James Carter

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Identify and describe the function of the pancreas
Secretes hormones, exocrine function (Acinar cells) synthesis, storage and secretion of digestive enzyme via pancreatic duct. Endocrine - (islet cells) secrete insulin and glucagon to regulate the blood glucose
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What do alpha cells produce?
Glucagon to decrease blood glucose levels
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What do beta cells produce?
Insulin in response to high blood glucose levels
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What do delta cells produce?
Somatostatin that inhibits the secretion of insulin and glucagon
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What is the role of insulin
Lowers blood glucose levels, converts glucose in glycogen, decreases glycogenolysis, decreases glucogenolysis, increases lipogenesis
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What is the role of glucagon?
accelerates the breakdown of hlycogen into glucose in the liver, converts other nutrients into glucose in the liver, then released into blood stream
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What is glycogenolysis?
Breakdown of glycogen to glucose
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What is glucogenolysis?
Conversion of other nutrients to glucose in the liver
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What is lipogenesis?
Production and accumulation of fat?
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Define diabetes mellitus
A metabolic disorder characterised by a raised level of glucose in the blood casued by an absence of, deficiency in or insensitivity to the hormone insulin. Results in an inability to control the use and storage of glucose
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What are the causes of diabetes?
Multifactorial predisposing factors including: environmental, obesity, immunological (destroying beta cells), viral/bacterial infections, genetics
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Define type 1 diabetes
Islet B cell destruction leading to absolute insulin deficiency which then has to have insulin replacement by subcutaneous injection/infusion
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Describe type 1 diabetes
characterised by hyperglycaemia, breakdown of body fats and proteins and development of ketosis.
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How does the body respond in type 1?
Hyperglycaemia cuases serum hyper-osmality drawing water from the intracellualar spaces into the circulation. This increases blood volume which increases renal bloof flow and hyperglycaemia acts as a diuretic and overall outcome is polyuria.
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What are the effects of hyperglycaemia in type 1?
Glucose inability to enter cells -reduced energy production, stimulates hunger (polyphagia), patient loses weight due to water loss - hypertension and tachycardia. Body uses other energy sources
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How does the body respond to hyperglycaemia?
Glucogenesis occurs - amino acids and body proteins used to form new glucose. Lipolysis - breakdown of fat stors into glycerol - produced ketones. This causes weight loss and neurological deficits can be seen
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What are the signs and symptoms of type 1?
Glycosuria, polyuria, polyphagia, polydipsia, weight loss, blurred vision, fatigue/tiredness, nausea/abdominal pain, DKA, coma, muscle cramps
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What is insulitis?
Chronic inflammatory process which destroys beta cells production of insulin
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What are the 3 symptoms that glycosuria gives?
Passing large quanitites of urine, thirst, genital soreness
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What is glycosuria?
When glucose spills over into urine
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What is polyuria?
Large quanities of urine
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what is polydipsia?
Thirst
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What is polyphagia?
Hunger
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Define type 2 diabetes
Predominantly insulin resistance to predominantly insulin deficiency
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What are the non-modifable factors for type 2?
Age, cultural background, family history, history of gestational diabetes, genetic, history of large baby in pregnancy
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What are the modifiable factors for type 2?
Obesity, BMI >25 with high abdo fat, hypotension, lack of physical activity
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What are the 3 physiological abnormalities in type 2?
Resistance to action of insulin in muscle and liver fat, defects in insulin secretion in response to glucose stimulus, increased glucose produced by the liver
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What happens in type 2 development?
insulin resistance - insulin receptors present on cell membrane, insulin locks onto membrane, glucose channel opens, insulin molecule and receptor enter the cell. Receptor is recyled to the surface to occur again - reistance occurs due no recyling.
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What is beta cell failure?
Cells continue to produce enough insulin -ineffective - cells become exhausted and die - insulin production reduces so further hyperglycaemia
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What are the complications of beta cell failure?
Cerebrovascular disease, retinopathy, cardiovascular disease, nephropathy, neuropath, peripheral vascular disease
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How is hypoglycaemia managed in type 2?
assess and modify risk factors, education, healthy diet, monitor blood glucose, ref. diabetic specialist, r/v. insulin manangement
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What is diabetic ketoacidosis?
Absolute deficiency of insulin and increase in insulin counter-regulatory hormones
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What are nursing intervention of DKA?
Vital signs, blood, fluid input/output, urinalysis
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Symptoms of DKA
Tachycardia, glucose levels >11 and ketones >3 , polyuria, polydipsia, vomiting, sweet smelling breath
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How is DKA treated?
Normalise osmolality, replace fluids, electrolyte replacement and balance, normalise blood glucose levels
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What are the complications of diabetes?
Hyper/hypoglycaemia, micro and macrovascular complicatios, retinopathy, nephropathy, MI
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Describe the DAFNE programme?
Dose adjustment to allow for normal eating, provides necessary skills to estimate the carbohydrates in each mean and correct dose of insulin
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What does the results of James' urine test show?
Glucose - large quanitite, thirst, gential soreness. Ketones - ?Ketoacidosis. Proteins - ?UTI, ?kidney problems. Pale - sig. intake of water, diuretic drug
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What is hyperinsulinemia?
Due to hyperglycaemia developing, pancreas secretes more insulin - blood sugars begin to rise
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Other cards in this set

Card 2

Front

What do alpha cells produce?

Back

Glucagon to decrease blood glucose levels

Card 3

Front

What do beta cells produce?

Back

Preview of the front of card 3

Card 4

Front

What do delta cells produce?

Back

Preview of the front of card 4

Card 5

Front

What is the role of insulin

Back

Preview of the front of card 5
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