Exam 2 pre lecture 2 Flashcards
how is pancreatic B cell affected in diabetes patients
B cells may be destroyed or stop working (decrease in function or mass)
what happens to incretin effect in diabetes pts
Diabetes patients have reduced incretin
a-cells contribution to diabetes
A cell defects. A cells help balance blood sugar by releasing glucagon to raise blood sugar
a cells seceret_______. How does that affect the blood sugar
Glucagon. This raises Blood sugar
Liver, muscle and adipose contribution to diabetes
There is a reduction in uptake in glucose in skeletal muscle
Increased lipolysis in adipose
Increased glucose production (gluconeogenesis)
brain contribution to diabetes
Increased appetite, reduced morning dopamine surge and increased sympathetic tone
colon/biome contribution to diabetes
Gut bacteria may decrease GLP-1 secretion
stomach/small intestine contribution to diabetes
increased rate of glucose absorption, quick stomach emptying =increased glucose absorption
kidney contribution to diabetes
Increased glucose reabsorption.
upregulation of SGLT2 can lead to
increased glucose absorption
Type 1 DM other name
LADA (Latent autoimmune disease of adulthood
Age of onset for type 1 and type 2 dm
Both can happen at any age, but
T1 usually <30
T2 usually >40
family history is seen in
Type 2
clinical presentation of T1 vs T2 diabetes
T1- all polys (polyuria, polydipsia, polyphagia)
T2- Mild polyuria, nocturia, polydipsia, fatigue
Risk factors for diabetes
FH, obesity, race, CVD
impaired glucose tolerance
A1C 5.7-6.4
HTN (130/80)
HDL<35
TG>250
PCOS
levels that puts you at risk for HDL and TG
HDL<35
TG>250
diagnosis levels for diabetes
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
Normal levels of fasting, A1C and 2-Hr OGTT
fasting<100
A1c<5.7
2 Hr OGTT<140
random<200
What A1c levels are at risk for DM but not quite
between 5.7 and 6.4
IFG (impaired fasting glucose) levels
Between 100 and 125
IGT (impaired glucose tolerance) levels
2 HR OGTT between 140 and 199
screening checks for T1 DM
IA-2
IA-2B
GAD (glutamic acid decarboxylase)
Zn transporter
Screening checks for T2 DM
Should begin at 35 yo
(obese, pregnancy, HIV pts) repeat at 3 year intervals
prediabetic pts should be tested for what? how frequently?
A1C, IGT, IFG
prevention tactics for T2 DM
Weight loss and physical activity
Initiation of metformin in prediabetic pts
Non PCOL therapy for T2 DM
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)
