Diabetes pt 2 Flashcards
what does sulfonylureas do
increases insulin secretion in second phase
what does alpha glucosidase inhibitors do
decrease carb absorption
is glucagon catabolic or anabolic
catabolic - promotes breakdown
what type of diabetes is more likely to have DKA
type 1
how does birth weight correlate with t2d
the lower the BW, the more insulin resistant and glucose intolerant the adult
a varient of what gene is one of the strongest associations between t2d
TCF7L2 gene
what hypoglycemic drug increases peripheral insulin sensitivity
thiazolidinediones
semaglutide drugs are what kind of drugs
glp-1 agonists
what increases insulin secretion in second phase
sulfonylureas
what increases release of catcholamines
infection, inflammation
anything that invokes fight of flight
what is DKA
diabetic ketoacidosis
how does diabetes cause nephropathy
injury to the glomerulus means you cant excrete waste and lack albumin - increases GFR
is there fruity breath or kussmal breathing with hhs? why
no because there is no ketogenesis
what are examples of catecholamines
epinephrine
norepinepherine
what are polyagonist
nasically a bunch of gut hormones that are similar to incretins
what does ectopic fat deposition with PCOS cause
hyperandrogenism (increased testosterone)
insulin resistance/hyperinsulinemia
ovarian disfunction
what do incretins do
stimulates insulin production
Name the different types of diabetes
gestational
PCOS
drug-induced
post-kidney transplant
LADA
what does meglitinides do
increase insulin secretion in the first phase
weight balance is controlled by what
the cns
what has more intense hyperglycemia, dehydration and hyperosmolarity? dka or hhs
hhs
what is MODY
maturity onset diabetes of the young
what are the 3 types of islets that can be transplanted
fresh islets
xenotransplants (non-human)
engineered cells
what does orlistat do, and what is it used for
inhibits lipase to stop fat digestion
used in obesity treatments
what is released with insulin and can cause fibrosis and destruction of the beta cells
amyloid proteins
defective signaling of high glucose can lead to what
a mild form of diabetes
name some microvascular complications of hhs
nephropathy
retinopathy
neuropathy
PAD
what does phentermine do and what is it used for
decreases appetite - for weight loss management
what are the two rapid acting insulins
lispro
aspart
how long does intermediate acting insulin last
about 12 hours, can be used as a basal insulin but might need to take it twice a day
what were found in genome wide scans of those with t2d (4)
variants in genes related to beta cell mass and function
gene variants related to melatonin receptor 2
genes associated with fat mass and obesity
clustering of gene variants
what is increased fetal fat deposition
macrosomia
what is kussmaul breathing
low pH makes people breath faster to get rid of some co2
Metabolic syndrome is more common in what type of diabetes
2
what do catecholamines have to do with blood sugar
they stimulate glycogenolysis and gluconeogenesis
what can cause nonenzymatic glycation
hyperglycemia with hhs
what are amyloid proteins
something released with insulinw
what hypoglycemic drug decreases carb absorption
alpha glucodiase inhibitors
what increase insulin secretion in the first phase
meglitinides
how do dpp IV inhibitors help extend the life of glp-1 agonists
prevents the breakwond of them via DPP IV
what syndrome is linked to insulin resistance (and therefore type 2 diabetes)
metabolic syndrome
how does hyperglycemia cause polyphagia
it increases proteolysis (protein and fat breakdown)
how can we extend the lifespan of glp-1 agonists
exenatide
couple it with fatty acids
is hhs more gradul or rapid
gradual
what is PAD
peripheral artery disease
what is retinopathy
disease of the retina
what drug eliminates glucose in urine to decrease it
sodium glucose cotransporter 2 inhibitors
what circuits in the brain modulate balance between nutrient intake and energy expenditure
cortical circuits
what promotes glucose uptake by the beta cell and the liver
glucokinase
what is the issue with glp-1 agonists
they have a very short half life
what is an anorexigenic pathway
satiety
what is the combination weight loss surgery
roux-en-y gastric bypass
what are the 5 other types of diabetes
gestational diabetes
polycystic ovary syndrome
drug-induced diabetes
post kidney transplant diabetes
latent autoimmune diabetes in adults
what form of diabetes if glucokinase associated with
MODY
what type of diabetes is more likely to have HHS
type 2
what is the only well established variant of diabetes based on mutation in a single gene
MODY
why are glp-1 agonists safer
they wont cause hypoglycemia
in genome wide scans, varients in genes related to what were the most important association with diabetes
beta cell mass and function
what is LADA
latent autoimmune diabetes in adults
