Diabetes Mellitus Learning Objectives

Question 1

Describe Type 1 DM.

Answer 1

• autoimmune disease of the B-cell
• process:
• inflammation of the islets
• autoantigens on B-cells get presented to T-cells
• activation of B-cells and production of autoantibodies
• further enhancement of inflammation of islets
• results- LITTLE, if any, PRODUCTION OF INSULIN

Question 2

Describe Type 2 DM.

Answer 2

• compensation by production of high amounts of insulin
• progressive decrease in weight and number of B-cells
• high levels of glucose and lipid causes apoptosis in B-cells
• leptin decreases insulin secretion
• proinflammatory cytokines can be toxic to B-cells
• b- cell exhaustion (instracellular oxidative stress, ER dysfunction, apoptosis)
• insulin deficiency

Question 3

What is apoptosis?

Answer 3

altered program cell death

Question 4

Name risk factors for the development of DM,

Answer 4

• age
• obesity
• hypertension
• physical inactivity
• family history
• metabolic syndrome
• increased IL-6
• increased C-reactive protein
• decreased adiponectin
• polycystic ovary syndrome

Question 5

explain increased C-reactive protein

Answer 5

it is the acute-phase protein produced by the liver in response to inflammation

Question 6

explain decreased adiponectin

Answer 6

it is when the adipokine that regulates lipid storage through hunger

Question 7

Name some prevention strategies for DM.

Answer 7

• weight loss can improve insulin sensitivity for obesity
• physical activity can improve glucose tolerance in the absence of weight loss
• proper management of diet, exercise and medication can prevent long term complications
• regular follow-ups

Question 8

Describe the role of physical activity in prevention and mitigating effects of disease.

Answer 8

• decrease blood glucose directly
• insulin requirements
• blood triglycerides
• increased HDL
• aids in weight loss

Question 9

hich type of DM is more common?

Answer 9

type 2

Question 10

Which type of DM is insulin dependent?

Answer 10

type 1

Question 11

Which type of DM is insulin resistant?

Answer 11

type 2

Question 12

Which type of DM is more likely to occur in childhood or adolescence?

Answer 12

type 1

Question 13

Which type of DM is more likely to occur in adults?

Answer 13

type 2

Question 14

What is gestational diabetes?

Answer 14

• 3rd type of DM

- characterized by hyperglycemia (raised blood sugar)- during preganncy

Question 15

How is DM characterized?

Answer 15

• characterized by high levels of blood glucose (sugar in blood that is the body’s main source of energy)
• DEFECTS in:
• insulin production
• insulin action

Question 16

What are some clinical manifestations in Type 1 DM?

Answer 16

• EXCESSIVE THIRST= high glucose concentrations pulls water out of cells osmotically
• FREQUENT URINATION= high osmotic pressure in kidney and incomplete resorption of glucose from urine
• EXCESSIVE HUNGER= depletion of intracellular stores of glucose and lipids and cellular starvation
• WEIGHT LOSS= fluid loss, loss of LBM due to poor use of glucose
• FATIGUE= poor use of nutrients, sleep loss due to urination at hight

Question 17

What are some clinical manifestations in Type 2 DM?

Answer 17

• may have classical signs but not
• fatigue
• relevant infection (increased MICROBE GROWTH, decreased HEALING due to impaired blood supply)
• visual changes (H2O balance in the eye changes due to changes in blood glucose, RETINOPATHY)
• paresthesia (sensations of tingling, pricking, burning)