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PHS 3300 > Diabetes pt 2 > Flashcards

Diabetes pt 2 Flashcards

1
Q

what does sulfonylureas do

A

increases insulin secretion in second phase

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2
Q

what does alpha glucosidase inhibitors do

A

decrease carb absorption

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3
Q

is glucagon catabolic or anabolic

A

catabolic - promotes breakdown

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4
Q

what type of diabetes is more likely to have DKA

A

type 1

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5
Q

how does birth weight correlate with t2d

A

the lower the BW, the more insulin resistant and glucose intolerant the adult

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6
Q

a varient of what gene is one of the strongest associations between t2d

A

TCF7L2 gene

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7
Q

what hypoglycemic drug increases peripheral insulin sensitivity

A

thiazolidinediones

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8
Q

semaglutide drugs are what kind of drugs

A

glp-1 agonists

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9
Q

what increases insulin secretion in second phase

A

sulfonylureas

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10
Q

what increases release of catcholamines

A

infection, inflammation
anything that invokes fight of flight

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11
Q

what is DKA

A

diabetic ketoacidosis

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12
Q

how does diabetes cause nephropathy

A

injury to the glomerulus means you cant excrete waste and lack albumin - increases GFR

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13
Q

is there fruity breath or kussmal breathing with hhs? why

A

no because there is no ketogenesis

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14
Q

what are examples of catecholamines

A

epinephrine
norepinepherine

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15
Q

what are polyagonist

A

nasically a bunch of gut hormones that are similar to incretins

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16
Q

what does ectopic fat deposition with PCOS cause

A

hyperandrogenism (increased testosterone)
insulin resistance/hyperinsulinemia
ovarian disfunction

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17
Q

what do incretins do

A

stimulates insulin production

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18
Q

Name the different types of diabetes

A

gestational
PCOS
drug-induced
post-kidney transplant
LADA

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19
Q

what does meglitinides do

A

increase insulin secretion in the first phase

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20
Q

weight balance is controlled by what

A

the cns

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21
Q

what has more intense hyperglycemia, dehydration and hyperosmolarity? dka or hhs

A

hhs

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22
Q

what is MODY

A

maturity onset diabetes of the young

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23
Q

what are the 3 types of islets that can be transplanted

A

fresh islets
xenotransplants (non-human)
engineered cells

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24
Q

what does orlistat do, and what is it used for

A

inhibits lipase to stop fat digestion
used in obesity treatments

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25
Q

what is released with insulin and can cause fibrosis and destruction of the beta cells

A

amyloid proteins

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26
Q

defective signaling of high glucose can lead to what

A

a mild form of diabetes

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27
Q

name some microvascular complications of hhs

A

nephropathy
retinopathy
neuropathy
PAD

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28
Q

what does phentermine do and what is it used for

A

decreases appetite - for weight loss management

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29
Q

what are the two rapid acting insulins

A

lispro
aspart

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30
Q

how long does intermediate acting insulin last

A

about 12 hours, can be used as a basal insulin but might need to take it twice a day

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31
Q

what were found in genome wide scans of those with t2d (4)

A

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

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32
Q

what is increased fetal fat deposition

A

macrosomia

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33
Q

what is kussmaul breathing

A

low pH makes people breath faster to get rid of some co2

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34
Q

Metabolic syndrome is more common in what type of diabetes

A

2

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35
Q

what do catecholamines have to do with blood sugar

A

they stimulate glycogenolysis and gluconeogenesis

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36
Q

what can cause nonenzymatic glycation

A

hyperglycemia with hhs

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37
Q

what are amyloid proteins

A

something released with insulinw

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38
Q

what hypoglycemic drug decreases carb absorption

A

alpha glucodiase inhibitors

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39
Q

what increase insulin secretion in the first phase

A

meglitinides

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40
Q

how do dpp IV inhibitors help extend the life of glp-1 agonists

A

prevents the breakwond of them via DPP IV

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41
Q

what syndrome is linked to insulin resistance (and therefore type 2 diabetes)

A

metabolic syndrome

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42
Q

how does hyperglycemia cause polyphagia

A

it increases proteolysis (protein and fat breakdown)

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43
Q

how can we extend the lifespan of glp-1 agonists

A

exenatide
couple it with fatty acids

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44
Q

is hhs more gradul or rapid

A

gradual

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45
Q

what is PAD

A

peripheral artery disease

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46
Q

what is retinopathy

A

disease of the retina

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47
Q

what drug eliminates glucose in urine to decrease it

A

sodium glucose cotransporter 2 inhibitors

48
Q

what circuits in the brain modulate balance between nutrient intake and energy expenditure

A

cortical circuits

49
Q

what promotes glucose uptake by the beta cell and the liver

A

glucokinase

50
Q

what is the issue with glp-1 agonists

A

they have a very short half life

51
Q

what is an anorexigenic pathway

A

satiety

52
Q

what is the combination weight loss surgery

A

roux-en-y gastric bypass

53
Q

what are the 5 other types of diabetes

A

gestational diabetes
polycystic ovary syndrome
drug-induced diabetes
post kidney transplant diabetes
latent autoimmune diabetes in adults

54
Q

what form of diabetes if glucokinase associated with

A

MODY

55
Q

what type of diabetes is more likely to have HHS

A

type 2

56
Q

what is the only well established variant of diabetes based on mutation in a single gene

A

MODY

57
Q

why are glp-1 agonists safer

A

they wont cause hypoglycemia

58
Q

in genome wide scans, varients in genes related to what were the most important association with diabetes

