Pathophys of pre-diabetes and diabetes

Question 1

Structure of human proinsulin

Answer 1

Prohormone that is cleaved into insulin and C-peptide. Insulin is made of 2 polypeptide chains A and B

Question 2

Steps in the primary method of insulin secretion

Answer 2

Glucose enters via GLUT2–> glycolysis causes a rise in ATP;ADP ratio–> ATP sensitive K channel closes–> depolarization–> opening of Ca channels–> rise in Ca facilitates insulin release

Question 3

Describe how cAMP increases insulin secretion

Answer 3

Increase cAMP stimulated by glucose mobilizes intracellular calcium stores contributing to membrane depolarization

Question 4

What happens when you are exposed to insulin for a continuous period of time?

Answer 4

receptors are internalized withing the cell membrane –> desensitize

Question 5

Modifiable causes of diabetes

Answer 5

weight/bmi
central obesity
Sedentary lifestyl

Question 6

Non-modifiable risk factors of diabetes

Answer 6

age, ethnicity, genetics

Question 7

____ is the leading cause of new blindness, chronic renal failure leading to dialysis, and non-traumatic amputations.

Answer 7

Diabetes

Question 8

What is the most common microvascular complication?

Answer 8

Chronic kidney disease

Question 9

Metabolic ketoacidosis is seen in T1D or T2D?

Answer 9

T1D

Question 10

Pathogenesis of ketoacidosis

Answer 10

Decreased insulin–> increased lipolysis–> increased glycerol and FFA–> B-oxidation of FFA–> increased ketones

Question 11

Onset of symptoms in T1D vs T2D

Answer 11

T1D: acute, subactue
T2D: slow or subacute

Question 12

Is a family history more commonly seen in T1D or T2D?

Answer 12

TID: uncommon
T2D: common

Question 13

Concordance in twins (T!D vs T2D)

Answer 13

1: 30-50
2: 90-95

Question 14

Is there an HLA association for T1D or T2D?

Answer 14

T1D

Question 15

How much of the population is thought to be pre-diabetic?

Answer 15

(IFG) 25.9%

Question 16

What is GLP1? And what does it go?

Answer 16

Incretin that is released after ingestion of a meal, promotes satiety and reduces appetite, decreases glucagon secretion, reduce hepatic glucose output, regulate gastric emptying, enhances glucose dependent insulin secretion