DM

Question 1

main cause of morbidity and mortality in this population

Answer 1

Cardiovascular diseases

Question 2

Diagnosis of Pre-diabetic person is with ………,tests

Answer 2

FPG=fasting plasma glucose (100—125)
indicates impaired fasting glucose

2h PG =Plasma glucose (140—199)
indicates impaired glucose tolerance

Question 3

Diagnosis of a diabetic person

Answer 3

Random blood glucose concentration >200

Question 4

Maturity —onset diabetes of the young (MODY)and monogenic diabetes

Answer 4

Gene mutation impiaring insulin production
لةشي زال

Question 5

Gestational DM

Answer 5

Must be During 2nd or 3rd trimester.

Question 6

Risk factors of DM

Answer 6

Cystic fibrosis
Chronic pancreatitis
Acromegaly
Cushing disease

Question 7

خشتةي سلايد ١٠

Question 8

خةلاياي عضلي وچةوري …………دةردةن

Answer 8

ليبتين/ريسستين/اديپونيكتين

Question 9

Beta pancreatic cells co-secrete ………..with insulin

Answer 9

Amylin =islet amyloid polypeptide (IAPP).

Question 10

C-peptide

Answer 10

بطيء پاكةو بوود لة بدن

Question 11

Insulin synthesis and secretion by beta cell

Answer 11

صورة س١٥

Question 12

Incretin hormones

GLP-1=Glucagon like peptide
GIP =Glucose dependent insulinotropic peptide

ايانة كامل وةك انسولين كاركةن ، يةكةميش فقط لة بنية شكل گلوكاگون دةد

Answer 12

gut peptides that are secreted after nutrient intake and stimulate insulin secretion together with hyperglycaemia.

Secreted by GIT, L-cells

Question 13

GLUT4

Answer 13

Insulin dependent glucose transporter
On muscle and fat cells

Question 14

Mitogenic effects of apoptosis

Answer 14

👇Apoptosis
👆precancerous cell proliferation

Question 15

the majority of individuals with type 1 DM……….. do not
have a relative with this disorder.

Answer 15

(>90%)

Question 16

Pathophysiology of DM—1

Answer 16

Infiltration of lymphocytes

The presence of two or more ICAs (Islet cell autoantibodies)was associated with risk of developing DM

• The antibodies do not have a direct role in beta cell death.

Question 17

Environmental triggers of DM1

Answer 17

include viruses (coxsackie, rubella,enteroviruses most prominently), bovine milk proteins,nitrosourea compounds, vitamin D deficiency, and environmental toxins.

Question 18

Children of pregnancies complicated by gestational hyperglycemia also exhibit an
increased risk of ………DM.

Answer 18

Type 2

ايانة اولما پةيايش بوون ، هايپوگليسيمي گرن ، لأن متعودن انسولين فرة دةربيةن ،بةرامبةر ئةو گلوكوزة فرةي لةدايگيانةو ارايان تيد

Question 19

👆FPG in DM2 is due to

Answer 19

👆glucagon hence 👆glucose liver output.

Question 20

• Hyperinsulinemia may increase the insulin action through Mitogenic pathways,

Answer 20

potentially accelerating diabetes-related conditions such as atherosclerosis.

Question 21

The increased adipocyte mass leads to increased levels of circulating free
fatty acids and other fat cell products, For example:

Answer 21

leptin, TNF-α, resistin, IL-6 and adiponectin
• Adipokines also modulate insulin sensitivity.
• Adiponectin :an insulin-sensitizing peptide.

Question 22

Overall beta cell function is reduced by as much as…….% at the onset of type 2
DM.

Answer 22

50

chronic hyperglycemia paradoxically impairs islet function
“glucose toxicity” and leads to a worsening of hyperglycemia.

• Elevated levels of free fatty acids“lipotoxicity”.

Elevations in pro-inflammatory cytokines may also worsen islet function.

Question 23

Post-prandial state in type 2 DM (after a meal=Fed state)
س٣٠/لم افهم بعد

Answer 23

hyperinsulinemia ) suppress gluconeogenesis, which results in fasting
hyperglycemia and decreased glycogen storage by the liver in the postprandial
state.

Question 24

Insulin resistance syndromes

Answer 24

Metabolic syndrome
Acanthosis nigricans
Poly-cystic ovary syndrome =PCOS
Lipodystrophies