A

beta cell mass and function

59
Q

what is LADA

A

latent autoimmune diabetes in adults

60
Q

wht are the benefits of intraperitoneal insulin infusion

A

targets liver directly
faster absorption
less hypoglycemia

61
Q

name two things from natural history that could cause t2d

A

thrifty genes
maternal low protein diet

62
Q

what do amylin mimetics do (2)

A

inhibits gastric emptying
weight loss

63
Q

what is the big difference between hhs and dka

A

hhs wont lead to ketogenesis

64
Q

what kind of drugs are tirzepatide

A

dual glp-1 and gip receptor agonists

65
Q

what do pre and probiotics do

A

affect microbiome metabolism

66
Q

why is the absorption of regular insulin delayed

A

because it takes time for the hexamers to dissolve

67
Q

what do thiazolidinediones do

A

increase peripheral insulin sensitivity

68
Q

name 4 types of treatment for type 1 diabetes

A

insulin replacement therapy
glucose monitoring
diet/exercise
education/stress management

69
Q

what can amyloid proteins cause

A

fibrosis and destruction of the beta cells

70
Q

how can ketone bodies lower the pH of your blood

A

they are acidic

71
Q

what is the basis of the thrifty gene association with t2 diabetes

A

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

72
Q

when is the best time to give rapid acting insulin

A

during meals

73
Q

what are the two types of insulin replacement therapy

A

subcutaneous insulin injections
continuous subcutaneous insulin infusion

74
Q

what breaks down glp-1 in circulation

A

DPP IV

75
Q

Describe DKA

A

ketoacidosis occurs and ketone bodies build up in the blood

76
Q

how does hyperglycemia cause polydipsia

A

causes a higher somolarity
stimulates hypothalamic thirst center

77
Q

variants in genes related to what were the most important associations with diabetes

A

beta cell mass and funciton

78
Q

when is short acting insulin typically used

A

hyperglycemic crisis

79
Q

why are closed loop systmes not perfect

A

there are delays in sensing glucose levels and insulin availability

80
Q

some t2d mutations mediates what kind of effect on incretins

A

a reduced incretin effect

81
Q

what is HHS

A

hyperglycemic hyperosmolar syndrome

82
Q

what kind of diabetes is LADA

A

slow progessive form of t1d

83
Q

what is a symptom os hhs that you wont find in dka

A

confusion and delirium

84
Q

what are hard exudates

A

little lesions on the outside of vessels

85
Q

what does topiramate do in conjuction with another drug

A

increases the effect of phentermine for a longer period of time

86
Q

what is proteolysis

A

protein and fat breakdown

87
Q

why is glucokinase important

A

if you dont have uptake of glucose by the beta cells, you cannot signal high glucose levels to the cell

88
Q

why wont hhs lead to ketogeneis

A

still enough insulin to use some glucose

89
Q

how does hyperglycemia cause polyuria

A

it increases osmotic duresis

90
Q

what is the rapid breathing associated with t1d called

A

kussmaul breathing

91
Q

name the 4 second line of oral ypoglycemic drugs

A

sulfonylureas
meglitinides
aplha glucosidase inhibitors
thiazolidinediones

92
Q

what were the first MODY mutations to be identified

A

glucokinase

93
Q

what is nonenzymatic gylcation

A

taking proteins and lipids and binding glucose to them

94
Q

describe ketoacidosis

A

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

95
Q

which type of diabetes has a strong genetic component

A

type 2

96
Q

adding what to phentermine will increase the length of the effects

A

topiramate

97
Q

what is IUGR

A

intrauterine growth retardation

98
Q

what is an orexigenic pathway

A

hunger pathway

99
Q

what is a basal-bolus insulin regine

A

its used to mimic the body’s natural insulin production as closely as possible

100
Q

what are the two kinds of gastric weight loss surgery

A

adjustable gastric banding
vertical sleeve gastrectomy

101
Q

what does glucokinase do

A

promotes glucose uptake by the beta cell and by the liver

102
Q

what was found with fresh islet transplants

A

did not work out long term

103
Q

waht is nephropathy

A

deterioration of kidney function

104
Q

name some macrovascular complications of hhs

A

nonenxymatic glycation
atherosclerosis
myocardial infarction
coronary artery disease

105
Q

will HHS lead to ketogenesis

A

nope

106
Q

what does it mean for something to be polygenic

A

based on mutations/changes in several genes

107
Q

what is PCOS characterized by

A

ectopic fat deposition

108
Q

is dka more gradual or rapid

A

rapid

109
Q

what is the first line of hypoglycemic drugs (oral)

A

metformin

110
Q

what is microangiopathy

A

a disease of the capillaries - they become too thick and weak that they bleed

111
Q

what is macroangiopathy

A

accelerated atherosclerosis - a quick build up of plaque and fatty material on the inner walls of arteries

112
Q

what do sodium glucose cotransporter 2 inhibitors do

A

eliminates glucose in urine to decrease it

113
Q

what is macrosomia

A

increased fetal fat deposition

114
Q

what is GLP-1

A

the main incretin

115
Q

name 5 typical symptoms of metabolic syndrome

A

lower hdl
high triglycerides
high bp
high glucose
large waist circumferece

116
Q

high glucose can pull ____ out of cells

A

potassium

117
Q

Name 3 things GLP-1 agonists do

A

enhance insulin secretion
supresses glucagon
inhibits stomach emptying to slow absorption of glucose

PHS 3300 (11 decks)

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