Diabetes Handout Flashcards
Diabetes is a chronic dz characterized by _____ by the islets of landhans
or by lack of response of target cells to
leads to disturbances w
impaired glucose leads to
Secondary DM results from
def of insulin sec
insulin (insulin resistance)
carb/fat/prot metabolism
persistent hypergly
dz that destroys panc islets (panc, panc ca, drugs)
Primary DM
Type 1
typical age
Type 2
typical age
Maturity onset DM of the young
similar to ___, onset is ____
IDDM
juvenile
NIDDM
adult, obese
MODY
T2, earlier, not obese
DM more common in
Leading cause of E, B, A
elderly
ESRD, blindness, amputations
T1DM
onset less than
begins in ___, dx in
pt usually not
Patho
caused by
20
childhood, adolesence
obese
severe insulin def/absence
destruction of panc islets
Genetic linkage of T1DM
Most freq occurs in
concordance w
strong assc w
these genes probably promote
Caucasians, NE descent
Identical twins
HLA-DR3/4
AI destruction of islets
Chronic autoimmune attack of T1DM directed against
depletes ___, leading to ____
Insulitis, characterized by
many pts have ___ in bloodstream
directed against intracellular
may have other ____, such as
panc B cells
B cells, atrophy/fibrosis of islets
early, lymph rich inflam infiltrate w/in islets
anti-islet cell ab
IC islet cell antigens (such as insulin)
AI dz, Graves/Addison/thyroiditis
Enviro factors for T1DM
viruses include
Hypothesis
viral infect of B cells
Coxsackie B, CMV, EBV
virus infects B cells w appropriate HLAD, induce AI rxn
T2DM onset above
indiv usually ____, link is
particularly seen w __, even w/out
Concordance bw identical twins
First degree relative T2DM have 5-10x ___ of DM than those w out FH
____ to HLA genes
can result from
30
obese, insulin resistance
central obesity, hypergly
exremely high
inc risk
not linked
Non HLA gene defects
T2DM has ___ of AI involvement
does not have
Derangement of ___ occurs
Islets can produce ____, but not enough to control
relative _____, even though serum insulin levels may be
in late stages, absolute ___ may develop (not like T1)
possibly caused by
no evidence
no insuliis, AA
insulin sec by b cells
insulin, hypergly
insulin def, normal/inc
insulin def
B cell damage w genetic predispos to injury, metabolic toxicity from hypergly
Insulin resistence means reduced
Could be dec number of ___ on target cells
or impaired ___ by insulin
such as GLUT4 not
Amylin is peptide produced by
in T2DM, accumulates w/in
has staining characteristics of
in late stage, islets can be replaced by
responsiveness of target cells to insulin
insulin recep
post recep signalling
trans to CM
B cells
islets
amyloid
amyloid
Long lasting hypergly can lead to
___ is the process when glucose non enzymatically attaches ____ of proteins
Glycated proteins can cross link one another to form
IC hypergly occurs in tissue that do not require
results in glucose within
Glucose converted to ___ via the polyol path
Sorbitol accumulates, leading to
forming of adv glycation end products
glycation
amino groups
AGEp
glucose uptake (eye lens, schwann cells of pN)
cells
sorbitol
osmotic cell injury, water influx, impaired pumps
Hyperglyc leads to activation of IC
Due to ___ synthesis, increased by ___ intermediates due to excess
Inc in ___ ions w/in cell due to ischemia/vasc dz
PKC
DAG, glycolytic, glucose
Ca
Vasc complications
accelerates ___ in l/m sized __
More ___ and occurs ___
Possible mechs
__ of serum lipoproteins may cause changes
___ tends to be low, ___ tends to be high, favoring
Glycated ___ w/in BV wwalls for AGE complexes which trap ___, this promotes
AGE modified plasma proteins bind receptors on ____, causing release of proatherogenic _____
inc incidence of ____
atherosclerosis
extensive, earlier
glycation
HDL, LDL, atherogenesis
collagen, LDL, atherogenesis
endothelial cells, cytokines/GF
HTN
Diabetes inc risk of _____ (MCC death in diabetics), as well as _____, ____ leading to ____
H___
assc w ___, more prev/severe in diabetics
Arteriolar walls become ____ w ___ lumens
Appears as ____ (glassy pink)
Dec ___ to tissue (ischemia)
leads to
MI, stroke, gangrene of LE, amputation
Hyaline arterolosclerosis
thickened, narrowed
hyaline
blood supply
PWH
Microangiopathy
diffuse thickening of
big problem in
Thickening due to ___ binding to glycated proteins w/in
Diabetic capillaries become ____
possibly due to ____ to endo cells, inc
basement membranes of caps
retina/kidneys
plasma proteins, bm
leaky to plasma proteins
AGE binding, permeability
