Diabetic Ketoacidosis and patho Questions and Answers 100% Verified

4 chronic complications of DM - 1. Microvasculature (retino, nephro, neuro) 2. Macrovasculature (cornary artery, peripheral arterial, stroke) 3. Infections 4. Lower-limb amputation 6 types of acute complications of DM - 1. Hypoglycemia- low blood sugar 2. Hyperglycemia-high blood sugar 3. Diabetic ketacidosis (DKA)-cannot utilize glucose as a fuel source w/o insulin 4. Hyperosmolar hyperglycemic nonketotic syndrome (HHNKS)- basic defect is lack of effective insulin 5. Somogyi effect 6. Dawn phenomenon acidosis - pH 7.35 condition of having too much H+ metabolic acidosis; decreased pH, decreased bicarb respiratory acidosis; decreased pH, increased PaCO2 alkalosis - pH 7.45 condition of having too little H+ metabolic alkalosis; increased pH, increased bicarb respiratory alkalosis; increased pH, decreased PaCO2 Anatomy of pancreas - Triangular gland behind the stomach anion gap - AG = Na - (Cl + HCO3) measures unmeasured ions in your bloodnormal range 10-14; patients presenting with DKA will have higher number Blood glucose regulation (6) - 1. When blood glucose levels rise above a set point, 2. the pancreas secretes insulin into the blood. 3. Insulin stimulates liver and muscle cells to make glycogen, dropping blood glucose levels. 4. When glucose levels drop below a set point, 5. the pancreas secretes glucagon into the blood. 6. Glucagon promotes the breakdown of glycogen and the release of glucose into the blood. (The pancreas signals distant cells to regulate levels in the blood = endocrine function.) Characteristics of Type 1 (4) - 1. Absolute insulin deficiency 2. Result of autoimmune destruction of insulin producing Beta cells 3. About 15% of all cases 4. Most often found under 40 (most common type found in childhood Characteristics of Type 2 (4) - 1. Associated with insulin resistance (fat, liver, and muscle cells do not respond to insulin) 2. Impaired insulin secretion and increased glucose production 3. About 85% of all cases 4. Most common in over 40s complications - lactic acidosis increased risk of stroke, MI, ischemic limb cerebral edema (more frequent in children) rebound ketoacidosis (don't stop insulin drip too early) Complications of DM (2) - 1. Acute complications (related to excessive hyperglycemia) 2. Chronic complicationsComplications of the lower limbs: the diabetic foot contribute to the increased risk of foot infections: (3) - 1. Neuropathy: loss of pain and pressure sensation 2. PVD: poor wound healing 3. Immunocompromise: impairs the ability of specialized leukocytes to destroy bacteria Define diabetes mellitus - Group of metabolic, endocrine disease of impaired sugar (glucose) metabolism leading to high blood sugar (hyperglycemia) Define Diabetic Neuropathies - A group of diseases that affect all types of nerves: including peripheral (sensorimotor), autonomic, and spinal nerves 1. The most common cause of neuropathy 2. The most common complication of diabetes 3. The prevalence is similar for type I and type II 4. Most commonly affects the distal portions of the nerves, especially the nerves of the lower extremities (peripheral neuropathy) Depending on underlying etiology, factors causing hyperglycemia may include... (4) - 1. an absolute insulin deficiency 2. reduction in insulin secretion 3. decreased glucose utilization 4. increased glucose production Dermatological manifestation - 1. disorders of healing 2. skin ulcers Diabetic Automatic Neuropathies affect almost every organ system of the body including (3) - 1. Cardiovascular 2. Gastrointestinal tract (GI) 3. Renal and UrinaryDiabetic macrovascular disease (atherosclerotic disease) (3) - 1. CAD: Coronary Artery disease 2. CVD: Stroke 3. PVD: Peripheral arterial disease Diabetic Nephropathy - 1. disease because the kidney's filtration mechanism is stressed 2. thickening in glomerulus (blood protein leak into urine) Diabetic Peripheral Neuropathies: Nerve lesions lead to altered sensorimotor function including: (4) - 1. Paresthesia (tingling on digits) 2. Loss of sensitivity and sensation to pain and temperature 3. decrease posture and movement awareness 4. decrease sensation of light touch diagnosis - hyperglycemia ( 250), acidosis (blood pH or = 7.3), serum bicarbonate (15), ketosis, anion gap metabolic acidosis, fluid deficit 6 L or more (deficits in serum sodium common) DKA - acute, major, life-threatening complication of diabetes mostly occurs in patients with type I; rarely seen in type II results from a relative or absolute lack of insulin combined with relative glucagon increases