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Medical Perspectives 411 > DM > Flashcards

DM Flashcards

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1
Q

DM literal meaning

A

blood sugar in urine, the urine tastes sweet, thats why MD use to drink to diagnose

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2
Q

DM is what kind of disease resulting from a ?

A

DM is a metabolic disease resulting from a defect in insulin secretion, action, or both, and is chronic, systemic disorder characterized by hypoglycemia and disruption of carbs, fat, and protein metabolism

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3
Q

What is responsible for DM ?

A

The chronic state of hypoglycemia is responsible for dysfunction and impairment in tissues and organs

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4
Q

Type I DM is called

A

insulin dependent/ juvenile

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5
Q

Type I DM is an

A

autoimmune response at the islet cells of the pancreas associated with an absolute deficiency of insulin production and secretion, typically before 14, peak onset 11

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6
Q

A patient with Type I DM requires

A

exogenous insulin to maintain life

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7
Q

Type II DM previously known as (On test)

A

Non-insulin dependent DM (NIDDM) or adult onset DM

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8
Q

Type II DM derived from a

A

combo of cellular resistance to insulin and an inadequate adjustment via secretion to the desensitized receptors, which are the alpha subunits on tyrosine kinase

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9
Q

Autoimmune component of Type II DM

A

happens in middle to late adulthood
does not impact affect of pancreatic beta cells
immune cells attack body cuz they see the cells as foreign invaders/ bad shit

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10
Q

Individuals have endogenous insulin production, yet

A

ineffective insulin action at the cellular level, so exogenous insulin is not effective in type II DM

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11
Q

Type II DM is associated with what

A

obesity, inactivity/ prolonged sedentary nature, smokers, age, gene susceptibility

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12
Q

Beta cells are unable to do what in type II DM

A

unable to increase production of insulin to compensate for the cell receptor hyposensitivity

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13
Q

When the body cannot use glucose the way that it should is considerd what?

A

preDB

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14
Q

When less glucose moves into the celll, plasma glucose levels rise =

A

preDB

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15
Q

Decreased insulin sensivity is

A

PreDB

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16
Q

The cells stop responding to the action of insulin (insulin resistance)

A

PreDB

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17
Q

Blood glucose levels are above normal but do not yet meet the criteria for diabetes diagnosis

A

preDB

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18
Q

100 mg/dl to 125 mg/dl plasma glucose levels

A

preDB

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19
Q

DB severe complications of: due to oxidative stress/ systemic inflammation include diseases and SX

A 
Heart disease 
stroke
Kidney disease
blindness
loss of limbs
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20
Q

WHAT IS THE MOST COMMON ENDOCRINE DISEASE?

A

DM

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21
Q

insulin is an antagonist to the hormone

A

cortisol

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22
Q

cortisol causes

A

hypoglycemia and stress to sys, and makes cells desitivied to insulin receptor, resitin

