Type II Diabetes

Question 1

Overview

Answer 1

Combination of
Beta cell dysfunction - impaired insulin secretion/inability to compensate for insulin resistance
Increased peripheral insulin resistance - insensitive target cells
Increased hepatic glucose output

Question 2

Mechanisms of insulin resistance

Answer 2

Mutation in insulin receptor gene
Presence of excess fatty acids
Dysregulated adipokines from adipose tissue
Defects in cellular translocation of Glut 4

Question 3

Features

Answer 3

Macrovascular disease, stroke, atherosclerosis
Asymptomatic/thirst/polyuria/weight loss
Ketone bodies present in low concentrations

Question 4

Metabolism

Answer 4

Some insulin present - suppresses glucagon secretion - no lipolysis/ketone body formation

Question 5

Treatment

Answer 5

Diet and exercise
Sulfonylureas (increase insulin secretion)
Biguanides (metformin)/thiazolidinediones (increase tissue insulin sensitivity)
Glucosidase inhibitors (decrease absorption and digestion of carbs)