Exam 2 pre lecture 2

Question 1

how is pancreatic B cell affected in diabetes patients

Answer 1

B cells may be destroyed or stop working (decrease in function or mass)

Question 2

what happens to incretin effect in diabetes pts

Answer 2

Diabetes patients have reduced incretin

Question 3

a-cells contribution to diabetes

Answer 3

A cell defects. A cells help balance blood sugar by releasing glucagon to raise blood sugar

Question 4

a cells seceret_______. How does that affect the blood sugar

Answer 4

Glucagon. This raises Blood sugar

Question 5

Liver, muscle and adipose contribution to diabetes

Answer 5

There is a reduction in uptake in glucose in skeletal muscle
Increased lipolysis in adipose
Increased glucose production (gluconeogenesis)

Question 6

brain contribution to diabetes

Answer 6

Increased appetite, reduced morning dopamine surge and increased sympathetic tone

Question 7

colon/biome contribution to diabetes

Answer 7

Gut bacteria may decrease GLP-1 secretion

Question 8

stomach/small intestine contribution to diabetes

Answer 8

increased rate of glucose absorption, quick stomach emptying =increased glucose absorption

Question 9

kidney contribution to diabetes

Answer 9

Increased glucose reabsorption.

Question 10

upregulation of SGLT2 can lead to

Answer 10

increased glucose absorption

Question 11

Type 1 DM other name

Answer 11

LADA (Latent autoimmune disease of adulthood

Question 12

Age of onset for type 1 and type 2 dm

Answer 12

Both can happen at any age, but
T1 usually <30
T2 usually >40

Question 13

family history is seen in

Answer 13

Type 2

Question 14

clinical presentation of T1 vs T2 diabetes

Answer 14

T1- all polys (polyuria, polydipsia, polyphagia)

T2- Mild polyuria, nocturia, polydipsia, fatigue

Question 15

Risk factors for diabetes

Answer 15

FH, obesity, race, CVD
impaired glucose tolerance
A1C 5.7-6.4
HTN (130/80)
HDL<35
TG>250
PCOS

Question 16

levels that puts you at risk for HDL and TG

Answer 16

HDL<35
TG>250

Question 17

diagnosis levels for diabetes

Answer 17

FBG>126 x2
A1C>or= 6.5
2H-ppG>200 during OGTT
random gluc>200

Need to have 2 different tests of 1 on two separate occasions to diagnose

Question 18

Normal levels of fasting, A1C and 2-Hr OGTT

Answer 18

fasting<100
A1c<5.7
2 Hr OGTT<140
random<200

Question 19

What A1c levels are at risk for DM but not quite

Answer 19

between 5.7 and 6.4

Question 20

IFG (impaired fasting glucose) levels

Answer 20

Between 100 and 125

Question 21

IGT (impaired glucose tolerance) levels

Answer 21

2 HR OGTT between 140 and 199

Question 22

screening checks for T1 DM

Answer 22

IA-2
IA-2B
GAD (glutamic acid decarboxylase)
Zn transporter

Question 23

Screening checks for T2 DM

Answer 23

Should begin at 35 yo

(obese, pregnancy, HIV pts) repeat at 3 year intervals

Question 24

prediabetic pts should be tested for what? how frequently?

Answer 24

A1C, IGT, IFG

Question 25

prevention tactics for T2 DM

Answer 25

Weight loss and physical activity
Initiation of metformin in prediabetic pts

Question 26

Non PCOL therapy for T2 DM

Answer 26

weight loss
monitor intake and limit sugar (45 gm/meal for women and 60 gm/meal for men)
Increase monounsaturated fats
less than 300 mg cholesterol (less than 200 for elevated cholesterol pts)