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Biochem BLOCK 4 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What is the percentage of diabetes in KY

A

11.3%

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2
Q

What is the leading cause of blindness in adults?

A

Diabetes

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3
Q

Diabetes is the _______ leading cause of death in the US

A

Seventh

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4
Q

Is DM a single disease?

A

Not a single disease but rather a group of multifactorial, polygenic syndrome characterized by elevation of fasting blood glucose caused by a relative or absolute deficiency in insulin

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5
Q

Diabetes is a group of multifactorial, polygenic syndrome characterized by ____________ caused by a relative or absolute ________________

A
  • elevation of fasting blood glucose

- deficiency in insulin

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6
Q

This type of DM is insulin-dependent or juvenile onset

A

Type 1

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7
Q

This type of DM is insulin-independent

A

Type 2

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8
Q

What are the 3 types of DM

A

Type 1
Type 2
Gestational

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9
Q

Age of onset of type 1 DM

A

Usually during childhood or puberty; symptoms develop rarely

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10
Q

Age of onset of type 2 DM

A

Freq after age 35; symptoms develop gradually

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11
Q

Nutritional status at time of disease onset in type 1 dm

A

Freq undernourished

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12
Q

Nutritional status at time of disease onset for type 2 dm

A

Obesity usually present

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13
Q

An autoimmune disease in which the beta cells of the pancreas are destroyed by cells of the immune system

A

Type 1

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14
Q

What is the trigger of type 1 DM

A

Physiologic stress and over the period of years, the beta cells are destroyed

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15
Q

When is the onset of type dm

A

Typically during childhood or puberty. Happens suddenly

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16
Q

Genetic disposition for type 1 dm

A

Some genetic predisposition

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17
Q

Symptoms of type 1 dm

A
  • 3 P (polyuria, polydipsia, and polyphagia (excessive urination thirst, and hunger)
  • ketoacidosis
  • fatigue and weight loss
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18
Q

Because of the deficiency of insulin, profound changes are seen in untreated type 1 dm: how does the body react?

A

As if it is in starvation mode

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19
Q

Why is there hyperglycemia in type 1 dm

A

Results from increased hepatic gluconeogensis and decreases glucose uptake by insulin sensitive GLUT-4 of adipose tissue and muscle

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20
Q

What does ketones result from in type 1 dm

A

The massive mobilization of FA from adipose tissue followed by hepatic ketogenesis

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21
Q

Lipoprotein lipase in type 1 dm

A

It is not sufficient in the absence of insulin causing a build up if VLDL

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22
Q

Ketosis and ketoacidosis in type 1 dm

A

Adipocytes release FA to be used as energy

In the liver excess FAs are used for ketone bodies

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23
Q

Hyperlipidemia in type 1 dm

A

In the liver, excess supply of FAs cannot be completely used for oxidation or ketogensis and become incorporated and secreted into VLDVL
-in the circulation lipoprotein lipase (LPL) levels are low due to less enzyme production-VLDL and chylomicrons accumulate causing hypertriacylglycermia

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24
Q

Treatment for type 1 dm

A

Exogenous insulin is required

25
Q

Treatment for type 1 dm is divided into two segments:

A

Standard and intensive therapy

26
Q

_______ is used to ascertain the long term effectiveness of the control of blood sugar

A

HbA1C

27
Q

Higher glucose means what for HbA1C?

A

More Hb is glycosylated to HbA1C

28
Q

Why is HbA1C a good measuring tool

A

Since RBCs live about 100 days, the HbA1C level gives an accurate measurement of blood glucose levels over several months

29
Q

What is the cut off limit for HbA1C to be healthy

A

6.5%

30
Q

Appropriate dosage of insulin is difficult to achieve and common complication of excess insulin administration is __________

A

Hypoglycemia

31
Q

Why is it so bad for someone with type 1 DM to become hypoglycemic?

