Diabtetes Flashcards
How does insulin work in glucose transport?
It binds to the insulin receptor to induce a signal transduction cascade which allows the glucose transporter GLUT4 to transport glucose into the cell
What are the other causes of diabetes type 3?
Drug and chemical induced, chromosomal mutations, and idiopathic.
When should you screen for gestational diabetes?
Before 15 weeks
What is the two step OGTT?
Gestational testing one hour non fasting OGGT at 24-28 weeks gestation and if positive 3 hour OGTT confirmed on repeat test
What is the one step OGTT?
75 g OGTT and if positive it confirms GDM
What level of sugar indicates GDM on a test?
BS over 140
T or F the diabetes type can be determined based on the age of diagnosis
F
T or F diabetes type can be determined based on body habits
F
What is metabolic syndrome and what are the signs?
In both type 1 and type 2 have two signs of metabolic syndrome. It is arising from insulin resistance and abnormal adipose tissue deposition and function. The signs are HTN, abdominal obesity, acanthosis nigricans, hirsutism
What is the difference between type one and type 2 DM?
Type one is 5-10% and is insulin dependent or juvenile DM. it is from autoimmune destruction the B cells in the pancreas which does not make insulin Type 2 is 90-95% of patients and they agave a decreased in circulating insulin and insulin resistance.
What environment factors can lead to type 1?
Viruses, toxins, and cows milk, cereals.
What is the first manifestation in children with type 1?
Ketoacidosis
What type of acidosis can type 2 lead to?
Hpyerosmolar nonketotic acidosis leading to coma
What is the ominous diet and its 8 factors.
8 factors that leads to hyperglycemia.
1. Defects in islet beta cells secretion lead to islet beta cells failure. 2. Decreased glucose uptake 3. Increased liver glycogen output. 4. Disturbance in lipid metabolism. 5. Impaired incretin effect. 6. Elevated basal glucagon levels cause the overall fasting glucose to increase. 7. A dysfunction of the kidney sodium dependent glucose transporter 2 and other molecules lead to disordered absorption of glucose. 8. The inhibitory effect of the appetite is weakened.
What do people with DM 2 NOT have that type 1 does
Autoimmune component, HLA markers, ketosis, and environmental insult.
What trimester can you expect GDM to occur?
Second trimester
At what age would you expect LADA?
30 or older
How is LADA different than type 1?
It is a slow onset but not as slow as type 2
What is glycogenesis?
Glycogen synthesis where glucose molecules are added to chains of glycogen for storage. It is activated by high glucose levels like after a high carbohydrate meal.
What are the endogenous synthesis processes of glucose in the liver?
Glycogenesis, glycogenolysis, and excerise or fasting.
What are the three non carb substrates that form glucose?
Pyruvate, lactate, glycerol
What are C peptide in type 1 versus type 2
Type 1 it’s low type 2 it’s elevated.
What do low C peptide levels point to?
Reduced or absent insulin secretion levels from the pancreas
Which system regulates insulin secretion?
PNS
What is realized in response to food ingestion
Gastric inhibitory polypeptide or GIP
What inhibits insulin secretion?
Sympathetic nervous system stimulation from exercise or somatostatin
How does muscle affect insulin?
Increases protein synthesis, increases glycogen synthesis, increases glucose transport
How does adipose affect insulin?
Increases triglyceride storage inhibits intracellular lipase
How does the hypothalamus affect insulin?
Decreases appetite
What is an elevated HGBA1C
Greater than 6.5%
What is an elevated fasting glucose?
126
What is an elevated oral glucose during a tolerance test?
> 200 at the 2 hour mark
What are the classic symptoms of hyperglycemia?
Polyuria polydipsia and unexplained weight loss in a random plasma glucose of greater than 200 mg/dL
If pre DM how often do you repeat testing?
Every 3 years
What are some risk factors for DM?
Gestational, diabetes, family, history of type two diabetes in a firstdegree relative, Native American, African-American, Latino, Asian, American and Pacific Islanders history of CVD physical and activity factors associated with insulin resistance like hypertension, low HDL triglycerides or PCOS
What is a pre diabetic HGBA1c
5.7-6.5
What are glycemic goals for non-pregnant adults?
Avoid hypoglycemia, hyperglycemia, keto, ptosis, hemoglobin A1c of less than 7% fasting glucose of 80 to 130 peak postprandial capillary glucose of 180 to our postal glucose of less than 140
What are glycemic goals in children?
Before meals 90-130
Bedtime 90-150
True or false while there is multiple criteria for diabetes diagnosis one option is a fasting glucose of greater than 126
True
At what age should asymptomatic adults without risk factors first be tested or screened for diabetes or pre-diabetes
35 years old
How often should the screening be repeated in asymptomatic adults
3 years
Asymptomatic adults of any age with a BMI greater than what should be screened for type two diabetes
25
Asymptomatic Asian American adults would be greater than what should be screening for type two diabetes
23
Children and adolescence age 10 years or older or after onset of puberty with a BMI greater than what percentile and one additional factor should be for type two
85th percentile
