Pathophysiology of Type 1 Diabetes Flashcards
The pancreas is a _________-peritoneal organ.
retro (it’s behind the stomach)
What fasting labs and oral glucose tolerance tests are diagnostic of diabetes?
Fasting:
- normal: less than 100
- pre-diabetes: 100 - 125
- diabetes: greater than 125
Oral glucose tolerance test:
- normal: less than 140
- pre-diabetes: 140 - 199
- diabetes: greater than 199
An HbA1c greater than or equal to _____ is diagnostic of diabetes.
6.5
The incidence of type 1 diabetes in the general population is ______, while with a first-degree relative it is _______.
1:300; 1:20
The monozygotic twin concordance rate is _______.
between 1:3 and 1:1
What three autoimmune disorders are most common in those with type 1 diabetes?
Thyroid disorders, celiac, and Addison’s
There are two alleles that are most likely to correlate with or predict type 1 diabetes: ____________. There are many other alleles –most often immune-related –that correlate with diabetes risk.
HLA; insulin production and metabolism
What are the four major islet autoantigens that predict diabetes?
- ZnT8
- Islet antigen 2 (IA-2)
- GAA
- Mixed insulin autoantibody (mIAA)
Just note that it’s a little odd that antibodies predict development of T1DM since it is predominantly a T-cell mediated process.
What pattern of autoimmune destruction in the pancreas is typical in those with TIDM?
Patchy –like vitiligo
What is the accelerator hypothesis?
Based on the observation that the rise in TIDM parallels the rise in obesity, the accelerator hypothesis posits that obesity stresses beta cells and increases likelihood of TIDM.
What is LADA?
Latent Autoimmune Diabetes of adulthood… a form of autoimmune diabetes presenting between ages 30 and 70 that has autoantibodies and six months of non-insulin requiring diabetes.
True or false: TIIDM is strongly associated with certain HLA isotypes.
False. There is no strong evidence of HLA involvement in TIIDM.
Family history is much higher in type ____ diabetes.
2
A current trial indicates that giving ______________ can potentially delay TIDM by 10 years.
oral insulin
Abatacept blocks ____________.
the CD80/86 receptor needed to activate the T-cell CD28 receptor
People typically present with signs and symptoms of diabetes when ________ percent of the beta cells have been destroyed.
80 to 90
What HLA is most associated with developing T1DM?
HLA DQB1 0302
Decreased duration of ____________ has been shown to increase risk of T1DM.
breastfeeding
The country with the highest rate of T1DM is __________.
Finland
What molecule mediates beta-oxidation of free fatty acids?
Hormone-sensitive lipase
Parenteral insulin has not been shown to ____________.
delay onset of symptoms
