Diabetes Part 1 Flashcards
Good simple definition of diabetes, not just type 1?
Metabolic disorder leading to hyperglycemia because we cant secret insulin or insulin isn’t having an effect.
In the US, diabetes is the leading cause of what 3 conditions?
End stage renal disease, adult onset blindness, and non traumatic lower extremity amputations because of atherosclerosis
What are the 4 criteria for the diagnosis of diabetes?
A1C over 6.5
Fasting glucose over 126
Random glucose over 200
2 hour glucose after oral tolerance test over 200
What are the prediabetes criteria?
Fasting glucose between 100 and 125
2 hour glucose after test 140-199
A1C between 5.7 and 6.4
Which 3 ethnic groups are at higher risk for diabetes?
Blacks, Hispanics and native Americans
What is the patho of type 1 diabetes?
T cells destroying beta cells
What is the gene and chromosome for the most common association for type 1 diabetes?
HLA gene cluster on chromosome 6p21.
What are the two most common haplotypes?
HLA DR3 and DR4
How much of the beta cells must be destroyed before overt Type 1 diabetes symptoms?
90%
Two big time risk factors for type 2 diabetes?
Obesity is number one
Sedentary lifestyle
2 main things going on with the patho of type 2 diabetes?
B cell dysfunction, meaning inadequate insulin secretion
Insulin resistance in the peripheral tissue
Explain the reasoning for beta cell dysfunction?
Because of the insulin resistance, the signal back to the pancreas is to pump our more insulin. Eventually there is exhaustion and failure of the beta cells to the increasing demand.
What are the three major tissues that are most insulin resistant in type 2 diabetes?
Skeletal muscle, fat and liver
What is one of the major issues with the liver being resistant to insulin?
Insulin uptake turns off gluconeogensis. If we can’t turn it off, the liver is continually secreting glucose into the blood. That’s why we have an elevated fasting glucose.
What is the problem with fat cells being resistant to insulin?
Remember, insulin is an anabolic hormone. So, if we cant bring it in to build, then hormone sensitive lipase will be going and breaking down TRIs, causing FFAs to be pumped into the blood.
