Block 1 -- Diabetes I Flashcards
Normal [glucose] (mg/dL and mM)
70-130 mg/dL
4-7 mM
function of beta cells
insulin + amylin
fx of amylin:
1) satiety
2) delayed glucose absorption
3) suppress gcg secretion
Sxs of DM:
1) polyuria, polydipsia, polyphagia
2) weight loss
3) fatigue
4) irritability
T2DM diagnosis criteria:
1) Sxs + random [glucose] ≥ 200 mg/dL
2) FPG ≥ 126 mg/dL
3) 2hr [glucose] ≥200 mg/dL during OGTT
4) A1c ≥ 6.5%
pre-diabetes criteria:
IFG 100-125 mg/dL
IGT 140-199 mg/dL
A1C 5.7-6.4
What is most common diagnostic test?
FPG (convenience, cost)
Why is A1C measured?
most reactive site of Hb for non-enzymatic glucose binding
– correlates with fasting and post-prandial [glucose]
What tissue changes occur in DM?
1) altered protein function/turnover, cytokine activation
2) osmotic + oxidative stress
3) altered GFR
4) reduced motor and sensory CV
What factors affect insulin sensitivity?
1) age
2) body weight
3) physical activity
4) illness
What changes occur to skeletal muscle in DM?
1) decreased glucose uptake
2) increased lipid storage
What changes occur to adipocytes in DM?
1) lipolysis, FFA release
2) muscle/liver FFA storage leads to chronic inflammation (macrophage)
3) adipocytokine release
- - TNF-alpha, IL contribute to IR
What changes occur to the liver in DM?
1) unrestrained glycogenolysis and gluconeogenesis
2) decreased glucose uptake and glycogen synthesis
3) lipogenic effects = steatosis
Mechanism for CV complications:
1) macrovascular (atherosclerotic) changes
What DM complications are related to microvasculature?
retino-, nephro-, neuropathies
