Diabetes

Question 1

What is the definition of diabetes?

Answer 1

relative or absolute deficiency of insulin, causing glucose intolerance

Question 2

At what level is a diabetic’s fasting blood sugar?

Answer 2

> 125 mg/dL

Question 3

Where will a diabetic’s glucose levels fall after a 75 gm glucose tolerance test?

Answer 3

> 200 mg/dL after 2 hours

Question 4

What percent of the US population are diabetic?

Answer 4

8-9%

Question 5

How many people in the US die per year from diabetes?

Answer 5

73,000

Question 6

What percent of diabetics go un-diagnosed?

Answer 6

50%

Question 7

What percent of the population is in a pre-diabetic state?

Answer 7

14%

Question 8

What fasting blood glucose level defines being pre-diabetic?

Answer 8

100-125 mg/dL, or HbAlc is 5.75-6.4%

Question 9

What are 4 symptoms of diabetes?

Answer 9

1. Polydipsia
2. Polyphagia
3. Polyuria
4. Unexplained weight loss

Question 10

Insulin does not effect glucose uptake in what?

Answer 10

neurons, kidney and red blood cells

Question 11

Insulin is what type of hormone (anabolic or catabolic)?

Answer 11

anabolic hormone (helps control normal growth patterns and tissue development)

Question 12

What is the main function of insulin?

Answer 12

Promote glucose and amino acids

Question 13

Through which membranes does insulin promote glucose and amino acids?

Answer 13

skeletal/smooth/cardiac muscle cells, fibroblasts, and fat cells

Question 14

Through which membranes does insulin promote glucose and amino acids?

Answer 14

skeletal/smooth/cardiac muscle cells, fibroblasts, and fat cells

Question 15

List 3 consequences of diabetes

Answer 15

1. Increased lipolysis resulting in blood ketosis and elevated triglycerides
2. Increased glycogenolysis and gluconeogenesis
3. Anabolic effect (protein catabolism of muscle-can cause wasting)

Question 16

Which type of diabetes requires insulin?

Answer 16

Type I

Question 17

What is the more common age of patients with type I diabetes?

Answer 17

3-20

Question 18

Where can glucose levels often fall before type I diabetes is diagnosed?

Answer 18

up to >500 mg/dl

Question 19

(T/F) Type I diabetics are often overweight

Answer 19

False

Question 20

What are 5 common effects on the body of a type I diabetic?

Answer 20

1. Ketoacidosis-dehydration;
2. Deep labored breathing (caused by acidosis)
3. Nausea
4. Coma
5. Anorexia

Question 21

What happens to the autoimmune system of a type I diabetic?

Answer 21

Loss of beta cells an autoimmune process-probably triggered by environment such as a viral infection

Question 22

What type of diabetes is commonly known as “adult-onset?”

Answer 22

Type II

Question 23

In type II diabetes, insulin levels are usually:

Answer 23

Normal

Question 24

What is a type II diabetic’s problem with insulin?

Answer 24

Resistance of insulin receptors to insulin stimulation

Question 25

Type II diabetes correlates with what two things?

Answer 25

Excessive visceral fat and hypertension/ risk for atherosclerosis, dyslipidemia

Question 26

Most type II diabetics are over what age?

Answer 26

30

Question 27

There are increasing numbers of type II diabetics due to what?

Answer 27

Obesity

Question 28

What percentage of type II diabetics are obese, where proper diet and exercise will reverse symptoms?

Answer 28

80-90%

Question 29

(T/F) Type II diabetics have very high glucose

Answer 29

True

Question 30

(T/F) There are MINIMAL ketones or acidosis for type II diabetics.

Answer 30

True

Question 31

Are certain ethnic groups at higher risk for type II diabetes?

Answer 31

Yes, Pima Indians, Hispanics, African Americans, etc.

Question 32

What are the likely genetics that stem type II diabetes?

Answer 32

Polygenic autosomal

Question 33

What is Metabolic Syndrome (Syndrome X)?

Answer 33

A group of risk factors that can increase your chance of developing heart disease, diabetes, and stroke.

Question 34

What are some features of metabolic syndrome (In short atherogenesis and thrombus?

