DM-Epidemiology, Etiology, & Pathophysiology

Question 1

About ___ in every 10 people have diabetes

Answer 1

1

Question 2

about 1 in __ people don’t know they have diabetes

Answer 2

5

Question 3

___ million american adults have prediabetes

Answer 3

96

Question 4

T/F Type 1 diabetes can develop at any age

Answer 4

T

Question 5

Risk factors for type 2 diabetes:

Answer 5

Being overweight
Having a family history
Being physically inactive
Being 45 or older

Question 6

Diabetes =

Answer 6

Hyperglycemia

Question 7

1 st century B.C. Greek physician, _____, named it diabainein, meaning “a
siphon” referring to the excessive urination
associated with the disease

Answer 7

Aretaeus the Cappadocian

Question 8

The word diabetes was first recorded in ____

Answer 8

1425

Question 9

In _____, the Greek mellitus, “like honey,” was added to reflect the sweet smell & taste of the patient’s urine

Answer 9

1675

Question 10

the four major islet hormones & the cells secreting them:

Answer 10

1. α cells making glucagon
2. β cells making insulin
3. δ cells making somatostatin
4. PP or F cells making pancreatic polypeptide

Question 11

Activation of these receptors suppresses chemoreflex-evoked sympathetic activity

Answer 11

GLP1R are found in chemosensory glomus cells of the carotid body

Question 12

primary stimulus for insulin release from pancreatic β-cells

Answer 12

Glucose

Question 13

Additional stimulatory & inhibitory factors that can also affect insulin release from the β-cell

Answer 13

• Stimulatory
• Glucose synergizes with other
  mediators & enhances the
  secretory response of the β-cell to
  these factors.
• GLP-1, CCK, Glucagon,
  Acetylcholine, Sulfonylurea drugs
• Inhibitory
• Epi-/norepinephrine, somatostatin

Question 14

____ separate C peptide from
insulin (orange- colored residues on proinsulin

Answer 14

Converting enzymes

Question 15

Describe the Insulin Regulation process in β-Cells

Answer 15

• Glucose Enters β-cell cell via glucose transporter protein (GLUT-2) & undergoes glycolysis → ATP
• ↑ ATP/ADP ratio → closure of the ATP-sensitive K + channels → Plasma membrane depolarizes & opens voltage-dependent Ca 2+ channels
• ↑ Ca 2+ influx + mobilization of intracellular stores of Ca 2+ → fusion of insulin-containing secretory granules with the plasma membrane & release of insulin (& C-peptide) into circulation

Question 16

In DM Type I: Ultimately, when β-cells are destroyed, there is not enough
endogenous insulin to prevent ____

Answer 16

Diabetic Ketoacidosis

Question 17

~____% of T1D patients have circulating islet cell antibodies

Answer 17

85

Question 18

How does Insulin resistence occur with Type II DM?

Answer 18

1. To maintain euglycemia, pancreas ↑ insulin secretion (Compensatory hyperinsulinemia)
2. As insulin resistance ↑ impaired glucose tolerance (IGT) develops (↑ postprandial glucose)
3. ↓ insulin +/– ↑ glucagon → ↑ hepatic glucose (Fasting hyperglycemia)

Question 19

Impaired Glucose Tolerance causes

Answer 19

• Sufficient insulin to prevent ketoacidosis
• Insufficient insulin to prevent hyperglycemia

Question 20

The fundamental problem With DMII is NOT Hyperglycemia but what?

Answer 20

Insulin resistance & Beta cell dysfunction

Question 21

Normal Pregnancy Carbohydrate Metabolism in Gestational Diabetes

Answer 21

• Mild fasting hypoglycemia
• Postprandial hyperglycemia
• Hyperinsulinemia

Question 22

What percentage of pregnant women appear to get peripheral insulin resistance

Answer 22

About 30%

Question 23

There is no known way to prevent this type of diabetes

Answer 23

T1

Question 24

GLP1R are found in chemosensory glomus cells of the carotid body and Activation of these receptors______ chemoreflex-evoked
sympathetic activity

Answer 24

suppresses

Question 25

Ultimately, when β-cells are destroyed, there is not enough endogenous insulin to prevent ____

Answer 25

Diabetic Ketoacidosis