Diabetes Complications

Question 1

One of every ________ healthcare dollars is spent on diabetes.

Answer 1

seven

Question 2

The leading causes of death in those with diabetes is ____________.

Answer 2

ischemic heart disease (#1) and other heart diseases (#2)

Question 3

If you have diabetes and you’ve never had a heart attack, your risk of having a heart attack is the same (roughly) as someone who ____________.

Answer 3

does not have diabetes but has had a heart attack

Question 4

Those with diabetes have much poorer survival post-______ than those without.

Answer 4

MI

Question 5

Insulin suppresses the production of _____________.

Answer 5

triglycerides; defects in insulin lead to hypertriglyceridemia

Question 6

True or false: statins are contraindicated in those with diabetes.

Answer 6

Heck no! Every person 40-75 with diabetes should be receiving a statin; it lowers numerous kinds of mortality.

Question 7

______ is made in excess in those with diabetes, leading to clots.

Answer 7

PAI-1 (plasminogen-activator inhibitor-1)

Question 8

Why are some tissues preferentially affected by hyperglycemia?

Answer 8

Some tissues –like the retina, nerves, and pericytes of the retina –contain aldose reductase that initiates the polyol pathway by converting glucose to sorbitol; the downstream product accumulates on proteins and destroys cells. (There are a couple other pathways.)

Question 9

What is it called when an amino group binds to a glucose?

Answer 9

Schiff base

Question 10

Schiff bases transition to __________, which themselves transition to _____________ –an irreversible product.

Answer 10

Amadori product; advanced glycation end products

Question 11

Why are advanced glycation end products deleterious?

Answer 11

Because they have a high affinity for amino groups on other collagen molecules and cross-link collagen; additionally, they bind to fat more easily, thus causing plaques to form

Question 12

After ten years with diabetes, ______ percent of people will develop diabetic retinopathy.

Answer 12

90

Question 13

Early intensive control of diabetic retinopathy leads to a “_________” effect.

Answer 13

legacy (in which people had better outcomes even years after the study interventions ended)

Question 14

True or false: about two-thirds of people with diabetes will develop diabetic nephropathy.

Answer 14

False. Only one-third.

Question 15

Distal symmetrical polyneuropathy –the most common form of diabetic neuropathy –initially presents with ___________ and then progresses to ____________.

Answer 15

hyperalgesia; absence of pain

Question 16

Roughly 80% of hospitalizations and deaths from diabetes are due to ________________.

Answer 16

cardiovascular disease

Question 17

Early intensive control of blood sugar in diabetics has been shown to _______________.

Answer 17

decrease future risk of cardiovascular events

Question 18

Fibroblasts are stimulated to produce more ECM by excess ____________ activity.

Answer 18

protein kinase C

Question 19

What is mononeuritis multiplex?

Answer 19

Vascular occlusion of the blood supply to one nerve –can improve with time

Question 20

Diabetes is the number one cause of ______________.

Answer 20

blindness, renal failure, and non-traumatic foot amputations

Question 21

Aldose reductase is a potential therapeutic target is the ___________ pathway.

Answer 21

polyol

Question 22

Diabetic foot disease is caused by ______________.

Answer 22

impaired blood flow to the feet coupled with impaired sensation