6 Diabetes

Question 1

Initial discoveries of diabetes mellitus are intrinsically like to what?

Answer 1

Polyuria

Question 2

What is Polyuria?

Answer 2

Production of large volumes of dilute urine.

Question 3

What does the term diabetes mean?

Answer 3

Greek for ‘go through’.

Question 4

What does the term mellitus mean?

Answer 4

Greek for ‘sweet’

Question 5

Classification of Type 1 Diabetes?

Answer 5

Due to autoimmune B-cell destruction, usually leads to absolute insulin deficiency, including latent autoimmune diabetes of adulthood.

Question 6

Classification of Type 2 Diabetes?

Answer 6

Due to progressive loss of adequate B-cell insulin secretion frequently on the background of insulin resistance.

Question 7

Classification of Gestational diabetes mellitus?

Answer 7

Diabetes diagnosed in the second or third trimester of pregnancy that was not clearly overt diabetes prior to gestation.

Question 8

Classification of Monogenic diabetes syndrome?

Answer 8

Neonatal diabetes and maturity-onset diabetes of the young.

Question 9

Classification of diseases of the exocrine pancreas??

Answer 9

Cystic fibrosis and pancreatitis

Question 10

Classification of drug- and chemical-induced diabetes?

Answer 10

Glucocorticoid use in the HIV/AIDS treatment or after organ transplantation.

Question 11

Type 1 and Type 2 diabetes are what kind of diseases?

Answer 11

Heterogenous disease (have several etiologies)

Question 12

What is a near certain predictor of T1 diabetes?

Answer 12

Two or more islet autoantibodies

Question 13

What two markers rise well before clinical onset of diabetes?

Answer 13

Glucose and A1C levels

Question 14

Describe insulitis?

Answer 14

T1 diabetes, progressive infiltration of self-reactive immune cells into the islets of Langerhans.

Question 15

What is insulitis referred to?

Answer 15

Seal of autoimmunity.

Question 16

Autoantibodies in T1DM?

Answer 16

• Islet cell cytoplasmic antibodies (ICCA)
• Islet Cell surface antibodies (ICSA)
• Antibodies against glutamic acid decarboxylase (GAD)
• Anti-Insulin antibodies

Question 17

How to treat T1DM?

Answer 17

• Exogenous insulin by injection or pump
• Islet or pancreas transplantation in a small subset of patients.

Question 18

Which form of diabetes is the most common?

Answer 18

T2DM

Question 19

Subjects at risk for T2DM display what initial symptoms?

Answer 19

Insulin resistance compensated by B-Cell hypersecretion of insulin (hyperinsulinemia)

Question 20

In broad strokes what occurs to cause T2DM?

Answer 20

Body can no longer sustain the needed level of insulin and thus lose insulin sensitivity.

Question 21

Most complications of Diabetes comes from what?

Answer 21

Chronic elevation of blood glucose levels, which leads to the damage of blood vessels (angiopathy).

Question 22

Microvascular disease refers to what?

Answer 22

Due to damage to small blood vessels

Question 23

Macrovascular disease referes to what?

Answer 23

Damage to the arteries.

Question 24

What are some examples of Microvascular complications?

Answer 24

• Retinopathy (eye disease)
• Nephropathy (kidney disease)
• Neuropathy (neural damage)

Question 25

What are some examples of Macrovascular complications?

Answer 25

* Accelerated cardiovascular disease. * Leads to Myocardial infarction and cerebrovascular disease * leads to strokes.

Question 26

What is the major cause of end-stage renal failure in the West?

Answer 26

Diabetic nephropathy.

Question 27

How is diabetic nephropathy clinically characterized?

Answer 27

* Development of proteinuria with a subsequent decline in glomerular filtration rate.

Question 28

Diabetic retinopathy is characterized by what?

Answer 28

A spectrum of lesions within the retina and is the leading cause of blindness amoung adults aged 20-74.

Question 29

What nerves are most likely to be effected by diabetic neuropathy?

Answer 29

Longer peripheral nerves that inennervate the lower limbs.

Question 30

More than _____ of all individuals with diabetes eventually develop neuropathy, with a lifetime risk of \_\_\_\_\_\_\_\_.

Answer 30

Half, one or more lower extremity amputations.

Question 31

What is the cause of death in up to 65% of diabetes patients?

Answer 31

Cardiovascular disease

Question 32

In Type _____ diabetes it is not common to see progression of CVD without an impairment in kidney function.

Answer 32

Type 1

Question 33

In type ____ diabetes, kidney disease remains a major risk factor for premature CVD, in addition to dyslipidemia, poor glycemic control, and persistent eveluations.

Answer 33

Type 1