DM

Question 1

What is type Ia DM?

Answer 1

Immune mediated destruction of islet cells

Question 2

What is type Ib DM?

Answer 2

idiopathic destruction of islet cells

Question 3

What is the endocrinopathy that causes DM?

Answer 3

Somtatostatinoma

Question 4

What are the diseases that can lead to DM?

Answer 4

Pancreatitis, CF, CA

Question 5

What is the hormone that causes GDM?

Answer 5

Progesterone

Question 6

What is the normal fasting plasma glucose levels?

Answer 6

<100 mg/dL

Question 7

What is the normal plasma glucose level 2 hours after a meal?

Answer 7

<140 mg/dL

Question 8

What is the diabetic fasting bg level?

Answer 8

> 126 mg/dL

Question 9

What is the diabetic bg level 2 hours after glucose load?

Answer 9

> 200 mg /dL

Question 10

What are the cells that are destroyed in DM I?

Answer 10

Beta cell destruction

Question 11

True or false: any drop in beta cells will change bg levels?

Answer 11

False-there are more beta cells that needed to meet demand

Question 12

What are the genes that are associated with DM I?

Answer 12

DQ and DR genes of the MHC class II

Question 13

What are the two haplotypes that are associated with DM I?

Answer 13

DR3 and DR4

Question 14

What are the antibodies that can be detected in DM I?

Answer 14

autoantibodies to islet cells, insulin, others

Question 15

Are the antibodies responsible for the destruction of islet Beta cells?

Answer 15

no, infiltration of activated T lymphocytes in beta cells is.

Question 16

What are the two possible triggers for DM I?

Answer 16

Toxins or viruses

Question 17

What is the effect of breastfeeding on the development of DM I?

Answer 17

Decreases risk

Question 18

What is the effect of living in first world countries on DM I?

Answer 18

Increases risk

Question 19

How could viruses theoretically cause the development of DM I?

Answer 19

Molecular mimicry

Question 20

What happens to gluconeogenesis in DM I?

Answer 20

increases

Question 21

What happens to glycogenolysis in DM I?

Answer 21

Increases

Question 22

What happens to glycolysis in DM I?

Answer 22

Decreases

Question 23

What happens to lipolysis/ketone production in DM I?

Answer 23

Increases

Question 24

What causes blurred vision seen in DM I?

Answer 24

Hyperosmolar state

Question 25

What causes the weight loss seen in DM I?

Answer 25

Depletion of water | Loss of muscle mass

Question 26

What causes the weakness/dizziness seen in DM I?

Answer 26

Postural hypotension | K loss and loss of muscle catabolism

Question 27

What causes the paresthesias seen in DM I?

Answer 27

Temporary peripheral sensory nerve dysfunction

Question 28

What causes LOC with DM I?

Answer 28

Dehydration of tissues | DKA

Question 29

What are the three ways to manage DM I?

Answer 29

Diet Edu Insulin

Question 30

Why can insulin not be given PO?

Answer 30

Peptide would be degraded by GI

Question 31

What are the two causes of DM II?

Answer 31

Insulin resistance or secretory defect (or both)

Question 32

What happens to Beta cell mass in DM II?

Answer 32

Increase since there is no uptake of glucose

Question 33

What happens to the insulin receptors in DM II?

Answer 33

Less of them OR decrease affinity to insulin

Question 34

What are the three adipokines?

Answer 34

Leptin IL-6 TNF-alpha

Question 35

What is the effect of adipokines?

Answer 35

Recruits immune cells

Question 36

Can an increase in insulin and beta cell mass overcome insulin resistance?

Answer 36

Yes

Question 37

What causes the increased beta cell stress in DM II?

Answer 37

Increased ER stress Adipokines Ectopic fat deposition in islets

Question 38

What is metabolic syndrome?

Answer 38

Hyperglycemia associated with: Hyperinsulinemia Dyslipidemia HTN

Question 39

Metabolic syndrome can lead to what?

Answer 39

CAD and Stroke

Question 40

What is the effect of insulin on Na retention?

Answer 40

Increases

Question 41

What is the effect of insulin on VLDL secretion?

Answer 41

Increases

Question 42

What is the effect of insulin on vascular smooth muscle cell proliferation? What does this result in?

Answer 42

Increases--results in atherosclerosis

Question 43

What is the significance of metabolic syndrome on management?

Answer 43

Changes therapeutic approach

Question 44

Which DM type has a higher concordance rate between monozygotic twins?

Answer 44

Type II

Question 45

What are the genes that predispose someone to DM II involved in?

Answer 45

Beta cell function

Question 46

Why are infections more common in DM II?

Answer 46

high sugar blood = good for bacteria

Question 47

What are the classic, severe signs/symptoms of DM II?

Answer 47

Polyuria, polydipsia, blurred vision, weakness

Question 48

What are the pharmacologic strategies toward DM II?

Answer 48

1. Increase insulin secretion or action 2. Inhibits gluconeogenesis 3. Inhibit glucose digestion/absorption 4. Suppress glucagon

Question 49

What is the effect of drugs that mimic GLP1 on treating DM II?

Answer 49

Promotes insulin secretion

Question 50

What is the effect of drugs that inhibit DDPP4 on treating DM II?

Answer 50

inhibits GLP1 degradation

Question 51

What is the effect of drugs that sulfonylurease and meglitinde analogs on treating DM II?

Answer 51

Inhibits that ATP sensitive K pump on beta cells which closes the channel and causes a depolarization

Question 52

What is the effect of drugs that thiazolidinediones on treating DM II?

Answer 52

Promote the expression of GLUT1 and GLUT4, and thus increase glucose uptake in peripheral tissues

Question 53

What are the symptoms of hypoglycemia?

Answer 53

``` Tachycardia Sweating Tremors Nausea Hunger ```

Question 54

What are neuroglycopenia symptoms

Answer 54

``` Irritability Confusion HA Speech difficulty Blurred vision LOC ```

Question 55

What is the treatment for hypoglycemia?

Answer 55

Glucagon/glucose

Question 56

What causes DKA?

Answer 56

insulin deficiency causes lipolysis, causing acidification of the blood

Question 57

When is DKA seen in DM II pts?

Answer 57

Sepsis, trauma, or surgery

Question 58

What are the treatment goals of DKA?

Answer 58

Restore plasma volume Reduces glucose Correct acidosis Replenish electrolytes