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nhm 365 > Module 9: Diabetes Pathophysiology > Flashcards

Module 9: Diabetes Pathophysiology Flashcards

1
Q

This is a group of diseases characterized by high blood glucose concentrations resulting from defects in:

  • Insulin secretion
  • Insulin action
  • Or both
A

diabetes mellitus

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2
Q

Galactose and most fructose are converted to _________.

A

glucose

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3
Q

If we don’t get glucose from CHO (food), the liver will make new glucose out of non-CHO substrates like lactate or AAs. What process is this called?

A

Gluconeogenesis

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4
Q

T/F: Glucose is the universal fuel source for every cell of the body.

A

T

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5
Q

T/F: RBCs can ONLY use glucose for fuel.

A

T

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6
Q

T/F: RBCs have mitochondria and go through glycolysis.

A

F (they don’t have mitochondria)

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7
Q

________ is termed a LOW blood glucose.

A

Hypoglycemia

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8
Q

_________ is termed a HIGH blood glucose.

A

Hyperglycemia

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9
Q

T/F: Hyperglycemia increases a person’s risk for atherosclerosis and CVD.

A

T

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10
Q

Hyperglycemia can cause microvascular complications in the vessels of the eyes and kidneys, leading to ____________and the _____________.

A

retinopathy, nephropathy

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11
Q

Hyperglycemia can cause damage to nerves called ______________.

A

neuropathy

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12
Q

Those with DM may have amputated toes and/or feet due to ________ damage and poor ______________ to those extremities.

A

nerve, circulation

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13
Q

The key regulators of blood glucose are the 2 peptide hormones: ______________ and __________.

A

glucagon, insulin

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14
Q

Insulin is synthesized and secreted by _______________ of the __________.

A

beta-cells, pancreas

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15
Q

Glucagon is synthesized and secreted by _________________ of the __________.

A

alpha-cells, pancreas

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16
Q

After eating CHO, blood glucose levels _________ and the pancreatic __________ cells secrete ___________ into the blood.

A

increase/rise, beta, insulin

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17
Q

Insulin stimulates _______________ uptake by cells. Then blood glucose returns to normal.

A

glucose

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18
Q

Without insulin, glucose can’t enter the cells leading someone to become _____________.

A

hyperglycemic

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19
Q

If blood glucose decreases/drops, then the pancreas secretes ____________.

A

glucagon

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20
Q

Glucagon stimulates the ___________ to break down glycogen and release that glucose into the _________.

A

liver, blood

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21
Q

______________ stimulates the liver to synthesize glucose from non-CHO (i.e. lactate & AAs).

A

Glucagon

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22
Q

When blood glucose levels ________________, insulin is secreted from pancreatic _____________ __________. This acts to __________ blood glucose levels.

A

increase/rise, beta cells, lower/decrease

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23
Q

T/F: The prevalence of diabetes increases with age.

A

T

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24
Q

T/F: The prevalence of diabetes is more common among those who are underweight.

A

F (more common in overweight and obese people)

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25
Q

T/F: Obesity is a major risk factor for Type 2 DM.

A

T

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26
Q

This type of diabetes is a stage of IMPAIRED glucose homeostasis (i.e. impaired fasting glucose, impaired glucose tolerance, etc.) This indicates they’re at a HIGH RISK for developing diabetes.

A

Prediabetes

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27
Q

This type of diabetes only accounts for about 5 - 10% of cases.

A

Type 1

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28
Q

Type 1 was previously called Insulin-dependent Diabetes Mellitus (IDDM) or “_____________ onset”.

A

juvenile

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29
Q

Type 1 diabetes is caused by destruction of the ____________ - secreting __________ cells of the pancreas; usually due to an autoimmune dysfunction.

A

insulin, beta

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30
Q

In Type 1 diabetes, the ______ cells lose their ability to produce ____________, leading to absolute insulin deficiency.

A

beta, insulin

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31
Q

T/F: Someone with Type 1 diabetes would required exogenous insulin to live.

A

T

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32
Q

Type 2 diabetes was previously called Non-insulin Dependent Diabetes Mellitus (NIDDM) and “___________ onset”.

A

adult

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33
Q

This type of diabetes develops during pregnancy.

A

Gestational diabetes

34
Q

In gestational diabetes, the hormones produced during pregnancy cause insulin _____________. SO the amounts of insulin needed are _________ to control blood glucose levels.

A

resistance, increased

35
Q

T/F: Gestational diabetes can go away when once the baby is born.

A

T

36
Q

T/F: A woman who had gestational diabetes is NOT at risk for developing Type 2 diabetes.

A

F (they’re at a much greater risk)

37
Q

IFG stands for impaired _________ _________.

A

fasting glucose

38
Q

FPG stands for fasting ____________ glucose.

A

plasma

39
Q

IGT stands for impaired glucose ____________.

A

tolerance

40
Q

T/F: Brain cells can use ketone bodies, but prefers glucose.

A

T

41
Q

What is the FPG of those with prediabetes (above normal)?

A

> 100 mg/dL and < 126 mg/dL

42
Q

Those who have Prediabetes have an elevated plasma glucose after ________g glucose load (> 140 and < 200mg/dL).

A

75

43
Q

In the initial onset of Type 1 DM, affected persons are usually __________, have abrupt onset of symptoms before the age of _____.

