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E 1.2: Histology, Anatomy, Pathology, and Infectious Diseases Lab > Week 2: Diabetes and Metabolism > Flashcards

Week 2: Diabetes and Metabolism Flashcards

1
Q

Give three examples of clinic space designs that are inclusive of all bodies

SDOH

A

Furniture appropriate for all (armless chairs)
Artwork that shows body diversity
Large enough blood pressure cuffs and hospital gowns

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2
Q

Define metabolic syndrome

A

≥3 of the following:
* Central or abdominal obesity
* High triglycerides
-150 milligrams per deciliter (mg/dL)
* Low HDL cholesterol
-Men < 40 and women < 50
* High blood pressure
-130/85 or more
* High fasting glucose
-100 mg/dL or more

If taking medication for said condition it counts i.e. hypertension meds

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3
Q

What are the waist circumference measurements indicating central obesity for men and women?

A

Men - greater than 40 inches
Women - greater than 35 inches

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4
Q

What are two major mechanisms causing hyperglycemia in uncontrolled diabetes mellitus?

A
  • Uninhibited gluconeogenesis
  • Insufficient glucose uptake into muscle & adipose
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5
Q

Name the four characteristic symptoms of hyperglycemia.

A
  • Polyuria
  • Polydipsia
  • Polyphagia
  • Fatigue
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6
Q

List two features of pathologic obesity.

A
  • High visceral white adipose tissue (WAT)
  • Impaired adipogenesis
  • Insulin Resistance
  • Ectopic lipid deposition
  • Adipocyte dysfunction and/or deficiency
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7
Q

How frequently are HbA1c levels typically checked?

A

Every 3 months

an erythrocytes life span is ~118 days

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8
Q

What is the minimum fasting glucose level that is diagnostic for diabetes?

A

> 126 mg/dL

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9
Q

What minimum A1c level is diagnostic for diabetes?

A

> 6.5%

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10
Q

What is HbA1c?

A

Glycated hemoglobin

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11
Q

List two features of metabolically healthy obesity.

A
  • High subcutaneous white adipose tissue (WAT)
  • Adequate adipogenesis
  • Healthy WAT remodeling
  • Adipocyte function maintained
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12
Q

In the absence of significant insulin signaling, what else signals GLUT-4 vesicles to fuse with the plasma membrane of myocytes?

A

Physical activity stimulates GLUT-4 to move to the membrane of only the actively contracting muscle fibers.

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13
Q

Name three outcomes that can be used to assess improved health in a weight-neutral wellness intervention.

A
  • Blood lipid levels
  • Blood pressure
  • Self-esteem
  • body image
  • depression
  • quality of life
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14
Q

What enzyme is primarily responsible for releasing fatty acids from VLDLs?

A

Lipoprotein lipase (LPL)

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15
Q

What are two common side effects of sulfonylureas?

A
  • Weight gain
  • Hypoglycemia
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16
Q

How does insulin prevent ketoacidosis?

A

It inhibits lipases within adipocytes.

i.e. hormone-sensitive lipase (h-sl) and atl

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17
Q

Explain why sulfonylureas run the risk of causing hypoglycemia but GLP-1 agonists usually do not.

A

Sulfonylureas stimulate glucose-independent insulin secretion.

GLP-1’s require glucose for insulin to work so you have high blood sugar

18
Q

This drug class blocks the clearance of GLP-1’s and GIP’s

A

DPP4 inhibitor (sitagliptin)

19
Q

This drug class blocks glucose reabsorption in the proximal tubule by blocking sodium-glucose transporters

A

SGLT2 inhibitor

20
Q

What is the major mechanism of action of Metformin?

A
  • Major
    -Reduces hepatic glucose output by inhibiting gluconeogenesis
  • Minors
    -Increases insulin sensitivity
    -Increases glucose uptake ‘
    -Decreases intestinal absorption

lactic acid is a substrate for gluconeogenesis so acidosis can occur

21
Q

What is the mechanism of action of sulfonylureas?

A

Increases insulin release from beta cells

22
Q

What are the expected levels of triglycerides and HDL in people with metabolic syndrome?

A
  • High triglycerides
  • Low HDL
23
Q

What are the expected C-peptide levels in newly diagnosed type 1 and type 2 diabetes?

A
  • Low for type 1 (no insulin is made in T1DM and cleavage of C-peptide is done last to activate insulin)
  • Typically normal-elevated for type 2
24
Q

Give three physiologic processes that occur in response to a weight-loss diet that make it difficult to not regain weight.

A
  • Reduced adipocyte size reduces leptin secretion
  • Decreased eating reduces GLP-1 and increases ghrelin
  • Decreased body weight decreases metabolic rate and therefore decreases caloric needs
25
Q

Name two common myths about the cause of obesity that perpetuate weight stigma.

SDOH

A
  • An individual’s weight is the result of poor food choices or laziness
  • Obesity is a matter of personal responsibility
26
Q

Name two ways that discrimination against people with large bodies contributes to obesity.

SDOH

A
  • Avoiding treatment
  • Promotes disordered eating
  • Reduced engagement with social support
  • Adoption of less healthful food choices
  • Emotional dysregulation
27
Q

What is the first line therapy for almost all patients with Type 2 Diabetes?

A

Metformin

28
Q

Name two diabetes drug classes associated with weight loss.

A
  • SGLT2 inhibitors (“gliflos” like empagliflozin, canagliflozin)
  • GLP-1 receptor agonists (liraglutide)
  • Biguanides (metformin)
29
Q

What hormone activates lipoprotein lipase activity within the capillaries of adipose tissue?

A

Insulin

break down fats to their componenents to import into adipocytes

30
Q

Give psychosocial reasons why the majority of people with obesity who attempt self-directed dieting regain most of the initial weight lost or even regain more weight?

SDOH

A
  • Increased: food obsession (cravings)
  • distractibility
  • emotional responsiveness (to food)
  • fatigue
  • low self-esteem
  • depression
  • obesogenic environment (food and food cues are everywhere)
31
Q

What is the primary mechanism for weight loss in people who use GLP-1 receptor agonists?

A

Increased satiety signals in the hypothalamus

32
Q

What is the primary function of glucagon?

A

To raise blood glucose levels during fasting by activating glycogenolysis and gluconeogenesis

33
Q

What dietary pattern is most effective for weight management?

SDOH

A

A sustainable food management that a patient will adhere to

34
Q

List two core concepts of the Health At Every Size perspective.

SDOH

A
  • Weight inclusivity
  • Health enhancement
35
Q

What hormone, released from adipose tissue, suppresses appetite, increases energy expenditure, and acts on the brain stem and hypothalamus

A

Leptin

36
Q

Mimic incretins to stimulate insulin secretion, reduce glucagon secretion, and delay gastric emptying

A

GLP-1 agonists

37
Q

Define insulin resistance.

A

Less than the expected biological response to a given concentration of insulin

38
Q

What is the mechanism of action of acarbose?

A

Inhibit carbohydrate absorption at intestinal brush border

39
Q

Name the characteristic symptoms of mild hypoglycemia.

A
  • Sweating
  • Hunger
  • Palpitations
  • Tremors
  • Anxiety
40
Q

Insufficient insulin signaling is a key feature of which type(s) of Diabetes Mellitus?

A
  • Type 1
  • Type 2

E 1.2: Histology, Anatomy, Pathology, and Infectious Diseases Lab (16 decks)

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