38. Type 1 vs. type 2 diabetes mellitus Flashcards Preview

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Flashcards in 38. Type 1 vs. type 2 diabetes mellitus Deck (19):
1

primary defect

Type 1: autoimmune destruction of β cells ( eg. due to glutamic acid decarboxylase antibodies
Type 2: increased resistance to insulin, progressive pancreatic β-cells failure

2

insulin necessary in treatment

Type 1: always
Type 2: sometimes

3

association with obesity


Type 2:

4

genetic predisposition

Type 1: weak ( 50% concordance in identical twins ), polygenic
Type 2: relatively strong ( 90% concordance in identical twins ), polygenic

5

association with HLA system

Type 1: yes ( HLA DR3 HLADR-5)
Type 2: no

6

glucose intolerance

Type 1: severe
Type 2: mild to moderate

7

insulin sensiyivity

Type 1: high
Type 2: low

8

ketoacidosis

Type 1: common
Type 2: rare

9

serum insulin level

Type 1:decreased
Type 2: variable

10

classic symptoms of polyuria, polydipsia, polyphagia, weight loss

Type 1: common
Type 2: sommetimes

11

histology

Type 1: islet leukocytes infiltrate
Type 2: islet amyloid polypeptide (IAPP) deposits

12

β cell number i the islets

Type 1: decreased
Type 2: variable ( with amyloid deposits)

13

• What is the underlying etiology of type 1 diabetes mellitus? Type 2?

Autoimmune destruction of β cells; increased insulin resistance, which progresses to failure of β cells

14

• Contrast the typical type 1 and 2 diabetes mellitus populations in terms of age, association with obesity, and genetic predisposition.

Type 1: <30 y/o, nonobese, weak genetic link (50% twin concordance); type 2: >40 y/o, obese, stronger genetic link (90% twin concordance)

15

• Contrast types 1 and 2 diabetes mellitus in terms of need for insulin therapy, insulin sensitivity, and serum insulin level.

Type 1: always needs insulin, high sensitivity, low serum insulin; type 2: may need insulin, low sensitivity, variable serum insulin

16

• Contrast type 1 and type 2 diabetes mellitus in terms of glucose intolerance and risk of ketoacidosis.

Type 1: severe glucose intolerance, ketoacidosis common; type 2: mild-moderate glucose intolerance, rare ketoacidosis

17

• Which type of diabetes mellitus is associated with the human leukocyte antigen (HLA) system? Which HLA types is it associated with?

Type 1: associated with HLA-DR3 and HLA-DR4; type 2: not associated with the HLA system

18

• Contrast type 1 and type 2 diabetes mellitus in terms of the number of β cells in the pancreatic islets and histology of the islets.

Type 1 islets: leukocytic infiltrates and fewer cells; type 2 islets: amyloid polypeptide (IAPP) deposits and varying numbers of cells

19

• A patient presents with polyuria, polydipsia, polyphagia, and weight loss. Is type 1 or 2 diabetes mellitus more likely?

Type 1 (all four symptoms are more commonly seen in this type of diabetes)