DM Physiology and Pathophysiology

Question 1

What cells secrete insulin?

Answer 1

the beta cells of the Islets of Langerhans found in the exocrine portion of the pancreas

Question 2

First precursor to insulin?

Answer 2

Preproinsulin (110 amino acids long)

Question 3

Which is the storage form of insulin?

Answer 3

The Heximer

Question 4

Which is the active form of insulin?

Answer 4

The Monomer

Question 5

Insulin is increased by (3 things)

Answer 5

Glucose, Amino Acids, and gastrointestinal enzymes (incretins)

Question 6

Alogliptin

Answer 6

Takeda

Question 7

Linagliptin

Answer 7

Tradjenta

Question 8

Sitagliptin

Answer 8

Januvia

Question 9

Saxagliptin

Answer 9

Onglyza

Question 10

Exenatide

Answer 10

Byetta And Bydureon

Question 11

Liraglutide

Answer 11

Victoza

Question 12

Which ion acts as an insulin secretagogue?

Answer 12

Ca2+

Question 13

How does calcium enter the B cell?

Answer 13

Influx through voltage dependent channels and release from an ER like compartment

Question 14

Phase 1 insulin release

Answer 14

Released within seconds of food ingestion, peaks in 1-2 minutes, lasts 10 minutes, suppresses hepatic glucose output, not seen in type 2 DM

Question 15

Phase 2 insulin release

Answer 15

occurs within 15 min of phase 1, lasts 1-2 hr, lowers postprandial rise in blood glucose

Question 16

This type of diabetes could be immune regulated or idiopathic.

Answer 16

Type 1 diabetes

Question 17

This type of diabetes is primarily insulin resistance or a secretory defect.

Answer 17

Type 2 diabetes

Question 18

Acute T1DM symptoms

Answer 18

Polyuria, Polydipsia, Weight Loss, Elevated BG, increased ketone bodies (ketoacidosis)

Question 19

Beta Cells secrete

Answer 19

Insulin

Question 20

Alpha cells secrete

Answer 20

glucagon

Question 21

Delta cells secrete

Answer 21

somatostatin

Question 22

Honeymoon Phase

Answer 22

Short period of time directly after acute symptoms when diabetic patients seem to make some of their own insulin. Then drops to making no insulin.

Question 23

In which type of Diabetes does genetics play the largest role?

Answer 23

Type 2 diabetes

Question 24

Symptoms of hypoglycemia

Answer 24

shaking, sweating, palpitations, confusion, and coma

Question 25

Microvascular Complications

Answer 25

Neuropathy, Nephropathy, and retinopathy

Question 26

Dawn Phenomenon

Answer 26

No nocturnal hypoglycemia, just normal diurnal rhythem of GH, Cortisol, and catecholamines (normoglycemic if tested at 2-3AM)

Question 27

Somogyi Effect

Answer 27

nocturnal hypoglycemia followed by hyperglycemia. (will have hypoglycemia if tested at 2-3 AM)

Question 28

Fasting Hypoglycemia caused by Insufficient Insulin Admin.

Answer 28

Will by hyperglycemic if tested at 2-3 AM