Pathophysiology of the Metabolic disorder

Question 1

Type 1 DM results for autoimmune _______ destruction, leading to absolute insulin deficiency

Answer 1

beta cell

Both genetic and environmental factors are implicated in this disease

Question 2

What is the purpose to managing DM?

Answer 2

To maintain healthy blood vessels and lower risk of micro/macrovasculr complications and comorbitites

Elevated BG damage the large and small blood vessels of the body

Question 3

Where is food ingested in excess of the immediate need of the vital organs stored as extra calories?

Answer 3

hepatic and muscle glycogen, adipose tissue and triglyceride, and to some extent tissue protein

Question 4

What are the 2 main fuels (sources of energy) in humans?

Answer 4

glucose and FFA

glucose is stored as glycogen in the skeletal muscle/liver, FFA is stored as TG primarily in the adipose tissue

Question 5

Insulin is a ___ hormone

Answer 5

anabolic (or storage) hormone

Question 6

Decreased insulin secretion enables ____ breakdown

Answer 6

glycogen, lipolysis, & hepatic ketogenesis

Question 7

True of false; counter regulatory hormones oppose insulins action

Answer 7

True; glucagon and catecholamines stimulate glycogenolysis and gluconeogenesis in the liver, therefore raising blood glucose

Growth hormone and cortisol are also insulin counter regulatory

Question 8

How does insulin regulate postprandial glucose?

Answer 8

Peripheral glucose utilization in insulin sensitive tissues (muscle and fat cells) and direct inhibition of hepatic glucose production and glucagon secretion, thus further decreasing gluconeogenesis

Question 9

How does Amylin inhibit post prandial glucose exertions?

Answer 9

By 3 primary actions

• regulation of food intake
• slowing of gastric emptying
• inhibition of digestive reactions (gastric acid, pancreatic enzymes, and bile

Question 10

GLP-1 ____ glucagon secretion

Answer 10

Suppresses

Question 11

Glucagon is an ____ cell pancreatic hormone associated with maintaining glucose homeostasis

Answer 11

alpha

Question 12

The _____ effect accounts for ~50% of the insulin secreted after a meal and, therefore, has a prominent role in postprandial metabolism

Answer 12

Incretin effect

Question 13

which two hormones released after a meal work together to increase beta cell sensitivity to glucose?

Answer 13

Glucagon like peptide- 1 (GLP-1) and Glucose dependent Insulin releasing polypeptide (GIP)

Question 14

Which enzyme rapidly metabolizes GIP and GLP-1?

Answer 14

Dipeptidyl peptidase-4 (DPP-4)

Question 15

Along with insulin resistance, obese people may also have ___ resistance

Answer 15

leptin

Question 16

Type 1 DM is most commonly dx’d before what age?

Answer 16

30

Question 17

When is GDM diagnosed?

Answer 17

Between 24-28 weeks of pregnancy

Question 18

True or false: DM1 is considered an autoimmune disorder

Answer 18

True; the body’s immune system generates antibodies that destroy the pancreatic beta cells, leading to the inability to produce the hormones insulin and amylin

Question 19

What are some examples of endocrine disrupting chemicals (EDC)?

Answer 19

heavy metals, persistent, organic pollutants, organophosphates, non calorie artificial sweeteners, emulsifiers, and disinfection products