Type 2 Diabetes (Patho) Flashcards
(slides 25-54)
T2DM accounts for how many of all diabetes cases?
90-95%
T2D is a progressive metabolic disease characterized by what?
insulin resistance & beta cell exhaustion in the pancreas
What percentage of T2DM cases are r/t obesity?
80%
If both parents have Type 2 DM, then there is a __% chance, the child will be too
40%
List the pathological mechanisms behind T2DM (4)
- Insulin resistance
- Deranged secretion of insulin
- Increased glucose production
- Beta cells become exhausted… apoptosis
List the risk factors for T2DM (12)
- Family history
- Obesity
- Ethnicity
- Age
- Gestational diabete
- Delivery of babies > 9 lbs
- Hypertension
- Metabolic Syndrome
- Polycystic ovary Syndrome (PCOS)
- Smoking
- Alcohol
- Corticosteroid use
How does insulin resistance lead to beta cell exhaustion?
beta cells try to compensate for it by producing more insulin. However, they eventually become exhausted and stop functioning properly, worsening the condition.
What is significant about ethnicity as a risk factor for T2DM?
African Americans, Hispanics, and Native Americans are at higher risk for diabetes than Asians or Caucasians. However, all ethnic groups are at risk.
Women with PCOS are at higher risk for T2DM due to what?
insulin resistance
How does smoking increase the risk for T2DM?
it increases inflammation and causes vasoconstriction, both of which contribute to higher diabetes risk, and worsening insulin resistance
Alcohol can have have negative effects on ______ and ______ regulation
insulin and glucose regulation
Explain the process of what occurs in a patient with T2DM whose blood sugar is high
- Initially there is increased insulin secretion by the Beta cells to bring down the blood sugar
2. Insulin is not effective and ultimately can not bring it down
3. Because the insulin levels are high…the body increases the level of glucose
4. Beta cells become exhausted
By the time many type 2 diabetics are diagnosed, they have lost about 50% of what?
beta cell function
List the features of metabolic syndrome (5)
- increased waist circumference or belly fat
- high triglycerides
- elevated BP
- high blood sugar
- a low HDL (good cholesterol)
What is Acanthosis Nigricans? What is it a sign of?
A sign of insulin resistance, where the skin becomes darker and thicker, often seen around the neck or armpits.
Visceral fat is particularly associated with ______ _______.
what is a key indicator of this?
insulin resistance
abdominal obesity is a key indicator
Why does obesity cause insulin resistance?
- Causes increase in adipose and free fatty acids
2. Induces inflammation and release of the associated inflammatory mediators
3. Increases stress on pancreatic B cells as insulin is increased
4. Results in liver increase glucose in the blood (impaired suppression)
elevated blood glucose levels can damage blood vessels, contributing to what?
the development of atherosclerosis, or plaque buildup in the arteries
What are chronic high insulin levels?
Individuals with insulin resistance often have chronically elevated insulin levels.
This can worsen the glucose imbalance and contribute to further vascular damage
What is one of the best ways to improve insulin sensitivity and reduce blood glucose levels?
regular exercise
How does exercise improve insulin resistance and lower blood glucose?
- Increases mitochondrial enzymes
- Increases insulin sensitivity
- Triglycerides get broken into free fatty acids to use for fuel
- Decrease BS, decrease insulin
- Increase glucagon
- Causes uptake of glucose from circulation
What is the difference between insulin sensitivity and insulin resistance?
Insulin sensitivity → how well your cells respond to insulin
insulin resistance → when cells become less responsive to insulin, potentially leading to high blood sugar and related health issues
Why does a sedentary lifestyle increase insulin resistance?
Those who do not exercise have decreased intracellular enzymes such as pyruvic acid
How can one’s diet cause insulin resistance?
A high glycemic diet (rich in processed foods and sugary foods) exacerbates insulin resistance.
Processed foods (rich in preservatives and artificial ingredients) contribute to poor health outcomes, unlike fresh, whole foods commonly consumed in Europe.