PATHO: In class Hormones Diabetes

Glucose

Preferred energy source for body cells

Glycogen

Stored form of glucose in the liver

Glycogenolysis

Breakdown of glycogen into glucose

Gluconeogenesis

Production of glucose from protein and fat in the liver

Lipolysis

Breakdown of triglycerides into fatty acids and glycerol

Ketogenesis

Production of ketones from fat breakdown

Hyperglycemia

High blood glucose

Hypoglycemia

Low blood glucose

Insulin

Hormone that lowers blood glucose by moving glucose into cells

Glucagon

Hormone that raises blood glucose by glycogenolysis and gluconeogenesis

Cortisol

Stress hormone that raises blood glucose

Epinephrine

Stress hormone that raises blood glucose

Norepinephrine

Stress hormone that raises blood glucose

Absorptive State

State after eating when insulin is released and glucose is used or stored

Post Absorptive State

Fasting state when glucagon is released and glucose is produced

Diabetes Mellitus

Group of disorders where body cannot produce or use insulin causing hyperglycemia

Type 1 Diabetes

Autoimmune destruction of beta cells causing absolute insulin deficiency

Type 2 Diabetes

Insulin resistance and relative insulin deficiency

Gestational Diabetes

Diabetes first diagnosed during pregnancy

Prediabetes

Blood glucose higher than normal but not high enough for diabetes diagnosis

Insulin Resistance

Cells do not respond properly to insulin

Beta Cells

Pancreatic cells that produce insulin

Polyuria

Frequent urination due to glucose pulling water into urine

Polydipsia

Excessive thirst due to dehydration

Polyphagia

Excessive hunger due to cells not getting glucose

Nocturia

Urination at night

Glucosuria

Glucose in the urine

Diabetic Ketoacidosis (DKA)

Insulin deficiency leading to hyperglycemia ketosis and metabolic acidosis

Ketones

Acids produced from fat breakdown

Kussmaul Respirations

Deep rapid breathing to compensate for metabolic acidosis

Hyperosmolar Hyperglycemic State (HHS)

Severe hyperglycemia dehydration and high osmolality without ketosis

Osmolality

Concentration of particles in blood

Hypoglycemic Unawareness

No early warning signs of low blood sugar

Microvascular Complications

Small blood vessel damage

Macrovascular Complications

Large blood vessel damage

Neuropathy

Nerve damage due to high glucose

Retinopathy

Retinal blood vessel damage due to high glucose

Nephropathy

Kidney damage due to high glucose

Gastroparesis

Delayed stomach emptying due to nerve damage

Neurogenic Bladder

Bladder dysfunction due to nerve damage

Erectile Dysfunction

Inability to maintain erection due to nerve and blood vessel damage

Proteinuria

Protein in urine due to kidney damage

End Stage Renal Disease

Kidney failure requiring dialysis

Peripheral Vascular Disease

Poor blood flow to limbs

Coronary Artery Disease

Disease of heart blood vessels

Cerebrovascular Disease

Disease of brain blood vessels leading to stroke

Retinal Detachment

Separation of retina causing vision loss

Macular Degeneration

Damage to central vision

Cataracts

Clouding of lens from sorbitol buildup

Glaucoma

Increased eye pressure causing optic nerve damage

Sorbitol

Sugar alcohol that accumulates in nerves and eyes causing damage

Polyuria Polydipsia Polyphagia

The three classic signs of hyperglycemia

DKA Diagnostic Criteria

Glucose over 250 ketones present acidosis present

HHS Diagnostic Criteria

Glucose over 600 high osmolality severe dehydration no ketosis

Fasting Glucose Normal

70 to 99 mg per dL

Fasting Glucose Prediabetes

100 to 125 mg per dL

Fasting Glucose Diabetes

126 mg per dL or higher

A1C Normal

Less than 5.7 percent

A1C Prediabetes

5.7 to 6.4 percent

A1C Diabetes

6.5 percent or higher

Post Prandial Normal

100 to 140 mg per dL

Post Prandial Prediabetes

141 to 199 mg per dL

Post Prandial Diabetes

200 mg per dL or higher

Stage 1 Type 2 Diabetes

Insulin resistance but normal glucose due to increased insulin production

Stage 2 Type 2 Diabetes

High post meal glucose as beta cells begin to fail

Stage 3 Type 2 Diabetes

High fasting glucose leading to diabetes diagnosis

Lipolysis Pathophysiology

Fat breakdown due to lack of insulin

Ketogenesis Pathophysiology

Ketone production from fat breakdown causing metabolic acidosis

Dehydration in Diabetes

High glucose causes osmotic diuresis leading to fluid loss

Infection Risk in Diabetes

High glucose poor circulation and immune dysfunction increase infection risk

Gestational Diabetes

New onset diabetes during pregnancy due to insulin resistance from pregnancy hormones

Baby Hypoglycemia After Birth

Maternal hyperglycemia causes baby to produce high insulin leading to low glucose after birth