diabetes

diabetes

Type 1 diabetes (IDDM)
1. weight loss
2. presents young
3. ketonuria
4. rapid onset
5. dehydration
6. hyperventilation
7. Type 1 Pathophysiology
  1. NO INSULIN PRODUCED
    1. ingested glucose remains in blood
      1. = HYPERGLYCAEMIA >8mmol/l
        renal system can't cope with increased glucose - renal threshold exceeded
        kidneys remove excess glucose as waste
        GLYCOSURIA
        water is attracted to glucose
        POLYURIA
        due to losing excess water, more fluid required for cell function
        POLYDIPSIA
    2. No glucose reaching cells
      1. pancreas releases glucagon to act on glycogen stores
        GLYCOGENOLYSIS
        Glycogen supplies quickly depleted
        GLUCONEOGENESIS (from lactic acid and amino acids)
        by product - Ketones
        KETONURIA
        if untreated KETOACIDOSIS - resulting in diabetic coma
      2. lipid metabolism activated
        WEIGHT LOSS
        EXHAUSTION
Type 2 diabetes (mature onset)
1. retinopathy
2. nephropathy
3. neuropathy
4. peripheral vascular disease
5. ischaemic heart disease
6. gradual onset
7. weight loss not always present
8. insidious exhaustion
9. Type 2 pathophysiology
  1. either: not enough insulin or insulin resistance
  2. as insulin still present no ketones are released
  3. because insulin inhibits gluconeogenesis
Gestational diabetes (GDM)
1. Family Hx of Type 2
2. Hypertension
3. > 30 yrs
4. obesity
5. previous large baby
6. Hx of GDM / impaired GTT
7. previous baby with congenital abnormality
8. previous late IUD
general signs and symptoms
1. polyuria
2. polydipsia
3. polyphagia
4. boils
5. lethargy
6. glycosuria
7. prolonged, frequent, recurring infections
8. pruritis vulvae

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	Created by mhairi.mair over 10 years ago