Week 12 - Diabetes Mellitus

Question 1

What are the 3 main causes of DM (pathophysiology)?

Answer 1

1. Inadequate/absent production of insulin (Type 1)
2. Insulin resistance (Type 2)
3. Elevated stress (cortisol)

Question 2

Why does inadequate/absent production of insulin occur? (3)

Answer 2

Destruction of beta cells
- genetics, viruses, pancreatic cancer, pancreatitis, idiopathic (unknown)
- over-production of insulin -> destroyed over time (autoimmune)

Question 3

Why does insulin resistance occur? (4)

Answer 3

Target cells are less able to metabolize the glucose available to them -> hyperglycemia -> hyperinsulinemia
- reduced binding of insulin to its receptors
- reduced receptor numbers
- reduced receptor responsiveness

Question 4

In lecture, what is hyperinsulinemia?

Answer 4

Beta cells keep getting triggered to produce insulin

Question 5

Why does elevated stress (cortisol) cause DM? (3)

Answer 5

• pro-inflammatory state
• Stimulated glyconolysis (glycogen breakdown to glucose) and gluconeogenesis (synthesis of glucose from non-carb precursors)
• ex. trauma, living conditions, societal, infection

Question 6

What are the 4 types of DM? (4, 9)

Answer 6

1. Autoimmune destruction
   - Type 1 Diabetes (T1DM) where complete destruction of beta cells occur
2. Insulin resistance/deficiency
   - Type 2 diabetes (prediabetes, lifestyle)
   - tissues stop responding to insulin
3. Maturity-Onset Diabetes of the Young
   - inherited genetic adaptation (ex. HNF-1betaG319S)
   - Management of fat and proteins to store and use energy
4. Gestational diabetes mellitus (GDM)

Question 7

DM contributes to 5 medical conditions. What are they?

Answer 7

Question 8

DM in Manitoba Statistics

Answer 8