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23
Q

Since 1970 DM rates have increased due to

A

prolonged life expectancy

increased incidence of obesity

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24
Q

diabetes insipidus caused by

A

trauma to hypothalamus

lack of ADH production

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25
Watching 2 or more hours of TV daily is a RF for
DM
26
Skipping breakfeast is a RF for
DM cuz coritsol is released to conserve glucose
27
Insulin is secreted by
beta cells (Tyrosine kinase) of pancreas
28
Insulin helps to
transport glucose into cells for fuel or for storage (glycogen/adipose)
29
insulin stimulates what mTOR stimulates
protein synthesis
30
insulin stimulates not carbs but
FFA storage
31
When glucose levels after meal,
beta cells increase secretion of insulin into the blood stream, thus, lowering plasma glucose levels
32
Blood glucose levels drop as the cells take up glucose, this does what?
reestablishes plasma homeostasis
33
Deposit large amounts of glucose in the liver as per glycogen storage, but unable if
insulin resistant or insensitive, which increases glucose secretion due to lack of phosphorylation of glucose to glucogen
34
Kidneys excrete excess
glucose in an attempt to balance blood sugar levels, making sweet urine yum
35
Kidney action of DM is due to
excessive water loss to osmotic diuretic force generated from glucose excretion, forces water out increasing urination
36
Increased fat mobilization occurs causing
excessive ketone formation creating decreased pH, increasing acidity
37
By-products of fat metabolism in combo with glucose excretion by the kidneys increase the
osmotic pressure and rapid dehydration can happen in conjuncton with elctrolyte imbalance
38
Muscle and most other body tissues are most blank to glucose
impermeable
39
What is used to increase permeability to glucose?
insulin increases cell membrane permability to glucose more than 10 fold/times
40
Liver is moderately | only organ to do this
permeable to glucose, both in and out, when insulin is or isn't present
41
Glucose can leave Liver
easily unless it has been phosphorylated, not converted to glycogen via glycogen synthase
42
Insulin promotes the activity of the
glucokinase enzyme, which phosporylates glucose and enzymes that promote glycogen synthesis (vital for later portion of exercise)
43
Insulin promotes protein what
storage in muscle cells as amino acids
44
Insulin promoting protein storage cuases promotion and enhances
protein synthesis, stimulates AA uptake across the plasma membrane
45
Protein and insulun increases
DNA/RNA transcriptional mechanism and inhbits protein catabolism, break down AA causing muscle wasting in DM due to protein synthesis lacking
46
Lipid and insulin stimulates the synthesis and storage of
TGs, which inhibits the enzyme that break down stored llipids, (HSL) Hormone sensitive lipase
47
DM has plasma lipid levels rise by approx
500%
48
DM results in
atherosclerosis
49
DM can cause
cardiovascular complications, and impaired protein use occurs for fuel
50
DM 3 three complication vascular/ neurology
Large blood vessels (atheroscelorss) small blood vessels (retina damage) nerves (neuropathies)
51
DM and mitochondria
excess superoxide production in the mitochondria
52
DM causes lack of the body to
heal or regenerate results in increased susceptibility to infection, or lack of ability to heal from infection (weak immune sys)
53
DM can result in
sensory, motor, and/or autonomic neurppathy
54
DM and ecg with autonomic neuopathy
ECG not accurate secondary to autonomic neuropathy
55
Sensory example with DM
Poor temp regulation/ BP regulation with exercise
56
There frequent what in DM
frequent ulceration
57
healthy A1C desire less than
5
58
Hemoglobin A1C indicates the average
hemoglobin exposure to glucose over a prolonged time period for approx. 30-60 days
59
insulin molecule is comprised of
large polypeptide of 51 amino acids
60
insulin facilitates
the entrance of glucose into peripheral tissues
61
Alpha cells of pancreas yield
glucagon
62
Beta cells of pancreas produce
insulin
63
Delta cells of pancreas produce
somatostatin
64
somatostatin regulates
GI absorption and motility
65
F cells of pancreas produce
pancreatic polypeptide
66
GLUT proteins are
glucose transporters from the intracellular storage sites to the cell membrane of skel muscle and other peripheral tissues
67
GLUT proteins synthesized and stored in the
Golgi system of the cell
68
GLUT-4:
glucose transporter in muscle and fat cells
69
GLUT4 promote
facilatated diffusion for glucose transport across the plasma membrane
70
Insulin binds to a specific insulin receptor (a paired receptor)
Tyrosine kinase
71
Alpha subunit =
receptor site
72
Beta:
enzyme that reuslts in autophosporylation through a tyrosine kinase mechanism that initiates a series of biochemical cellular reactions
73
Insulin Receptor Substrates (IRSs) get
phosphorylated by tyrosine
74
IRSs initate changes in
various metabolic pathways that result in increase glucose uptake
75
IRSs initiate the translocation of
glucose transporters from intracellular storage sites to the cell membrane
76
IRSs and GLUT proteins promote
facilated diffusion via glut4
77
As plasma glucose [ ] rise, what happens
beta cells increase synthesis/ release of insulin
78
increased plasma glucose causes insulin to take it into cells, which reduces
blood glucose [ ] to normal
79
increased plasma glucose causes insulin to take it into cells, controlled by other factors:
cortisol, thyroxine (T4), lipid, and AA [ ]
80
Insulin release inhibits what
glucagon synthesis/release from the alpha cells
81
Reduced insulin release is correlated w/
increased glucagon
82
Factors afecting insulin release
Elevated blood glucose rising AA and Fatty acid levels ACh through parasympathetic pathways Somatostatin and sympathetic nervous system pathways
83
Rising AA and fatty acid levels increases
insulin secretion
84
ACh through parasympathetic pathways increases
insulin secretion
85
Somatostatin and sympathetic nervous system pathways
decreases insulin release allowing increase in blood glucose levels
86
Hyperglycemia
lack of insulin mediated tissue glucose uptake
87
Microangiopathy and why?
abnormalities in small diameter blood vessels because of thickening of the basement membrane causing occulsions causing ischemia to tissues
88
hyperglycemia and microangiopathy damage by DM
Retina kidneys poor wound healing
89
Microangiopathy disease
large vessel thickening resulting in atherosclerosis, diseases include HTN, MI, CVA, and these conditions also demonstrate insulin resistance even when not combined with DM
90
adverse effects of exogenous insulin for type I DM
hypoglycemia
91
Immunosuppressants for type I DM
has an autoimmune origin, drugs that suppress the immune sys are becoming more common
92
sulfonylureas act directly on
pancreatic beta cells
93
sulfonylureas stimulate the release of
endogenous insulin
94
sulfonylureas released directly into the
hepatic portal vein travelling to the liver, which inhbits hepatic glucose production
95
sulfonylureas effect, increased insulin prodcution also aids in
glucose entry into muscle tissue
96
sulfonylureas most succesful for individuals with early
type II DM and still have good beta cell function
97
biguanides act directly on the
liver to decrease hepatic glucose production, also increase sensitvity of peripheral tissues to insulin
98
Alpha-glucosidase inhibitors inhbit
sugar breakdown in the intestines and also delays glucose absorption from the intestines
99
Thiazolidinediones similar mech to
biguanides
100
Dietary management non-pharm intervention for DM
total caloric intake and percentage of those being carbs
101
Weight loss non-pharm intervention for DM reduce the amount of
tissue that requires insulin, therby reducing the need for exogenous drugs

Medical Perspectives 411 (9 decks)

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