diabetes Flashcards
two aspects of DM type 2
decreased reaction to insulin
islet beta cell dysfunction
is there a genetic component to type 2 DM
yes
what do you get first when insulin resistance develops
beta cells compensate leading to hyperinsulinemia
what is the problme with free fatty acids
lipotoxiticy kills beta cells -> apoptosis
what is MODY
maturity onset diabetes of the young - single gene mutation diabetes
how frequent is MODY
up to 5%
how prevalent is gestational diabetes
20%
which test for gestational dm
oral glucose tolerance test
mech of action - metformin
inhibits gluconeogenesis and decreases insulin resistance, glucose take-up by skeletal muscles improved
Sulfonylureas and prandial glucose regulators mechanism of action
close potassium channels to increase insulin secretions
side effect of Sulfonylureas and prandial glucose regulators
hypoglycemia
names of DPP4 inhibitirs
–gliptin eg linagliptin
main fuel in longterm fasting
ketones
what causes damage in DM
glucose toxicity and lipotoxicity
proliferative vs non-proliferative retinopathy in DM
% of DM pts with nephropathy
40%
how does diabetes lead to hypoglycemia
unopposed glucagon takes glucose out of blood and promotes glycogen synthesis
why does the body produce ketones in DM
thinks it is in starvation state because no insulin
how does hypertriglyceridemia cause insulin resistance
the non-used by the mitochondria fats stop the activated insulin receptor being able to transport the GLUT4 protein to the membrane
where does direct hernia travel
transversalis fascia (which makes up the posterior wall of the inguinal canal) and the superficial ring.
what does helicobacter pylori secrete to help it survive
urease
what do chief cells secret
pepsinogen
what do parietal cells secrete
HCl and intrinsic factro
