Diabetes (Slide Deck 1) Flashcards

1
Q

What is the function of Beta Cells?

A

Produce insulin and amylin

Insulin released in response to elevated blood glucose levels

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2
Q

What is the function of Alpha Cells in the pancreas?

A

Produce glucagon

Glucagon released in response to low blood glucose levels

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3
Q

What is the normal range of blood glucose levels?

A

4-7 mM

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4
Q

If I eat a meal __ is released Glycogenesis __ and Gluconeogenesis __

A
  1. Insulin
  2. Increase
  3. Decrease
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5
Q

If blood glucose decreases throughout the night Glycogenolysis __ and Gluconeogenesis __

A

Increases
Increases

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6
Q

What is glycogenolysis?

A

Its the breakdown of glycogen into glucose-1-phosphate and eventually into glucose

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7
Q

What is gluconeogenesis?

A

It is the generation of glucose from various sources (G1P)

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8
Q

What is gluconeogenesis?

A

It is the generation of glucose from various sources (G1P)

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9
Q

What are the other important regulatory hormones for glucose/insulin control?

A

Epinephrine, growth hormone, cortisol

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10
Q

What does the presence of insulin stimulate the production of in skeletal muscle?

A

Proteins from AA

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11
Q

What is the process of glycogenesis?

A

Glucose to glycogen

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12
Q

What is the process of Glycogenolysis

A

Liver glycogen is split back into glucose

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13
Q

In starvation or insulin deficiency what process does this lead to?

A

Lipolysis

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14
Q

What is Lipolysis

A
  • TG’s split back to glycerol and FAs ->Metabolism of FFA’s -> β-hydroxybutyrate, acetoacetic acid, and acetone (ketone bodies)
  • These ketone bodies can be used as an energy source
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15
Q

Insulin is a __ storing hormone. How?

A

Fat

It stimulates the conversion of glucose to glycerol phosphate
& free fatty acids (FFA’s) and is stored as TG’s in fat cells

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16
Q

What are the two classifications of prediabetes?

A
  • Impaired glucose tolerance (IGT)
  • Impaired fasting glucose (IFG)
17
Q

What is the prevalence of T1DM?

A

10%

18
Q

What level of beta cell destruciton do we see hyperglycemia occur?

A

80-90%

19
Q

What is the Honeymoon Phase of T1DM?

A
  • Correction of hyperglycemia causes insulin secretion to recover temporarily & insulin requirements may be quite low
20
Q

What is Prediabetes

A
  • An intermediate state between normal glucose levels and diabetes
21
Q

Prediabetes is a strong predictor of?

A

T2DM & CVD

22
Q

TD2M is a combination of?

A

impaired insulin secretion and insulin resistance

23
Q

What happens to the Beta cells in T2DM patients?

A

↓ β-cell mass, as well as a β- cell secretory defect….this continues to deteriorate with time

24
Q

What occurs in the skeletal muscles due to T2DM

A

Muscle is resistant to insulin actions hence there is decreased glucose uptake by it

25
Q

What occurs in the Liver during T2DM

A
  • Resistance to insulin action on the liver results in the inability to suppress hepatic glucose production
26
Q

What occurs in the Adipose Tissue during T2DM

A

*Adipocytes become resistant to antilipolytic effects of insulin which leads to ↑ lipolysis (Increase in TG in blood)

  • Leads to elevated FFA’s in the circulation which can stimulate liver glucose production, impair skeletal muscle sensitivity & impair insulin release
27
Q

What types of symptoms are generally associated with T1DM?

A

Acute symptoms of short duration!
* Polyuria
* Polyphagia
* Polydipsia
* Weight loss
* Fatigue
* Blurred vision
* Infections

28
Q

What types of symptoms are generally associated with T2DM?

A
  • Is commonly discovered incidentally, as patients may be asymptomatic
  • May have nonspecific symptoms (i.e. fatigue) or:
  • polyuria
  • polydipsia
  • nocturia
29
Q

What is DKA and where is it most common?

A

Diabetic ketoacidosis and it is prevalent in T1DM

30
Q

What genes (HLA Class II Genes) are associated with which form of diabetes?

A

T1DM

31
Q

What is gestational diabetes mellitus?

A

Develops during pregnancy due to insulin resistance, and increases the risk of developing T2DM in both mother/child

32
Q

Risk factors of GDM?

A
  • Previous GDM
  • Member of high-risk population
  • Previous delivery of macrosomic infant
  • Age ≥ 35yo
  • Obesity
  • PCOS
  • Acanthosis nigricans
  • Corticosteroid use
33
Q

What weeks of pregnancy should women be screened for GDM?

A

between weeks 24-28 weeks of pregnancy; earlier if risk factors are present

34
Q

How is T2DM screened?

A

Fasting plasma glucose or A1C as initial screening tests

35
Q

What is the criteria for screening for T2DM without intervention (When is rescreening required)

A

FPG <5.6mmol/L or A1C <5.5
Rescreen as recomended

36
Q

What is the criteria for “At Risk rescreen more often” T2DM

A

FPG 5.6-6.0mmol/L or A1C 5.9

37
Q

What is the criteria for Prediabetes rescreening more often? T2DM

A

FPG 6.1-6.9mmol/L or A1C 6.4

38
Q

What is the criteria for being TD2M diagnosed?

A

FPG >7.0mmol/L or A1C >6.5 or 2hrs PG in a 75g OGTT >11.1
Or random PG >11.1mmol/L