PEDS CH. 48 ENDOCRINE | GUARANTEED SUCCESS STARTS
HERE! LEARN, PRACTICE & EXCEL!
What is the cardinal sign of diabetes mellitus Answer: Hyperglycemia
Pathophysiology of diabetes mellitus Answer: Insulin created by Beta Cells located in the
islets of Langerhans in the pancreas.
Upon eating, insulin secretion increases and moves glucose from the blood into the liver,
muscle and fat cells.
If minimal insulin influence, the glucose remains in the blood stream
Describe the role of insulin Answer: Transports and metabolizes glucose for energy
Stimulates storage of glucose in the liver and muscle
Signals the liver to stop producing glucose
Enhances storage of dietary fat in adipose tissue
Accelerates transport of amino acids into cells
Describe Type 1 diabetes Answer: Autoimmune disorder that occurs in genetically
susceptible individuals
Immune system creates T lymphocytes to DESTROY B cells of the pancreas and this results
in INADEQUATE INSULIN PRODUCTION
Kidneys try to lower glucose to they start to urinate out glucose(polyuria/glycosuria)
Metabolism of fat accumulates leading to acidosis and ketones
Describe type 2 diabetes Answer: Closely correlated with body habitus and obesity (low
physical activity). Also perhaps to possible exposure while in utero
Body produces enough insulin, however there is INADEQUATE BODY RESPONSE OR
INADEQUATE INSULIN SECRETION
Clinical characteristics Type 1 diabetes Answer: Onset usually less than 30yo
Thin, recent weight loss
Etiology: genetic, immunological, environmental
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
, Little or no insulin endogenous insulin
Need insulin to preserve life
Ketosis prone when insulin absent
Acute complication: Diabetic ketoacidosis
Clinical characteristics Type 2 diabetes Answer: Onset usually older than 30yo
Typically obese
Etiology: Obesity, hereditary and environmental factors
Decrease in endogenous insulin or increased with insulin resistance
Most can control hyperglycemia through weight loss if obese
Ketosis can happen, but uncommon
Oral antidiabetic meds utilized if dietary modifications and exercise ineffective
Acute complication: Hyperglycemic hyperosmolar nonketotic syndrome
Diabetes mellitus
long term complications Answer: Prolonged exposure to high blood glucose levels results
in damage to the blood vessels and nerves
Failure to thrive
Poor wound healing
Cerebrovascular disease
Peripheral vascular disease
Nephropathy
Neuropathy
Retinopathy
Criteria for Diabetes diagnosis** Answer: Random plasma glucose levels greater than
200mg/dL
Fasting glucose greater than 126mg/dL (NPO for 8 hours)
2 hour post load glucose equal to 200mg/dL during an oral glucose tolerance test
Hemoglobin A1C - normal (7.5-8.5)
Diabetic ketoacidosis
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
HERE! LEARN, PRACTICE & EXCEL!
What is the cardinal sign of diabetes mellitus Answer: Hyperglycemia
Pathophysiology of diabetes mellitus Answer: Insulin created by Beta Cells located in the
islets of Langerhans in the pancreas.
Upon eating, insulin secretion increases and moves glucose from the blood into the liver,
muscle and fat cells.
If minimal insulin influence, the glucose remains in the blood stream
Describe the role of insulin Answer: Transports and metabolizes glucose for energy
Stimulates storage of glucose in the liver and muscle
Signals the liver to stop producing glucose
Enhances storage of dietary fat in adipose tissue
Accelerates transport of amino acids into cells
Describe Type 1 diabetes Answer: Autoimmune disorder that occurs in genetically
susceptible individuals
Immune system creates T lymphocytes to DESTROY B cells of the pancreas and this results
in INADEQUATE INSULIN PRODUCTION
Kidneys try to lower glucose to they start to urinate out glucose(polyuria/glycosuria)
Metabolism of fat accumulates leading to acidosis and ketones
Describe type 2 diabetes Answer: Closely correlated with body habitus and obesity (low
physical activity). Also perhaps to possible exposure while in utero
Body produces enough insulin, however there is INADEQUATE BODY RESPONSE OR
INADEQUATE INSULIN SECRETION
Clinical characteristics Type 1 diabetes Answer: Onset usually less than 30yo
Thin, recent weight loss
Etiology: genetic, immunological, environmental
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
, Little or no insulin endogenous insulin
Need insulin to preserve life
Ketosis prone when insulin absent
Acute complication: Diabetic ketoacidosis
Clinical characteristics Type 2 diabetes Answer: Onset usually older than 30yo
Typically obese
Etiology: Obesity, hereditary and environmental factors
Decrease in endogenous insulin or increased with insulin resistance
Most can control hyperglycemia through weight loss if obese
Ketosis can happen, but uncommon
Oral antidiabetic meds utilized if dietary modifications and exercise ineffective
Acute complication: Hyperglycemic hyperosmolar nonketotic syndrome
Diabetes mellitus
long term complications Answer: Prolonged exposure to high blood glucose levels results
in damage to the blood vessels and nerves
Failure to thrive
Poor wound healing
Cerebrovascular disease
Peripheral vascular disease
Nephropathy
Neuropathy
Retinopathy
Criteria for Diabetes diagnosis** Answer: Random plasma glucose levels greater than
200mg/dL
Fasting glucose greater than 126mg/dL (NPO for 8 hours)
2 hour post load glucose equal to 200mg/dL during an oral glucose tolerance test
Hemoglobin A1C - normal (7.5-8.5)
Diabetic ketoacidosis
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
