Exam 3 - diabetes mellitus Flashcards
DM is a dysfunction of:
the endocrine pancreas
What does type 1 DM affect the metabolism of?
fat, protein, and carbohydrates
DM is not one disease, but a what? with what in common?
group of diseases WITH glucose intolerance in common
DM is characterized by:
hyperglycemia
DM can be the result of defects in what?
- insulin secretion
- insulin action
- or both
What type of DM is most common in children?
Type 1 diabetes
Define type 1 diabetes mellitus:
insulin-dependent diabetes mellitus
What type of DM is most common in adult? or has an onset during adulthood?
type 2 diabetes
define type 2 diabetes mellitus:
non-insulin-dependent diabetes mellitus
What is type 2 diabetes associated with?
obesity and insulin resistance
What are four ways to diagnose diabetes mellitus?
- glycosylated hemoglobin HgA1C levels
- more than 1 fasting plasma glucose greater than 140 mg/dl
- 2 hour plasma glucose during oral glucose tolerance testing (OGTT)
- random glucose levels about 200 mg/dl with symptoms
What kind of method is HgA1C?
method to follow plasma glucose over time
What do glucose molecules do with hemoglobin?
glucose molecules join to hemoglobin in 120 day life span of RBCs
What is typical of those with poorly controlled diabetes and HgA1C?
those with poorly controlled diabetes have increased levels of glycosylated hemoglobin
What values will be elevated with DM?
HgA1C, FPG, or OCTT
what are two other risk factors for DM?
- impaired glucose tolerance (IGT)
2. impaired fasting glucose (IFG)
what does impaired glucose tolerance come from?
diminished insulin secretion
what does impaired fasting glucose come from?
from enhanced hepatic glucose output
What happens with the pancreas and beta cells in type 1 DM?
- pancreatic atrophy
2. loss of beta cells
Type 1 diabetes mellitus characterizes what percent of diabetes in western world?
10%
What is Type 1 diabetes the result of?
genetic susceptibility and environmental factors
What is there a strong genetic associated of with type 1 DM?
with HLA class II antigens DR and DQ
What are two genetic susceptibility factors that increase risk of type 1?
- first-degree relative with type 1
2. strongest association with MHC
What are two environmental factors that increase risk of type 1?
- viral infection: H. pylori infection
2. exposure to cow’s milk proteins, relative lack of vitamin D