Diabetes Mellitus Flashcards
Metabolic syndrome is a group what what 6 risk factors?
Abdominal obesity, dyslipidemia, hypertension, insulin resistance, prothrombotic state, proinflammatory state
Prothrombotic state means high __ in blood
High fibrinogen or plasminogen activator inhibitor-1 (more likely to have blood clots)
Give the values for each:
- Elevated waist circumference
- Elevated triglycerides
- Reduced HDL
- Elevated blood pressure
- Elevated fasting glucose
~metabolic syndrome is if you have 3 more
- Men= or greater than 40 inches; women= or greater than 35 inches
- Equal or greater than 150 mg/dL
- Men = less than 40 mg/dL; women= less than 50 mg/dL
- Equal or greater than 130/85 mmHg
- Equal or greater than 100 mg/dL
Ketosis is more common in type 1 or type 2 diabetes?
Which one is more genetic?
Type 1
Type 2
- Plasma insulin levels in type 1 vs type 2 diabetes
2. Acute complications of both?
- Type 1 = low to absent
Type 2= normal to high - Type 1= ketoacidosis
Type 2= hyperosmolar coma
Normal blood glucose levels
70-100 mg/dl OR 4-6 mM
What is the renal threshold value?
180 mg/dl
Well fed state occurs after
During well fed state, what happens to endogenous glucose production? Glucose disposal?
Eating a meal with carbohydrates
Endogenous glucose production is suppressed; rate of glucose disposal increases (glucose going into tissues)
Which hormone increases glucose stimulated insulin secretion and glucose suppression of glucagon secretion
GLP-1
How much time does it take for glucose concentrations to become close to fasting level?
2 hours
Pathophysiology of DM:
Excess endogenous glucose production causes ?
What else causes this?
Hyperglycemia; also caused by uncontrolled hepatic gluconeogenesis
Pathophysiology of DM:
Hyperglycemia causes __ glucose utilization and __ glucose update by GLUT4
Decreased; reduced
Decreased GLUT4 uptake by peripheral tissue has to do with which type of DM
Type 2
DM will cause ___ fat mobilization
Which hormone is involved and where is it located?
Increased
Hormone sensitive lipase (which is inside the adipose tissue)
~HSL causes lipolysis
DM will also cause an increase to what other 2 levels?
Decrease in ? why?
Increased cholesterol (high LDL) and increased triglycerides
Decreased endogenous fat synthesis (because insulin triggers the storage of fat)
Why does DM cause hypertriglyceridemia ?
Inactive lipoprotein lipase (because it is stimulated by insulin)
So in DM which enzyme is inactive? Which is overactive?
Inactive = lipoprotein lipase Overactive= hormone sensitive lipase
HbA1C
- Formed by
- Name of test that tests this level to determine DM?
- Extent of glycation is dependent on?
- Normal HbA1C level?
- What level indicates poor control of DM?
- Non enzymatic glycation of HbA
- Glycated hemoglobin test
- Plasma concentration of glucose
- 4-6% of total HbA
- Higher than 7%
Prediabetes:
- Fasting blood glucose?
- HbA1C?
- 2 hours after eating levels?
- 100-125 mg/dl
- 5.7-6.4%
- 140-199 mg/dl
When you have DM/starvation, lipolysis occurs producing?
This then gets transformed to?
Acetyl CoA
Ketone bodies
Diabetic Keto acidosis:
Which ketone will make breath smell fruity?
Will have __ plasma bicarbonate/K+
Acetone
Decreased
Complications of Type II DM
- What is AGE?
- What can it cause?
- What can it effect?
- Give an example of AGE?
- Advanced glycosylation end products
- Vascular complications/tissue changes
- Enzyme action, molecular structure, removal of age related molecules
- HbA1C
Diabetic cataract is caused by which two things?
Aldose reductase and sorbitol
When does most cases of gestational diabetes occur?
Risk factors for gestational diabetes?
How will it affect the baby?
24-28 weeks
Obesity and type 2 diabetes
Baby will be bigger than average (when being born-not forever)