A

The cells of the pancreas that produce glucagon also become compromised and the neuropathy that develops as the disease progresses inhibits epinephrine secretion, which are the two systems the body uses to defend against hypoglycemia

32
Q

The frequency with hypoglycemic episodes, coma, and seizures is particularly high with _________

A

Intensive treatment regimens

33
Q

What is the most common form of diabetes?

A

Type 2

34
Q

Who has the highest prevalence for type 2 DM

A

American indians, alaskan natives, hispanic and latino americans, African americans, and asian Americans

35
Q

How does type 2 dm develop?

A

Gradually without obvious symptoms

36
Q

How does type 2 dm manifest?

A

As a result of the combination of two conditions

  1. Insulin resistance
  2. Dysfunction beta cells
37
Q

Which has a stronger genetic predisposition, type 1 or type 2?

A

Type 2

38
Q

The decreased ability of target tissues, such as liver, adipose, and muscle, to respond properly to normal (or elevated) circulating concentrations of insulin

A

Insulin resistance

39
Q

Causes of insulin resistance

A
  • excess body weight
  • physical inactivity
  • older age
40
Q

If you have insulin resistance, do you have diabetes?

A

No, you have to have insulin resistance and dysfunctional beta cells. Just having insulin resistance would be prediabetic

41
Q

Type 2 DM develops in insulin resistant individuals who also show what

A

Impaired beta cells function that CANNOT longer secrete sufficient insulin to compensate for the elevated blood glucose levels

42
Q

Risk factors for the progression of insulin resistance and type 2 DM are

A
  • obesity
  • physical inactivity
  • aging
43
Q

Possible causes for B cells deterioration

A
  • glucose and free FAs toxicity
  • proinflammatory environment
  • genetics
44
Q

How are the metabolic changes in type 2 DM in comparison to Type 1

A

Similar in scope but usually milder because some insulin is still usually present

45
Q

What can vary within those with type 2 dm

A

Some variable degrees of hyperglycemia and hyperlipidema depending on the progression of the disease

46
Q

What is one key difference between type 1 and type 2 DM?

A

Ketosis is rare in Type 2 DM

47
Q

What are some lifestyle changes one can make to manage type 2 DM

A

Weight reduction, regular exercise, and diet modification

48
Q

What are some drugs used to manage type 2 dm

A
  • metformin
  • sulfonylureas
  • thiazolidinediones
  • a-glucosidase inhibitors
  • insulin therapy may be required
49
Q

Bariatric surgert in management of type 2 dm

A

Restricting the amount of food the stomach can hold to help with weight loss

50
Q

What are the main things that can be done to manage type 2 DM

A
  1. Lifestyle change
  2. Drugs
  3. Bariatric surgery
51
Q

A type of diabetes that is similar to type 2 but is first seen or diagnosed when a women is pregnant

A

Gestational diabetes

52
Q

Which type of dm is gestational dm most similar to?

A

Type 2

53
Q

When does gestational dm go away?

A

After the baby is born

54
Q

What is common of woman who are diagnosed with gestational diabetes?

A

Many, not all, women are usually overweight before getting pregnant. Other risk factors include family hx of dm, twins, older age

55
Q

What are potential problems for the baby if gestational DM is not treated?

A
  • preterm birth
  • large baby
  • low blood sugar after birth
  • stillbirth
  • increased risk for type 2 DM
56
Q

Abnormal metabolic changes in diabetics lead to

A
  • accelerated (early onset) atherosclerosis and CVD
  • retinopathy-leading cause of adult blindness
  • nephropathy
  • neuropathy
57
Q

What is the leading cause of adult blindness?

A

Retinopathy caused by abnormal metabolic changes in diabetics

58
Q

In tissues in which glucose uptake is not dependent on insulin, hyperglycemia causes __________

A

An increase in uptake

59
Q

What is one cause of cataracts due to metabolic abnormalities in diabetics?

A

Lens of the eye will take up excess glucose and convert into sorbitol and will cause cataracts

Biochem BLOCK 4 (11 decks)

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