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Diabetes – Quiz 7 KNH 411 Glyco – sugar Keto – ketone group Nocto – night Phago – eating, ingestion Uro – urine Islets of Langerhans – cell types that are sources for insulin, glucagon, gastrin, etc. Pancreas – secretes pancreatic juices to intestines; internal secretions of insulin and glucagaon Alkalosis – decrease in hydrogen ion concentration of arterial blood below normal levels Diabetes mellitus - a chronic metabolic disorder in which the use of carbohydrate is impaired and that of lipid and protein is enhanced. It is caused by an absolute or relative deficiency of insulin and is characterized, in more severe cases, by chronic hyperglycemia, glycosuria, water and electrolyte loss, ketoacidosis, and coma Fasting blood sugar or glucose (FBS, FBG) - Blood glucose levels taken after not eating or drinking anything other than water overnight. A normal level is under 110, over 110 shows impaired glucose tolerance or insulin resistance, and over 126 is diabetic. Its ratio in comparison to fasting insulin can also indicate insulin resistance Gestational DM - carbohydrate intolerance of variable severity with onset or first recognition during pregnancy Glycosylated hemoglobin - any one of four hemoglobin A fractions (AIa1, AIa2, AIb, or AIc) to which d-glucose and related monosaccharides are covalently linked; concentrations are increased in the erythrocytes of patients with diabetes mellitus, which can be used as a retrospective index of glucose control over time in such patients. Impaired glucose tolerance (IGT) - pre-diabetic state of dysglycemia, that is associated with insulin resistance and increased risk of cardiovascular pathology Type 1 DM - a condition characterized by high blood glucose levels caused by a total lack of insulin. Occurs when the body's immune system attacks the insulin-producing beta cells in the pancreas and destroys them. The pancreas then produces little or no insulin. Type 1 diabetes develops most often in young people but can appear in adults. Insulin resistance - diminished effectiveness of insulin in lowering plasma glucose levels, arbitrarily defined as a daily requirement of at least 200 units of insulin to prevent hyperglycemia or ketosis; usually due to binding of insulin or insulin receptor sites by antibodies; associated with obesity, ketoacidosis, and infection. Ketosis - a condition characterized by the enhanced production of ketone bodies, as in diabetes mellitus or starvation. Type 2 DM - a condition characterized by high blood glucose levels caused by either a lack of insulin or the body's inability to use insulin efficiently. Type 2 diabetes develops most often in middle-aged and older adults but can appear in young people. Glycosuria - urinary excretion of carbohydrates Hyperglycemia - an abnormally high concentration of glucose in the circulating blood, seen especially in patients with diabetes mellitus Hyperinsulinism - Increased levels of insulin in the plasma due to increased secretion of insulin by the beta cells of the pancreatic islets; decreased hepatic removal of insulin is a cause in some patients, although hyperinsulinism usually is associated with insulin resistance and is commonly found in obesity in association with varying degrees of hyperglycemia Hypoglycemia - Symptoms resulting from low blood glucose (normal glucose range 60–100 mg/dL [3.3–5.6 mmol/L]), which are either autonomic or neuroglycopenic. Autonomic symptoms include sweating, trembling, feelings of warmth, anxiety, and nausea. Neuroglycopenic symptoms include feelings of dizziness, confusion, tiredness, difficulty speaking, headache, and inability to concentrate. Ketoacidosis - a type of metabolic acidosis associated with high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids Ketonuria - Enhanced urinary excretion of ketone bodies Nocturia - Purposeful urination at night, after waking from sleep; typically caused by nocturnal urine volume in excess of bladder capacity or incomplete emptying of the bladder because of lower urinary tract obstruction or detrusor instability. Polydypsia – excessive thirst Polyphagia – excessive eating; excessive appetite for food Polyuria – excessive urination in large volumes Reactive hypoglycemia or postprandial syndrome - recurrent episodes of symptomatic hypoglycemia occurring 2–4 hours after a high carbohydrate meal (or oral glucose load) Atrophy - A wasting of tissues, organs, or the entire body, as from death and reabsorption of cells, diminished cellular proliferation, decreased cellular volume, pressure, ischemia, malnutrition, lessened function, or hormonal changes Cataract - Complete or partial opacity of the ocular lens Diabetic coma - coma that develops in severe and inadequately treated cases of diabetes mellitus and is commonly fatal, unless appropriate therapy is instituted promptly; results from reduced oxidative metabolism of the central nervous system that, in turn, stems from severe ketoacidosis and possibly also from the histotoxic action of the ketone bodies and disturbances in water and electrolyte balance. Gangrene - Necrosis due to obstruction, loss, or diminution of blood supply Gastroparesis - Weakness of gastric peristalsis, which results in delayed emptying of the bowels. Glaucoma - A disease of the eye characterized by increased intraocular pressure, excavation, and atrophy of the optic nerve; produces defects in the field of vision and eventual blindness. Insulin shock - severe hypoglycemia produced by administration of insulin, manifested by sweating, tremor, anxiety, vertigo, and diplopia, followed by delirium, convulsions, and collapse. Lipodystrophy - Defective metabolism of fat Macrovascular disease - a disease of any large (macro) blood vessels in the body. It is a disease of the large blood vessels, including the coronary arteries, the aorta, and the sizable arteries in the brain and in the limbs. Microvascular disease - disease of the smallest blood vessels, such as those found in the eyes, nerves, and kidneys. The walls of the vessels become abnormally thick but weak. Then they bleed, leak protein, and slow the flow of blood to the cells. Nephropathy – any disease of the kidney Neuropathy - A classic term for any disorder affecting any segment of the nervous system Osteopenia - Decreased calcification or density of bone; a descriptive term applicable to all skeletal systems in which such a condition is noted; carries no implication about causality. Retinopathy - noninflammatory degenerative disease of the retina Endocrinology - The science and medical specialty concerned with the internal or hormonal secretions and their physiologic and pathologic relations Glucagon - A hormone consisting of a straight-chain polypeptide of 29 amino acyl residues, extracted from pancreatic alpha cells. Parenteral administration of 0.5–1 mg results in prompt mobilization of hepatic glycogen, thus elevating blood glucose concentration. It activates hepatic phosphorylase, thereby increasing glycogenolysis, decreases gastric motility and gastric and pancreatic secretions, and increases urinary excretion of nitrogen and potassium; it has no effect on muscle phosphorylase. As the hydrochloride, it is used in the treatment of type I glycogenosis (von Gierke disease) and hypoglycemia, particularly hypoglycemic coma due to exogenously administered insulin. Gluconeogenesis - The formation of glucose from noncarbohydrates, such as protein or fat Glycogenolysis - The hydrolysis of glycogen to glucose Glucose tolerance factor - a compound containing chromium that helps in blood sugar regulation Ketone bodies - Any of three related compounds (acetone, acetoacetic acid, beta-hydroxybutyric acid) produced during the metabolism of fats Oral hypoglycemic agents - Anti-diabetic drugs treat diabetes mellitus by lowering glucose levels in the blood; administered orally Self-monitoring of blood glucose (SMBG) - A means of testing levels of blood glucose via a fingerstick blood sample and a blood glucose testing meter to determine the glucose result.