Med Surg: Final- Diabetes

What is the definition of diabetes?

A chronic disorder of glucose metabolism resulting in hyperglycemia due to defects in insulin secretion, insulin action, or both.

What happens in Type 1 diabetes and who is usually affected?

Autoimmune destruction of pancreatic beta cells leads to absolute insulin deficiency, usually developing in younger people, requiring lifelong insulin therapy.

What are the main causes and triggers of Type 1 diabetes?

Genetic predisposition (HLA genes) and rare environmental triggers such as viral infections or toxins.

How does Type 1 diabetes affect the body at the cellular level?

No insulin is produced → glucose cannot enter cells → hyperglycemia; increased fat breakdown leads to ketone production → risk for diabetic ketoacidosis (DKA).

What are the classic clinical features of Type 1 diabetes?

Polyuria, polydipsia, polyphagia, unexplained weight loss, fatigue, blurred vision, nausea, vomiting (especially in DKA).

How is Type 1 diabetes managed?

Lifelong insulin therapy, blood glucose monitoring, nutrition and exercise balance, education on insulin injection techniques, and sick-day rules.

What are the acute and chronic complications of Type 1 diabetes?

Acute - DKA; Chronic - microvascular and macrovascular damage including eye, kidney, and nerve damage.

What characterizes Type 2 diabetes and how does it differ from Type 1?

Type 2 diabetes involves insulin resistance plus relative insulin deficiency and progressive beta-cell dysfunction; most patients produce some insulin but it is ineffective.

What are the risk factors for developing Type 2 diabetes?

Genetic predisposition, obesity, sedentary lifestyle, and aging.

How does Type 2 diabetes affect the body at the cellular level?

Cells become resistant to insulin → impaired glucose uptake → pancreas compensates by increasing insulin secretion → eventual beta-cell failure.

What are the early clinical features of Type 2 diabetes?

Often asymptomatic initially; may include polyuria, polydipsia, fatigue, slow wound healing, recurrent infections; severe cases can lead to hyperosmolar hyperglycemic state (HHS).

How is Type 2 diabetes managed?

Lifestyle modifications (diet, exercise), oral antidiabetic drugs (metformin), non-insulin injectables, insulin if needed.

What is gestational diabetes and when does it occur?

Pregnant women experience glucose intolerance due to placental hormones; usually returns to normal after delivery.

What are the risk factors for gestational diabetes?

Obesity (BMI ≥30), family history of diabetes, previous GDM or large baby (>9 lbs), age >35, certain ethnicities (Hispanic, African American, Asian).

How does gestational diabetes affect the body?

Placental hormones cause insulin resistance → pancreas cannot compensate → hyperglycemia.

When and how is gestational diabetes screened?

24-28 weeks gestation via Oral Glucose Tolerance Test (OGTT).

How is gestational diabetes managed?

Diet and exercise, blood glucose monitoring, insulin if needed.

What are the potential complications of gestational diabetes?

Maternal - increased risk of Type 2 diabetes later; Fetal - macrosomia, hypoglycemia at birth.

What is the primary function of insulin in the body?

Insulin is an anabolic hormone produced by pancreatic beta cells; it lowers blood glucose and facilitates glucose uptake into muscle and fat cells.

What are the key actions of insulin in the body?

Stimulates glycogen synthesis in liver and muscle, promotes fat storage, enhances protein synthesis.

What is the normal fasting blood glucose range?

70-110 mg/dL; above 126 mg/dL requires intervention.

How does the body maintain homeostasis of blood glucose?

High glucose → pancreas releases insulin → cells absorb glucose → stored as glycogen; Low glucose → pancreas releases glucagon → liver breaks down glycogen → glucose released.

How does insulin regulate glycogen metabolism?

Insulin stimulates glycogenesis (glucose → glycogen) and inhibits glycogenolysis; glucagon stimulates glycogen breakdown during fasting.

What are the classic symptoms of diabetes?

Polyuria, polydipsia, polyphagia.

What are other common signs of diabetes?

Fatigue, blurred vision, slow wound healing, recurrent infections.

What are symptoms specific to Type 1 diabetes?

Weight loss, nausea, vomiting (especially in DKA).

What are symptoms specific to Type 2 diabetes?

Often asymptomatic early, tingling or numbness in extremities.

What is Hemoglobin A1C and what does it indicate?

Glycated hemoglobin reflecting average blood glucose over 2-3 months, indicating long-term glycemic control.

What are the normal and diagnostic Hemoglobin A1C values according to ADA?

Normal <5.7%, Pre-diabetes 5.7-6.4%, Diabetes ≥6.5%.

Why is Hemoglobin A1C important in diabetes management?

It monitors long-term glycemic control, is not affected by short-term fluctuations, and assesses treatment effectiveness; goal <7%.