Insulin/AntiDM (lec 27)

Question 1

DM Type 1 caused by?

Results in?

Answer 1

non-fxning pancreatic β-cells (don’t respond to glucose)

no circulating insulin

Question 2

DM Type 2 caused by?

Answer 2

2º to extra-pancreatic factors: tissues insensitive to circulating insulin

chronic overfeeding -> sustained β-cells stim -> hyperinsulin -> desensitized receptors

Question 3

DM signs/sxs?

Answer 3

Polyuria/dipsia/phagia,
weak/fatigued,
blurred vision,
vaginitis,
peripheral neuropathy

Question 4

Chronic diabetic syndrome signs/sxs?

Answer 4

Ocular: cataracts, retinopathy
CV: atherosclerosis, HTN, gangrene
Neuro: neuropathy, GI, GU
Skin: xanthoma, infection, shin spots

Question 5

Insulin deficiency causes what?

Answer 5

hyperglycemia
hyperlipidemia
hyperketonemia
myoglobinuria
glucosuria
microangiopathy

Question 6

DM diagnostics?

Answer 6

Fasting:
plasma glu > 126 on > 1 test

Post glu ingestion:
plasma glu @ 2hrs > 200

Question 7

Hemoglobin A1c is?

Tells us?

Answer 7

glycosylated protein

long term blood [glu]
A1c follows glu levels

Question 8

Hgb A1c normal level?

Poorly controlled DM?

Controlled DM?

Answer 8

< 6%

> 10%

< 7%

Question 9

Insulin release inhibited by?

Answer 9

⍺2-agonists,

SNS

Question 10

Insulin release stim by?

Answer 10

glucose,
β2-adrenergic agonists,
AA, FA, ketone bodies

Question 11

Insulin metabolized by?

Answer 11

liver/kidney

Question 12

High insulin causes what?

Signs/sxs?

Answer 12

hypoglycemia

tachy,
confusion,
sweating,
vertigo,
lipodystrophy

Question 13

↑ insulin requirements caused by?

Answer 13

fever, surgery, trauma
pregnancy, thyrotoxicosis
↑ insulin-binding antibodies
↑ GH
Cushings