ______ in the liver and muscles & free fatty acids are stored as triglyceride in fat cells.

glycogen

22

During a prolonged fast or after illness or injury, proteins are broken down & some of the _______ are converted into glucose.

amino acids

23

Transportation of glucose:

Movement into some cells requires the presence of specific carrier proteins, glucose transport proteins (GLUT) & insulin.

24

Transportation of glucose: Insulin

Insulin is like a 'key' that opens 'locked' membranes to glucose allowing glucose in the blood to move into cells to generate energy.

25

Insulin effects on metabolism and cellular process

THE MAIN metabolic effects of insulin are to STIMULATE GLUCOSE UPTAKE IN SKELETAL MUSCLE & HEART MUSCLE and to suppress liver production of glucose & very low-density lipoprotein (VLDL)

26

Insulin and liver produced glucose

Also a MAIN metabolic effect- to suppress liver production of glucose & very low-density lipoprotein (VLDL)

27

Insulin and the liver

In the liver, insulin promotes the production & storage of glycogen *(glycogenesis)* at the same time that it inhibits glycogen breakdown into glucose (glycogenolysis).

28

Name this process:

Conversion of fats to acids

ketogenesis

29

Name this process:

Conversion of proteins to glucose

Gluconeogenesis

30

Insulin and Ketogenesis and Gluconeogenesis

Insulin increases protein & lipid (fat) synthesis and inhibits ketogenesis & gluconeogenesis.

31

Insulin & muscle:

In muscle, insulin promotes protein & glycogen synthesis.

32

Insulin & fat:

In fat cells, insulin promotes triglyceride storage.

33

Insulin overall:

Insulin keeps blood glucose levels from becoming too high & help keep blood lipid levels in the normal range.

34

Insulin in fasting state (not eating for 8hrs)

Insulin secretion is suppressed, which leads to increased gluconeogenesis in the liver & kidneys, along w/INCREASED glucose generation by the breakdown of liver glycogen.

35

Insulin in the fed state:

Insulin released from pancreatic beta cells reverses this process.
At the same time, insulin also enhances glucose uptake & use by cells & reduces both fat breakdown and protein breakdown.

36

Name this process:

Fat breakdown

lipolysis

37

Name this process:

Protein breakdown

proteolysis

38

Absence of Insulin: pg-1412 (read)

Insulin is needed to move glucose into ____ _____.

body tissues

39

Name this condition:

Without insulin, glucose builds up in the blood, causing _____.

hyperglycemia

40

Hyperglycemia causes _____ and _______ imbalances, leading to the classic symptoms of diabetes:
Polyuria, polydipsia, and polyphagia

fluid / electrolyte