Diabetes and Insulin Resistance

Question 1

diabetes mellitus

Answer 1

two types due to metabolism impairments with insulin

Question 2

type I diabetes

Answer 2

early onset, rare, lack of insulin secretion, pancreatic problems

Question 3

type II diabetes

Answer 3

adult onset, due to receptors not working, most common

Question 4

gestational diabetes

Answer 4

increased insulin in mother’s diet makes the fetus bigger than usual. mother is glucose intolerant only during pregnancy

Question 5

LADA

Answer 5

latent autoimmune diabetes (type I DM in older people)

Question 6

MODY

Answer 6

maturity onset diabetes of the young

get as an adolescent due to gene mutation

Question 7

secondary DM

Answer 7

get diabetes after these other problems occur

1. cushing syndrome
2. cancer
3. drugs that induce hyperglycemia
4. chronic pancreatitis

Question 8

diabetes-intracellular glucose defiency

Answer 8

get a breakdown of protein and fat due to glycogen depletion
hyperglycemia in blood but it cannot enter the cells (starving cells)
get hyperphagia (increased appetite)

Question 9

lipemia

Answer 9

increased fat in the blood due to diabetes. an increase in glucagon causes FA oxidation so there is more FFA in the plasma

Question 10

how does obesity cause insulin resistance?

Answer 10

increase in fat causes an increase in FFA that cannot go into visceral adipose tissue.
there is more fat deposited to the skeletal muscle and liver which causes insulin resistance

Question 11

dysbiosis

Answer 11

disruption of the microbiome, in the gut this can lead to insulin resistance and obestiy

Question 12

what are some causes of obesity?

Answer 12

1. genetics
2. fam history
3. low exercise
4. high calorie intake
   5 . metabolism
5. cushing’s
6. hypothyroidism
7. insulinoma

Question 13

Kir6.2

Answer 13

ATP sensitive channel gene; implicated in risk factor for diabetes

Question 14

causes of obesity linked insulin resistance

Answer 14

1. increased FFA
2. intracellular lipid accumulation
3. receptor downregulation
4. altered microbiome
5. high upperbody to waist/hip ratio

Question 15

metabolic syndrome

Answer 15

get fat accumulation at the waist
also have high triglycerides, glucose, blood pressure, HDL
these all occur to increase risk of stroke, heart attack, etc.

Question 16

polysystic ovarian syndrome

Answer 16

insulin resistance!
risk of metabolic syndrome
hyperandrogenism
signs: central obesity, acne, hair loss

Question 17

clinical features of diabetes

Answer 17

1. polyuria and polydipsia (thirst and urination)
2. weakness/fatigue
3. polyphagia (hunger) with weight loss
4. blurred vision
5. peripheral neuropathy
6. keoacidosis

Question 18

what are the 3 tests done to examine insulin sensitivity?

Answer 18

1. Glucose tolerance test- look at clearnace of glucose after eating some
2. insulin tolerance test- give insulin and look at glucose tolerance
3. hyperinsulinemic-euglycemic clamp

Question 19

what is HbA1C

Answer 19

hemoglobin A1C, it is glycated Hb

Question 20

what is the normal and diabetic FPG level?

Answer 20

normal FPG: 100mg/dL

diabetes: 126mg/dL

Question 21

what is the diabetes diagnosis based on?

Answer 21

1. Fasting glucose 126

2. random glucose levels above 200mg/dL

Question 22

how does TZD work?

Answer 22

it is a drug that acts on tissue to increase glucose uptake

Question 23

somogyi effect

Answer 23

the tendency of the body to react to hypoglycemia by overcompensating, thus resulting in high blood sugar (i.e. during exercise)

Question 24

dawn phenomenon

Answer 24

get high blood glucose early in the morning due to a release of counterregulatory hormones.

Question 25

diabetic ketoacidosis

Answer 25

breakdown ketones due to inability to use glucose, gives off acetone

Question 26

hyperglycemic hyperosmolar coma

Answer 26

severe hyperglycemia and hyperosmolarity and dehydration | causes confusion and lethargy

Question 27

what is the most common cause of death in patients with DM?

Answer 27

heart attack