Exam 2 pre lecture

Question 1

what is polyuria

Answer 1

frequent urination

Question 2

polydipsia meaning

Answer 2

excessive thirst

Question 3

what is polyphagia

Answer 3

lack of weight gain and feeling hungry

Question 4

WHat are the 3 cardinal signs of diabetes

Answer 4

polyuria, polydipsia, polyphagia

Question 5

What is the mechanism leading to the 3 polys

Answer 5

high BG leads to glucose in urine.
This leads to excessive water loss (polyuria) leading to dehydration and polydipsia.
Inability to utilize glucose as fuel lowers BW and leads to excessive hunger

Question 6

what is the criteria for diagnosis of diabetes

Answer 6

A1C > or = 6.5% or fasting plasma glucose (FPG) > or = 126

2-H plasma glucose of >200
random plasma glucose >200

Question 7

Type 1 diabetes is also known as

Answer 7

Insulin dependent diabetes mellitus (IDDM)

Question 8

What percent of people have type I DM

Answer 8

10%

Question 9

insulin secretion in Type I DM

Answer 9

no functional insulin secretion due to near complete loss of pancreatic B cells

Question 10

Type I DM may cause ________

Answer 10

ketoacidosis

Question 11

Why does T 1 DM lead to ketoacidosis

Answer 11

We use fatty acids for fuel leading to the production of ketoacids

Question 12

Age onset of T I DM

Answer 12

early

Question 13

what is T I DM

Answer 13

an autoimmune response that specifically targets pancreatic B cells

Question 14

FH for T 1 DM

Answer 14

often negative family history

Question 15

What are the two antibodies that suggest an immune response against pancreatic B cells

Answer 15

ICA- islet cell cytoplasmic antibodies
IAA- Insulin antibodies

Question 16

how does T 1 DM appear as person ages

Answer 16

Early on, they have 100% BCM (Beta cell mass) and are ICA and IAA negative. presence if ICA and IAA suggest immune response to pancreatic B cell. loss of BCM is gradual and fasting blood glucose (FBG) is normal until 70% of BCM is lost.

Question 17

what is OGTT, what is it used for?

Answer 17

Oral glucose tolerance test, we give large bolus of glucose and BG is measured. SHows hyperglycemia if BCM does not have enough insulin to bring it down.

Question 18

What is C-peptide

Answer 18

It indicates the presence of functioning B cell mass. It is a marker for insulin secretion even if they are receiving exogenous insulin

No c-peptide= no BCM left

Question 19

sensitivity vs selectivity difference

Answer 19

sensitivity- if someone does not have type I DM, but have IA-2 they have a 57% chance of developing it

selectivity- 99% of T 1 DM have antibodies against IA-2

Question 20

T 2 diabetes % of diabetic population

Answer 20

90

Question 21

T 2 DM is also known as_________ and can be classified into _______ and ________

Answer 21

non-insulin dependent diabetes mellitus

can be classified into obese and non-obese

Question 22

percentage of obese T 2 DM pts

Answer 22

80%- obese, 10% non-obese

Question 23

non obese T 2 DM is often referred to as

Answer 23

MODY (maturity onset diabetes of young)

Question 24

Why is T2 DM referred to as MODY

Answer 24

age of onset is below 25

Question 25

age of onset of obese T 2 DM

Answer 25

usually over 35

Question 26

Which one is positive for FH, T1 or T2

Answer 26

T2

Question 27

Insulin secretion in T1 vs T2

Answer 27

T1 has no secretion while T2 has low secretion

Question 28

what aspect of obese T 2 diabetics leads to loss of B cell mass

Answer 28

Obese T 2 diabetics show insulin resistance, this leads to overproduction of insulin stressing B cell. Leads to loss of B cell mass.

Question 29

What are the 4 consequences of lack of insulin

Answer 29

Hyperglycemia-
glucosuria
hyperlipidemia
uninhibited glucagon secretion-

Question 30

How does a lack of insulin affect glycogen synthesis

Answer 30

decreases it

Question 31

how does a lack of insulin affect gluconeogenesis

Answer 31

insulin inhibits gluconeogenesis. A lack causes aa conversion into glucose

Question 32

how does a lack of insulin lead to hyperlipidemia

Answer 32

causes increased fat mobilization from fat cells.

Also increased fat oxidation (leads to ketoacidosis sue to accumulation of ketone bodies)

Question 33

relationship between insulin and glucagon

Answer 33

glucagon is opposite of insulin. Insulin inhibits glucagon.

Question 34

prolonged hyperglycemia complications

Answer 34

Cardiovascular
neuropathy
nephropathy
ocular
increased susceptibility to infections

Question 35

what are some CV complications hyperglycemia could cause

Answer 35

Micro and macro angiopathy (damage to large and small BV)

Question 36

what are some neuropathies hyperglycemia could cause

Answer 36

accumulation of glucose in nerves are then reduced by aldose reductase to sugar alcohol. This leads to reduced protection from oxidative damage and H20 accumulation in neurons

Question 37

What are some nephropathies caused by hyperglycemia

Answer 37

Changes in renal vasculature and to glomerular basement membrane

Question 38

What are some ocular complications that could be caused by hyperglycemia

Answer 38

Cataracts, retinal microaneurism

Question 39

Insulin therapy goals in diabetics

Answer 39

keep avg glucose below 150.
fasting-70-110
pre-meal- 80-130
peak food- less than 180

Question 40

ideal A1c vs A1c for diabetic pt

Answer 40

ideal 6 or below
diabetic 7 or below

Question 41

Why is A1c a goof measure

Answer 41

It is considered a good average of total glucose levels because it is a sum total of the exposure of erythrocytes to glucose concentration in blood stream