Diabeetus Flashcards
What are the exocrine functions of the pancreas?
Producing digestive enzymes released into the duodenum for protein, fat, and carb breakdown.
What are the endocrine functions of the pancreas?
Regulating blood glucose via hormones from the islets of Langerhans.
What hormones do pancreatic beta and alpha cells release?
Beta cells release insulin; alpha cells release glucagon.
How does insulin lower blood glucose?
Facilitates glucose uptake and promotes glycogen storage.
How does glucagon raise blood glucose?
Stimulates glycogen breakdown and glucose production.
What are the four main types of diabetes mellitus?
Type I: Insulin-dependent, autoimmune destruction of beta cells.
Type II: Non-insulin-dependent, linked to insulin resistance.
Type III: Secondary to conditions like pancreatitis.
Type IV: Gestational diabetes due to pregnancy-related insulin resistance.
What are the three cardinal symptoms of diabetes?
Polydipsia (thirst), polyuria (urination), and polyphagia (hunger).
What is the sorbitol pathway?
Converts excess glucose to sorbitol and fructose, causing osmotic stress in cells.
Why does the sorbitol pathway cause damage?
Osmotic stress leads to cell damage, contributing to neuropathy and blindness.
What does the fasting blood glucose (BG) test measure?
Baseline glucose levels after an overnight fast.
What does the glucose tolerance test measure?
BG response after consuming a glucose drink over several hours.
What is the structure of insulin?
A peptide hormone with alpha and beta chains linked by disulfide bonds.
What is proinsulin?
The inactive form of insulin that becomes active after C-peptide cleavage.
What are insulin secretagogues?
Substances like glucose, amino acids, and incretins that stimulate insulin release.
What is the insulin receptor pathway?
Insulin binds to a tyrosine kinase receptor, initiating GLUT translocation for glucose uptake.
What is GLUT2, and where is it found?
A low-affinity glucose transporter in beta cells and the liver, active at high BG levels.
What is GLUT4, and where is it found?
A moderate-affinity glucose transporter in muscle and adipose tissue, responsive to insulin.
What are the four types of insulin preparations?
Rapid: Lispro, aspart.
Short: Regular insulin.
Intermediate: NPH.
Long: Glargine, detemir.
What is an intensive insulin dosing regimen?
Basal + bolus with long-acting insulin for baseline and rapid-acting for meals.
What is a conventional insulin dosing regimen?
Premixed insulin (e.g., 70:30) for less precise, easier dosing.
How does an insulin pump work?
Provides continuous subcutaneous insulin for tight glucose control.
How do you calculate insulin for carb coverage?
Divide carb intake by the carb-to-insulin ratio (e.g., 60g carbs ÷ 15g/unit = 4 units).
How do you calculate insulin correction for high BG?
Determine how many units lower BG to the target level (e.g., 200 mg/dL → 100 mg/dL needs 2 units if 1 unit lowers 50 mg/dL).
What are the symptoms of hypoglycemia?
Anxiety, blurred vision, sweating, slurred speech, shakiness, and confusion.
How is hypoglycemia treated?
Glucose tablets, sugary drinks, or glucagon injection if severe.
What is the MOA of biguanides like metformin?
Reduce hepatic glucose production.
What are insulin secretagogues, and give examples?
Drugs that increase insulin release by blocking potassium channels (e.g., sulfonylureas, meglitinides).
What is the MOA of thiazolidinediones (TZDs)?
Enhance insulin sensitivity via PPAR activation.
What is the MOA of alpha-glucosidase inhibitors?
Delay carbohydrate absorption in the intestine.
What is the MOA of bile acid binding resins?
Reduce glucose reabsorption by binding bile acids in the intestine.
What is an example of an amylin analog, and how does it work?
Pramlintide; suppresses glucagon release and reduces BG.
What are examples of incretin-based therapies?
GLP-1 agonists (e.g., semaglutide) and DPP-4 inhibitors.
What is the MOA of SGLT2 inhibitors?
Increase glucose excretion in urine.
What are adjunctive therapies for pre-diabetes?
Diet, exercise, metformin, statins, and ACE inhibitors.
What is the first-line treatment for Type II diabetes?
Lifestyle interventions and metformin.
What are second-line treatments for Type II diabetes?
Sulfonylurea, TZD, or DPP-4 inhibitor.
What are third-line treatments for Type II diabetes?
SGLT2 inhibitors, GLP-1 agonists, or basal insulin.