wht are the benefits of intraperitoneal insulin infusion
targets liver directly
faster absorption
less hypoglycemia
name two things from natural history that could cause t2d
thrifty genes
maternal low protein diet
what do amylin mimetics do (2)
inhibits gastric emptying
weight loss
what is the big difference between hhs and dka
hhs wont lead to ketogenesis
what kind of drugs are tirzepatide
dual glp-1 and gip receptor agonists
what do pre and probiotics do
affect microbiome metabolism
why is the absorption of regular insulin delayed
because it takes time for the hexamers to dissolve
what do thiazolidinediones do
increase peripheral insulin sensitivity
name 4 types of treatment for type 1 diabetes
insulin replacement therapy
glucose monitoring
diet/exercise
education/stress management
what can amyloid proteins cause
fibrosis and destruction of the beta cells
how can ketone bodies lower the pH of your blood
they are acidic
what is the basis of the thrifty gene association with t2 diabetes
hunter-gatherers
had a gene to store energy for later - didnt know when the next meal would be; dont need that now, just causes obesity
when is the best time to give rapid acting insulin
during meals
what are the two types of insulin replacement therapy
subcutaneous insulin injections
continuous subcutaneous insulin infusion
what breaks down glp-1 in circulation
DPP IV
Describe DKA
ketoacidosis occurs and ketone bodies build up in the blood
how does hyperglycemia cause polydipsia
causes a higher somolarity
stimulates hypothalamic thirst center
variants in genes related to what were the most important associations with diabetes
beta cell mass and funciton
when is short acting insulin typically used
hyperglycemic crisis
why are closed loop systmes not perfect
there are delays in sensing glucose levels and insulin availability
some t2d mutations mediates what kind of effect on incretins
a reduced incretin effect
what is HHS
hyperglycemic hyperosmolar syndrome
what kind of diabetes is LADA
slow progessive form of t1d
what is a symptom os hhs that you wont find in dka
confusion and delirium
what are hard exudates
little lesions on the outside of vessels
what does topiramate do in conjuction with another drug
increases the effect of phentermine for a longer period of time
what is proteolysis
protein and fat breakdown
why is glucokinase important
if you dont have uptake of glucose by the beta cells, you cannot signal high glucose levels to the cell
why wont hhs lead to ketogeneis
still enough insulin to use some glucose
how does hyperglycemia cause polyuria
it increases osmotic duresis
what is the rapid breathing associated with t1d called
kussmaul breathing
name the 4 second line of oral ypoglycemic drugs
sulfonylureas
meglitinides
aplha glucosidase inhibitors
thiazolidinediones
what were the first MODY mutations to be identified
glucokinase
what is nonenzymatic gylcation
taking proteins and lipids and binding glucose to them
describe ketoacidosis
body must break down fats
lipids broken down in liver
beta oxidation turns fatty acids to acetyl-CoA
acetyl-CoA gets converted to ketone bodies
which type of diabetes has a strong genetic component
type 2
adding what to phentermine will increase the length of the effects
topiramate
what is IUGR
intrauterine growth retardation
what is an orexigenic pathway
hunger pathway
what is a basal-bolus insulin regine
its used to mimic the body’s natural insulin production as closely as possible
what are the two kinds of gastric weight loss surgery
adjustable gastric banding
vertical sleeve gastrectomy
what does glucokinase do
promotes glucose uptake by the beta cell and by the liver
what was found with fresh islet transplants
did not work out long term
waht is nephropathy
deterioration of kidney function
name some macrovascular complications of hhs
nonenxymatic glycation
atherosclerosis
myocardial infarction
coronary artery disease
will HHS lead to ketogenesis
nope
what does it mean for something to be polygenic
based on mutations/changes in several genes
what is PCOS characterized by
ectopic fat deposition
is dka more gradual or rapid
rapid
what is the first line of hypoglycemic drugs (oral)
metformin
what is microangiopathy
a disease of the capillaries - they become too thick and weak that they bleed
what is macroangiopathy
accelerated atherosclerosis - a quick build up of plaque and fatty material on the inner walls of arteries
what do sodium glucose cotransporter 2 inhibitors do
eliminates glucose in urine to decrease it
what is macrosomia
increased fetal fat deposition
what is GLP-1
the main incretin
name 5 typical symptoms of metabolic syndrome
lower hdl
high triglycerides
high bp
high glucose
large waist circumferece
high glucose can pull ____ out of cells
potassium
Name 3 things GLP-1 agonists do
enhance insulin secretion
supresses glucagon
inhibits stomach emptying to slow absorption of glucose