A

lean, 30

44
Q

This “phase” is after the dx of Type 1 DM and correction of hyperglycemia and metabolic derangements, when the person may not need much exogenous insulin and can maintain normal blood glucose for up to 1 year.

A

Honeymoon phase

45
Q

Type 1 DM may be due to an ____________ disorder. Where the body destroys its own ____-cells in the pancreas as if they’re foreign antigens.

A

autoimmune, beta

46
Q

Idiopathic means that the cause is __________.

A

unknown

47
Q

-Hyperglycemia
- Excessive thirst (polydipsia)
- Frequent urination (polyuria)/glycosuria
- Significant wt loss
- Electrolyte disturbance
- Ketoacidosis

Are all sx of which type of diabetes?

A

Type 1

48
Q

Polydipsia is excessive _________

A

thirst

49
Q

Polyuria is frequent __________

A

urination

50
Q

Normally when the kidneys filter blood, all the glucose is reabsorbed in the __________ tubules.

A

renal

51
Q

____________ is the presence of glucose in the urine.

A

Glycosuria

52
Q

In ketoacidosis, the cells resort to burning ________ for fuel instead of glucose. Beta oxidation of FAs are done to an extent that it leads to the formation of ____________ bodies.

A

fat, ketone

53
Q

Is Type 1 or Type 2 Diabetes more common?

A

Type 2

54
Q

T/F: Type 2 Diabetes has a cure.

A

F

55
Q

Type 2 Diabetes is due to a progressive loss of ______ -cell insulin secretion, frequently on the background of ________ resistance.

A

beta, insulin

56
Q

T/F: Someone with Type 2 DM would rarely experience ketoacidosis.

A

T

57
Q

In Type 2 DM, ATP is NOT required for glucose uptake. But it requires ___________ proteins to enter the cell.

A

transport

58
Q

Glut - 4 transporter is a ________ protein that facilitates ___________ uptake from the blood into muscle and fat cells.

A

transport, glucose

59
Q

People with Type 2 DM have higher than normal levels of insulin, but their cells are not responding to it. This is called what???

A

Insulin resistance

60
Q

Insulin resistance may be due to decreased tissue ______________ or not ____________ to insulin.

A

sensitivity, responsive

61
Q

When the pancreas can no longer keep up and produce enough insulin, then blood glucose levels will ________ initially after meals, but also eventually in the ________ state too.

A

increase, fasted

62
Q

Type 2 DM begins with ___________ resistance.

A

insulin

63
Q

Increased __________ ___________ production (from the liver) causes increased FPG in Type 2 DM.

A

hepatic glucose

64
Q

T/F: Someone may go years without signs & sx of Type 2 DM.

A

T

65
Q
  • Insidious onset
  • Often goes undiagnosed for yrs
  • Hyperglycemia
  • Polydipsia
  • Polyuria
  • Polyphagia/hyperphagia
  • Weight loss (occasionally)

These are the sx of which type of DM?

A

Type 2

66
Q
  • Family hx of DM
  • Older age
  • Obesity, particularly intra-abdominal obesity
  • Physical inactivity
  • Prior hx of gestational DM
  • Impaired glucose homeostasis
  • Higher risk among certain racial/ethnic groups (African American, Latino, Native American, Asian American, Pacific Islander)

These are the risk factors of which type of diabetes?

A

Type 2

67
Q
  • Insulin resistance
  • Compensatory hyperinsulinemia
  • Abdominal obesity
  • Dyslipidemia (elevated TG, low HDL)
  • HTN

These are characteristics of _____________ syndrome.

A

metabolic

68
Q

Metabolic syndrome is a risk factor for _________.

A

CVD

69
Q

What are the methods of DM Dx?

A
  • Fasting plasma glucose (FPG)
  • Random plasma glucose
  • Oral glucose tolerance test (OGTT) 2-hr Plasma Glucose
  • Hemoglobin A1C (HbA1c)
70
Q

How is a FPG blood test performed?

A

No calories for at least 8 hrs

71
Q

How is a random plasma glucose blood test performed?

A

At any time of day

72
Q

How is an oral glucose tolerance test (OGTT) 2-hr plasma glucose test performed?

A

pt is fasted and takes a 2 hr blood draw AFTER oral glucose load of 75 g glucose

73
Q

A Hemoglobin A1C (HbA1c) blood test provides an estimate of __________ blood glucose over the past few ___________. This test measures _____________ __________.

A

average, months, glycosylated hemoglobin

74
Q

HbA1c is a measure of how much __________ adheres to hemoglobin of ________ blood cells.

A

glucose, red

75
Q

T/F: The higher a person’s blood glucose, the higher their HbA1c.

A

T

76
Q

The ADA recommends for people aged ______ years and older to be screened for DM, and repeat every ________ yrs.

A

35, 3

77
Q

T/F: High risk persons should be screened for DM at a younger age and more frequently.

A

T

78
Q

Recommendation for glycemic control (in nonpregnant adults w/DM) of HbA1c level is _______%.

A

< 7.0%

79
Q

Recommendation for glycemic control (in nonpregnant adults w/DM) of PREPRANDIAL CAPILLARY PLASMA GLUCOSE level is __________ mg/dL (4.4 - 7.2 mmol/l).

A

80 - 130

80
Q

Recommendation for glycemic control (in nonpregnant adults w/DM) of PEAK POSTPRANDIAL CAPILLARY PLASMA GLUCOSE level is _________ mg/dL (< 10.0 mmol/l).

A

< 180

nhm 365 (23 decks)

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