Answer 34

1. Complex interaction between obesity and Insulin resistance 2. Type II diabetes-insulin receptors refractory to insulin 3. Abnormal lipid metabolism-high triglycerides & LDL, low HDL 4. excess fat around waist 5. Hypertension Increased risk for atherosclerosis 6. Prothrombic tendency 7. Proinflammatory state

Question 35

What are three pathogenesis factors of metabolic syndrome?

Answer 35

1. Increased visceral adiposity 2. Impaired glucose metabolism and insulin sensitivity 3. Increased hepatic inflammation and cirrhosis

Question 36

What are 3 major metabolic complication of metabolic syndrome?

Answer 36

1. Very high glucose 2. Hyperosmolar consequences, including coma 3. Brain swelling due to increased osmolarity

Question 37

What percent of pregnancies result in gestational diabetes due to the stress of pregnancy?

Answer 37

3-10% of pregnancies

Question 38

(T/F) Gestational diabetes lasts beyond pregnancy

Answer 38

False

Question 39

What are two risks in babies with diabetic mothers?

Answer 39

Early hypoglycemia in baby if mothers not well controlled | Fetal malformation if mothers not well controlled

Question 40

What can diabetes do to the placenta?

Answer 40

Can cause problems with insufficient placental function and babies that are abnormally large with excessive insulin secretion

Question 41

Glucose becomes sorbitol and is trapped in lens of eye. Opthalmic swelling follows and causes what?

Answer 41

Swelling, cataracts, retinopathy, neuropathy, glaucoma and blindness

Question 42

Diabetics are (more/less) prone to infection and have (fast/slow) healing

Answer 42

more, slow

Question 43

(T/F) Diabetics' symptoms often worsen with stress

Answer 43

True

Question 44

What is the most common cause of death in diabetics?

Answer 44

Coronary atherosclerosis with MI

Question 45

Other secondary complications associated with diabetes:

Answer 45

``` Autonomic nerve dysfunction abnormal GI motility hypotonic bladder increased UTI Accelerated atherosclerosis unhealthy cholesterols lipid metabolism Kidney, heart, and brain complications ```

Question 46

What often happens to the feet and extremities of diabetics?

Answer 46

Peripheral neuropathies –loss of touch and pain in extremities (such as feet); gangrene (frequent feet amputations)

Question 47

What are 4 oral concerns with diabetic patients?

Answer 47

Increased gingivitis and periodontitis Poor wound healing (issue with oral surgery or implants) Abnormal infections such as thrush/candida Xerostomia (increased caries)

Question 48

What are the 5 types of insulin?

Answer 48

Rapid-acting, short acting, NPH (neutral protein hagedorn), Insulin glargine, Insulin determir

Question 49

Which two types of insulin are good long-acting, background insulins?

Answer 49

Insulin determir and insulin glargine

Question 50

How long is the onset, peak, and persist of short-acting insulin?

Answer 50

30 min. onset, peaks 2-3 hours, persists 5-8 hours

Question 51

What substance helps to delay onset and lengthen duration of short-acting insulin?

Answer 51

crystalline zinc

Question 52

What are the pharmacokinetic features of NPH (neutral protein hagedorn)?

Answer 52

onset=2-15 hrs; duration=4-12 hours

Question 53

Which type of insulin is often mixed with other shorter acting insulins for both immediate insulin and sustained insulin needs?

Answer 53

NPH (neutral protein hagedorn)

Question 54

What HbA1C level is considered to be diabetic?

Answer 54

Greater than 6.5%

Question 55

Insulin from beta cells promotes amino acid and glucose movement into what five types of cells?

Answer 55

1. Skeletal 2. Smooth muscle 3. Cardiac Muscle 4. Fibroblasts 5. Fat cells

Question 56

What cell is particularly sensitive to disruptions in insulin? And Why?

Answer 56

Fat cells MOST IMPORTANT - CAN CAUSE DIABETES BY SELECTIVELY BLOCKING INSULIN EFFECTS IN FAT CELLS

Question 57

Insulin works with what receptor on cell membranes?

Answer 57

GLUT 4

Question 58

Which two peptides are secreted from beta cells in the islets of Langehans?

Answer 58

Glucose and Peptide C