Mod 8: dm2 Flashcards
4 Risk factors for diabetes type two
Age
Activity level
hypertension
History fam
The prediabetic state with central obesity, dyslipidemia, pre-hypertension, and elevated fasting blood glucose w ^risk for cardiac events is called _____ syndrome
Metabolic syndrome
Metabolic syndrome acidosis Must have three of Waist circumference triglycerides HDL Bp fasting glucose
Waist circumference >40 men, >35 w triglyceride >150 HDL m: <40 w: <50 Bp >130/85 fasting glucose >100
DM2 Underlying pathological process:
vInsulin ______
vInsulin _______
vInsulin cell receptors
vInsulin secretion to meet metabolic needs
How does obesity contribute to insulin resistance
^___, v___, and _____=vinsulin ___
^leptin, vAdiponectin, inflammation = vInsulin synthesis
Free fatty acids in obesity interfere with _____, v_____, alter ____action
Free fatty acids promote ___ and cause ___of beta cells
interfere with intracellular insulin signaling, vTissue response to insulin, alter incretin action
promote inflammation and cause apoptosis
Insulin resistance is increased by:
the release of inflammatory ____
reduced ___activity
cytokines released
reduced mitochondrial activity
what prevents the appearance of diabetes in the obese for many years
what will eventually fails and cause insulin deficiency
hyperinsulinemia
Beta cells
what causes an increase in ^glucagon levels (2)
_____ being less responsive to ____
v____
alpha cells being less responsive to glucose inhibition
amylin deficiency
decreased level of ___ is also associated with insulin resistance
grelin
Beta cell responses to ___ is ___ in prediabetes and DM2
response to incretins is reduced
DKA not likely because _____
there is no need for ______
also no signs of _______
there is some insulin secretion so no need for gluconeogenesis
so no signs of metabolic acidosis either
More severe DM2 s/s (6) are d/t glucose rising much higher (400-900) than type 1 bc initial s/s are mild
fatigue, infections, weight loss, neuropathy, visual changes, pruritis
Secondary DM can be d/t (6)
CCPASE
CA cushing pancreatitis acromegaly steroid use excess glucagon secretion
All pregnants should be screened between ___-___ wks gestation
If they have gestational dm, screen them __-__wks postpartum
upon birth, child may have ___ and____
24-28
6-12wks
hyperplasia of pancreatic islet cells and hypoglycemia
