Type II DM Flashcards
Diabetes results from…
defects in insulin secretion, insulin action, or both
what is the common theme in diabetes
hyperglycemia
what is the prevalence of diabetes
25 millions in US
what are the classification of diabetes
- type I diabetes (5-10%)
- type II diabetes (90-95%)
type 1 diabetes is an ?
autoimmune disease
what happens in type 1 diabetes
pancreatic beta cell destruction
what happens in type 2 diabetes
combination of peripheral resistance to insulin action and an inadequate secretory response by beta cells
type II diabetes has a twin concordance rate between ?
70 and 90%
what are the 3 notable genes implicated in type II DM
- TCF7L2 gene
- PPAR receptor
- IRS genes
what is the most important environmental risk factor for type II DM
obesity
what happens first in type II DM and then followed by what?
first, impaired insulin action and then impaired insulin secretion
what is the pathophysiologic pearl for type II DM
it seems like to progress to overt T2DM, you need impaired insulin secretion, which seems to arise after a long history of insulin resistance
what are the factors for the development of insulin resistance
- increased free fatty acids and adipocyte endocrine dysfunction
- reduced incretin release
- insulin receptor desensitization due to chronically high levels of serum glucose
what does incretins do?
- decrease gastric emptying
- increase insulin release
- reduce glucagon secretion
non-esterified fatty acids increase ?
insulin resistance
