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BioChem Exam 2 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What does diabetes show in urine?

A

sugar and high blood sugar

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2
Q

When does diabetes develop

A

when insulin production or use is inadequate

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3
Q

Besides type I and II what are two other types of diabetes?

A

gestational

secondary

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4
Q

What percentage of people in US have diabetes?

A

9.3% or 28.9 million

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5
Q

Symptoms of diabetes

A
  • increased urine
  • increased thirst
  • unexplained weight loss
  • fatigue
  • blurred vision
  • sores that don’t heal
  • increased hunger
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6
Q

What are the three ways you can diagnosis diabetes?

A
  • A1C test (Hemoglobin A1c, HbA1c, glycohemoglobin test)
  • fasting plasma glucose test (FPG)
  • oral glucose tolerance test
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7
Q

What percent would your A1C level be if you had diabetes?

A

6.5 and above

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8
Q

What percent would your A1C level be if you had pre diabetes?

A

5.7 - 6.4

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9
Q

What is a normal A1C?

A

about 5

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10
Q

What would your FPG be in diabetes?

A

126 or above

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11
Q

What would your FPG be in pre diabetes?

A

100 - 125

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12
Q

What would a normal FPG be?

A

99 or below

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13
Q

What would a diabetic oral glucose tolerance test be?

A

200 or above

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14
Q

What would a pre diabetes oral glucose tolerance test be?

A

140 - 199

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15
Q

What would a normal oral glucose tolerance test be?

A

139 or below

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16
Q

Which is more sensitive FPG or oral glucose tolerance test?

A

Oral glucose tolerance test

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17
Q

When is an oral glucose tolerance test given?

A

Fasting 8 - 12h

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18
Q

When is a baseline level drawn for an oral glucose tolerance test?

A

0 hour

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19
Q

Oral glucose tolerance test

A
  • given measured dose of glucose

- blood drawn at various time points

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20
Q

What is the glucose dose based on in US?

A

based on body weight

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21
Q

What type of diabetes is the most common?

A

type II

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22
Q

What percent of people with diabetes have type II?

A

90-95%

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23
Q

When does type II diabetes occur?

A

any age, but mostly older age and obesity

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24
Q

Characteristics of T2D

A
  • hyperglycemia
  • hypertriglyceridemia
  • ketoacidosis NOT common
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25
Q

Insulin levels in T2D

A

normal or elevated

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26
Q

What is T2D often preceded by?

A

obesity

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27
Q

Insulin levels in T2D vs obese with no diabetes

A

not as high as obese with no diabetes

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28
Q

What can cause T2D?

A

IR

impaired B-cell function

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29
Q

Risk factors of T2D

A
  • family history
  • 45 and older
  • race
  • overweight, not active
  • history of gestational
  • impaired glucose tolerance (pre diabetes)
30
Q

When does someone with pre diabetes develop T2D?

A

10 years

31
Q

Gestational diabetes

A
  • during pregnancy

- can cause complications for mother and baby

32
Q

Link between obesity and T2D

A
  • obese are hyperinsulinemic
  • response to insulin diminished
  • elevated FFAs –> cause IR
  • Increase in TNFa, resisting
  • decrease in adiponectin
33
Q

What is the percentage of those with T2D that are obese?

A

80%

34
Q

Factors predisposing obese individuals to T2D

A
  • lipid toxicity
  • adipose inflammation
  • altered adipokine secretion
  • genetic factors
35
Q

Insulin and glucose

A

improves glucose uptake in muscles and adipose tissue

36
Q

Insulin and gluconeogenesis

A

Suppresses

37
Q

Insulin and glycogen

A

promotes storage in liver and adipose tissue

38
Q

Insulin and FAs

A

promotes synthesis in liver and adipose tissue

39
Q

Insulin and fat storage

A

Improves in adipose

40
Q

Insulin and protein

A

suppresses breakdown in muscles

41
Q

What drug targets the liver and gluconeogenesis?

A

biguanides

42
Q

What drug targets the pancreas and stimulate insulin release?

A

Sulfonylureas

43
Q

What drug targets the gut and improves insulin secretion?

A

GLP-1R

44
Q

What drug inhibits glucose reabsorption by kidneys?

A

SGLT2 inhibitors

45
Q

What does adipose tissue release on demand?

A

FFA

46
Q

What is adipose tissue responsive to?

A

insulin

47
Q

What does adipose tissue secrete?

A
  • adipokins
  • cytokines
  • growth factors
48
Q

Adipose tissue inflammation and T2D target

A
  • inflammatory mediators released from obese AT
  • chronic low grade inflammation risk factor
  • TNFa impairs insulin signaling
49
Q

What are some anti-inflammatory drugs used to treat T2D?

A
  • salsalates
  • PPAR gamma agonists
  • Interleukin 1 receptor antagonist
50
Q

Strengths of bariatric surgery

A
  • effective in achieving weight loss
  • reduction in co-morbidities
  • enhanced survival
51
Q

Weaknesses of bariatric surgery

A
  • preoperative mortality
  • surgical complications
  • frequent need for reoperation
52
Q

When does T1D usually appear?

A

Childhood or in teens

53
Q

Insulin and T1D

A

secretion is very low

54
Q

T1D and cells

A
  • defective B-cell function due to autoantibodies
55
Q

Characteristics of T1D

A
  • hyperglycemia
  • hypertriglyceridemia
  • severe ketoacidosis
56
Q

Hyperglycemia

A
  • inability of tissues to take up glucose

- accelerated hepatic gluconeogenesis

57
Q

Hypertriglyceridemia

A
  • Increased VLDL production
  • chylomicron accumulation
  • low LPL activity
58
Q

Ketoacidosis

A
  • Increased AT lipolysis

- accelerated hepatic FA oxidation

59
Q

Management of T1D

A
  • insulin therapy
  • islet cell transplantation
  • dietary and lifestyle modification
60
Q

Complications of insulin therapy

A
  • hypoglycemia
  • insulin allergy
  • immune insulin resistance
  • lipodystrophy at injection site
61
Q

Which type of diabetes is insulin deficiency?

A

T1D

62
Q

Which type of diabetes is insulin resistance?

A

T2D

63
Q

Long term complications of diabetes

A
  • stroke
  • heart disease
  • HTN
  • vascular disease
  • foot problems
  • eye disease
  • renal disease
  • neuropathy
64
Q

Biochemical mechanisms of diabetes complications

A
  • advanced glycation end products
  • sorbitol pathway
  • oxidized LDL
  • oxidative stress
65
Q

Polyol pathway

A
  • conversion of glucose to sorbitol
66
Q

What enzyme is used in the Polyol pathway?

A

aldose reductase

67
Q

When is the polyol pathway activated?

A

if large amounts of glucose are present

68
Q

What does an increased sorbitol accumulation lead to?

A

increased oxidative stress

69
Q

What can polyol pathway cause?

A

glycation of cellular proteins impairing their function

70
Q

What is the clinical significance of the polyol pathway?

A

Diabetic complications

BioChem Exam 2 (6 decks)

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