diabetes mellitus

Question 1

fed/absorptive state

Answer 1

increased blood glucose -> secretion of insulin (which brings blood glucose back down)

Question 2

fasted state

Answer 2

secretion of glucagon -> gluconeogenesis

Question 3

insulin binding sites

Answer 3

adipose tissue, skeletal muscle, and liver

Question 4

GLUT 4

Answer 4

insulin-dependent glucose transporter found on adipose tissue and muscle: clears glucose from blood

Question 5

insulin effect on adipose tissue

Answer 5

promotes lipid/adipose tissue storage, and inhibits breakdown of stored lipids

Question 6

insulin effect on the liver

Answer 6

glycogen synthesis

Question 7

what is the most common cause of type 2 diabetes

Answer 7

insulin resistance due to development of obesity

Question 8

sorbitol dehydrogenase enzyme promotes what product?

Answer 8

fructose

Question 9

uncontrolled type 2 DM shows…

Answer 9

gluconeogenesis in the liver AND blood levels of VLDL

Question 10

higher than normal A1c test result interpretation

Answer 10

mostly not controlling blood glucose

Question 11

factor that contributes to development of diabetic retinopathy

Answer 11

glucosamine 6-phosphate

Question 12

cause of diabetes type 1

Answer 12

autoimmune disease destroy cells that create insulin (cannot activate GLUC4)

Question 13

signs/symptoms of diabetes type 1

Answer 13

polyuria, polydipsia, polyphagia, weight-loss, blurred vision

Question 14

diabetic ketoacidosis

Answer 14

side effect presents mainly in DM1, over production of ketones

Question 15

diabetes type 1 treatment

Answer 15

insulin injections

Question 16

acanthosis nigricans

Answer 16

brown skin lesions a sign/symptom of DM2

Question 17

most common side effect of DM type 2

Answer 17

hyperosmolar hyperglycemic nonketotic syndrome

Question 18

diabetes type 2 treatment

Answer 18

lifestyle modification and medications

Question 19

gestational diabetes signs/symptoms

Answer 19

hypertension, macrosomia, preterm birth

Question 20

gestational diabetes treatment

Answer 20

meal planning, exercise, glucose monitoring, insulin

Question 21

diabetic eye diseases

Answer 21

diabetic retinopathy, cataract, and glaucoma

Question 22

polyol pathway (pathology of diabetic retinopathy)

Answer 22

hyperglycemia leads to increased sorbitol > sorbitol directly damages cells or indirectly through depletion of glutathione

Question 23

hexosamine pathway (pathology of diabetic retinopathy)

Answer 23

increased glycosylation of Sp1 transcription factor (pro-inflammatory)

Question 24

protein kinase C signaling (pathology of diabetic retinopathy)

Answer 24

increased synthesis of diacylglycerol and activation of protein kinase C (pro-inflammatory)

Question 25

role of polyol pathway

Answer 25

detoxification of toxic aldehydes | aldose reductase converts aldehyde to alcohol (glucose to sorbitol)

Question 26

enzyme that converts aldehyde to alcohol

Answer 26

aldose reductase

Question 27

hexosamine pathwya

Answer 27

minor pathway | fructose 6-phosphate > UDP-N-acetylglucosamine

Question 28

UDP-N-acetylglucosamine

Answer 28

product of hexosamine pathway - causes glycosylation of protiens including Sp1 transcrition factor

Question 29

UDP-N-acetylglucosamine

Answer 29

product of hexosamine pathway - causes glycosylation of protiens including Sp1 transcrition factor

Question 30

Glycosylated hemoglobin

Answer 30

(A1c test) hemoglonin glycosylation (non-enzymatic) measured and reported as percentage of total hemoglobin "% of Hb with glucose attached" - non-fasting- look at glycemic control over 3 mo span

Question 31

Oral glucose tolerance test

Answer 31

overnight fast - blood glucose measured before and 2 hours after glucose solution consumption

Question 32

Fasting plasma glucose test

Answer 32

diagnosing diabetes/managing diabetes - plasma glucose measured after 8 hour fast

Question 33

random plasma glucose test

Answer 33

non-fasting glucose test, used in acute settings when dm symptoms present -- usually further testing required

Question 34

carbohydrate metabolism in DM1

Answer 34

increased gluconeogenesis, decrease (lack of increase) of GLUT4 transporter activity in skeletal muscle and adipose tissue >>hyperglycemia

Question 35

lipid metabolism in DM1

Answer 35

``` >increased hormone-sensitive lipase >increased VLDL synthesis >decreased lipoprotein lipase (extracellular adipose) >increase ketone synthesis (liver) >>hyperlipidemia + diabetic ketoacidosis ```

Question 36

carbohydrate metabolism in DM2

Answer 36

increased gluconeogenesis, decrease GLUT4 transporter activity >>hyperglycemia

Question 37

lipid metabolism in DM2

Answer 37

>increased hormone-sensitive lipase >increased VLDL synthesis >decreased lipoprotein lipase >>hyperlipidemia