Diabetes Flashcards
MODY types?
2- glucokinase deficiency
others- delayed insulin response too gllucose
MODY description?
Autosomal dominant –> dysfunctional beta cells
MOD treatment?
sulfonylureas (increase intracellular Ca2+)
What does HLA status have to diabetes?
Human leukocyte antigen
- 95% 3 or 4
- 3 aB against beta cells (later onset)
- 4 aB against insulin
- 2 protective
TCF7L2 effect
homozygous –> doubles risk (T2DM)
FTO effect
Increased obesity risk; works by modulate methylation of RNA
EPO
increased risk for retinal complications
What does acetoacetic acid have to do with diabetes?
ketone produced by DKA
What does beta hydroxybutyric acid have to do with diabetes?
ketone produced by DKA
What causes oxidative stress and apoptosis? what does this cause?
excess glucose shunting to alternative pathways
macro and microvascular problems
Manifestations of hyperglycemia
Thirst, frequent urination,
blurred vision
fatigue
hunger
Prediabetic fasting glucose? Goal for diiabetics?
100-125 mg/dL
goal<130
Prediabetic OGTT? Goal?
140-200mg/dL
Goal <180
Prediabetic HbA1C? Goal?
5.7-6.6%
<7%
Blood pressure goal?
<130/80
Goal LDL?
<100mg/dL
What makes up metabolic syndrome?
Waist circumference high triglycerides low HDL High BP High fasting glc
Types of insulin?
long acting bolus insulin (short acting)
What does metformin do?
Decreases production/output of glucose form liver
T2DM, beta cell failure after how many years?
10 years after diagnosis (usu 50% fxn at diagnosis)
Path: What color is insulin?
Brown yellow; stored as hexamers
Path: what color is glucagon?
Red
What are the CRHs?
glucagon
epinephrine
cortisol
Growth hormone
How do you prolong incretin in treating diabetes?
GLP1 analogues (generally better, but nausea and subQ) DPP4 inhibitors
