Pathology of Diabetes Mellitus and its complications (finish when revising)

Question 1

what kind of cell secrete insulin?

Answer 1

beta cells

Question 2

what fraction of islet cells are beta cells?

Answer 2

2/3rds

Question 3

where is insulin from beta cells secreted into?

Answer 3

blood in capillaries

Question 4

insulin binds to its receptor and drives glucose into…

Answer 4

adipocytes

Question 5

Glucose metabolism pathway:

…………… glucose
………….. insulin
…………… glucose uptake by cells
…………… glucose in serum

Answer 5

increase

increase

increase

decrease

Question 6

Genes found so far in aetiology of type 1 diabetes

Answer 6

Human Leukocyte antigen (HLA) molecules

Question 7

what are HLA molecules?

Answer 7

molecules that help T cells recognise self from non-self

Question 8

In type 1 diabetes, cells cannot distinguish own cells from ….. cells

therefore causing an ………… …………… on pancreatic beta cells

Answer 8

other

autoimmune attack

Question 9

In T1DM, the autoimmune attack on islet cells leads to …………….. infiltration of islets and therefore destruction of …….

Answer 9

lymphocyte

beta cells

Question 10

3 possible environmental factors for diabetes

Answer 10

chemicals

bacteria in gut altered in infancy

viral infection

Question 11

Aetiology of T2DM is not entirely known. It is thought to be a combination of what 2 factors?

Answer 11

reduced tissue sensitivity to insulin (insulin resistance)

inability to secrete very high levels of insulin

Question 12

expanded upper body visceral fat mass (pot belly) results in increased

Answer 12

free fatty acids in blood

Question 13

increased free fatty acids leads to decreased….

Answer 13

insulin receptor sensitivity

not clear why this happens

Question 14

in general - central adiposity leads to an increase in what?

Answer 14

peripheral sensitivity to insulin

Question 15

What type of diabetes is autoimmune?

Answer 15

Type 1

Question 16

What type of diabetes is insulin resistant?

Answer 16

type 2

Question 17

what part of T2DM makes it reversible?

Answer 17

central adiposity

Question 18

in type 2 - insulin secretion does not increase enough to counteract insulin resistance caused by… …..

Answer 18

central adiposity

Question 19

what is the most common cause of death in diabetes?

Answer 19

MI

Question 20

diabetes greatly accelerates what condition?

Answer 20

atherosclerosis

Question 21

What happens to the basal lamina in diabetes?

Answer 21

thickened

build up of molecules under endothelial cell

Question 22

arteriolar disease is also known as

Answer 22

hyaline change

Question 23

arteriolar disease results in narrowing of vessels which can lead to ………

Answer 23

ischaemia

Question 24

large and small vessel disease in DM is usually ……..

Answer 24

reversible