Block 1 -- Diabetes I Flashcards Preview

PHS 933 > Block 1 -- Diabetes I > Flashcards

Flashcards in Block 1 -- Diabetes I Deck (17):
1

Normal [glucose] (mg/dL and mM)

70-130 mg/dL
4-7 mM

2

function of beta cells

insulin + amylin

3

fx of amylin:

1) satiety
2) delayed glucose absorption
3) suppress gcg secretion

4

Sxs of DM:

1) polyuria, polydipsia, polyphagia
2) weight loss
3) fatigue
4) irritability

5

T2DM diagnosis criteria:

1) Sxs + random [glucose] ≥ 200 mg/dL
2) FPG ≥ 126 mg/dL
3) 2hr [glucose] ≥200 mg/dL during OGTT
4) A1c ≥ 6.5%

6

pre-diabetes criteria:

IFG 100-125 mg/dL
IGT 140-199 mg/dL
A1C 5.7-6.4

7

What is most common diagnostic test?

FPG (convenience, cost)

8

Why is A1C measured?

most reactive site of Hb for non-enzymatic glucose binding
-- correlates with fasting and post-prandial [glucose]

9

What tissue changes occur in DM?

1) altered protein function/turnover, cytokine activation
2) osmotic + oxidative stress
3) altered GFR
4) reduced motor and sensory CV

10

What factors affect insulin sensitivity?

1) age
2) body weight
3) physical activity
4) illness

11

What changes occur to skeletal muscle in DM?

1) decreased glucose uptake
2) increased lipid storage

12

What changes occur to adipocytes in DM?

1) lipolysis, FFA release
2) muscle/liver FFA storage leads to chronic inflammation (macrophage)
3) adipocytokine release
-- TNF-alpha, IL contribute to IR

13

What changes occur to the liver in DM?

1) unrestrained glycogenolysis and gluconeogenesis
2) decreased glucose uptake and glycogen synthesis
3) lipogenic effects = steatosis

14

Mechanism for CV complications:

1) macrovascular (atherosclerotic) changes

15

What DM complications are related to microvasculature?

retino-, nephro-, neuropathies

16

What changes occur to microvasculature?

1) advanced glycosylation end-products (thicker, harder cells - breakages
2) sorbitol increases (osmosis)
3) DAG/PKC activation

17

What are goals of therapy for DM?

1) treat hyperglycemia and alleviate sxs
2) prevent and reduce acute/chronic complications
3) avoid hypoglycemia