Diabetes and its effect on metabolism

Question 1

what is type 1 diabetes caused by

Answer 1

caused by an autoimmune destruction of beta cells in the pancreas

Question 2

what happens in type 2 diabetes

Answer 2

occurs when cells become resistant to the effects of insulin and the pancreas cannot make enough insulin to overcome the resistance

Question 3

what are the risk factors for type 1 diabetes

Answer 3

family history and age

Question 4

when are you likely to develop type 1 diabetes

Answer 4

at young ages

Question 5

which type of diabetes is insulin dependent

Answer 5

type 1

Question 6

what are the risk factors for type 2 diabetes and prediabetes

Answer 6

• overweight
  -over 45 years of age
• immediate family member with type 2
• not physically active
  -had gestational diabetes
• certain ethnic groups

Question 7

which form of diabetes is more common in americans

Answer 7

type 2

Question 8

what are common symptoms of diabetes

Answer 8

-urinating often
- thirsty
- feeling hungry even though you are eating
- extreme fatigue
- blurry vision
-cuts/ bruises are slow to heal
- weight loss even though you are eating (type 1)
- tingling, pain , numbness in hands and feet (type 2)

Question 9

what is the normal, prediabetic, and diabetic fasting plasma glucose levels

Answer 9

normal: under 100
pre: 100-125
diabetic: over 125

Question 10

what is the normal, prediabetic, and diabetic concentration for oral glucose tolerance test

Answer 10

normal: less than 140
pre: 140-199
diabetes; greater than 200

Question 11

what do prolonged high blood glucose levels lead to

Answer 11

production of advanced glycation end products (AGEs)

Question 12

what is HbA1c

Answer 12

glycated form of hemoglobin

Question 13

how often do we take HbA1c and why

Answer 13

every 3 months because that is the time of RBC turnover

Question 14

what does HbA1c measure

Answer 14

blood glucose over a long period of time

Question 15

what happens in the insulin binding pathway when the insulin receptor doesn’t recognize insulin or cant bind it

Answer 15

glut4 transporters are not moved to the membrane to transport glucose into the cell so circulating levels of glucose remain high

Question 16

what pathway is blocked when insulin cant bind to its receptor

Answer 16

PI3K/Akt/mTOR

Question 17

what effect does diabetes have on other organ systems

Answer 17

• cardivascualr disease
• neuropathy
  -nephropathy
• retinopathy
• poor wound healing
  -skin conditions
  -hearing impairment
• alzheimer’s disease

Question 18

what inflammatory response is increased in diabetic patients

Answer 18

TNF-alpha and IL-1 levels are increased

Question 19

what causes the inflammatory response in diabetic patients

Answer 19

• glycemic control
• AGE’s
  -periodontal disease

Question 20

what happens to fatty acid production if you don’t produce enough insulin or receptor does not recognize insulin

Answer 20

FA production increases

Question 21

what substance causes vasodilation

Answer 21

eNOS

Question 22

what substance causes vasoconstriction

Answer 22

angiotensin 2

Question 23

what are the 2 forms of diabetic retinopathy

Answer 23

dry and wet

Question 24

what are the 2 phases in diabetic retinopathy

Answer 24

1. nonproliferative retinopathy
2. proliferative retinopathy

Question 25

what happens in the nonproliferative retinopathy stage

Answer 25

forms cotton wool spots that obstructs the retina and creates blurred vision

Question 26

what happens in proliferative retinopathy

Answer 26

abnormal growth of blood vessels in the eye that are irreversible

Question 27

what form of retinopathy is more common

Answer 27

dry

Question 28

what are the various forms of insulin available for type 1 diabetes

Answer 28

rapid acting, short acting, long acting

Question 29

how can type 2 diabetes be controlled

Answer 29

diet, exercise, maintain healthy weight, medications

Question 30

how does insulin medication work

Answer 30

lowers blood glucose by stimulating cellular uptake and glycogen synthesi

Question 31

how does metformin work

Answer 31

works on the liver to reduce the release of glucose in type 2 diabetes

Question 32

how do sulphoylureas work

Answer 32

increase insulin release by pancrease

Question 33

how do GLP-1 receptor agonists work

Answer 33

incretin receptor agonists

Question 34

how do DPP-4 inhibitors work

Answer 34

increase incretin levels

Question 35

how do thiazolinediones work

Answer 35

reduces fatty acid oxidation and thereby increases use of glucose as fuel

Question 36

what other pathways does insulin increase the rate of

Answer 36

glycogen synthesis and lipogensis

Question 37

what do angiotensin and renin do

Answer 37

peptide hormones that cause vasoconstriction and subsequent rise in blood pressure

Question 38

what is the mechanism of action of the angiotensin/renin pathway

Answer 38

renin cleaves angiotensin into angiotensin 1 which is then used to form angiotensin 2 from ACE

Question 39

what does NO do

Answer 39

powerful vasodilator with a short half life