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Third Exam for Patho > Diabetes mellitus > Flashcards

Diabetes mellitus Flashcards

1
Q

Where do we glucose from?
___________
Ingested

Storage (gluconeogenesis and glycolysis)
-Liver
-Muscle

A

Diet

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2
Q

Glucose use

During fasting 75% glucose use occurs in the
________
Liver
GI tract
Does not require insulin

A

Brain

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3
Q

Glucose Use
Remaining 25% occurs in ________

Requires insulin

A

muscle

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4
Q

Glucose Use
Small percent occurs in adipose

A
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5
Q

____________is the only hormone that decreases blood levels of glucose and thats why its so important

A

Insulin

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6
Q

Glucose regulating hormones
____________
-Decreases blood levels

A

Insulin

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7
Q

_____________
-Secreted with insulin

A

Amylin

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8
Q

_______________
-Increases blood levels

A

Glucagon

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9
Q

_______________
Maintains blood glucose during fasting

Thus it increases glucose levels

A

Glucagon

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10
Q

____________

Major effect is exerted in fasting
Breakdown of glycogen to glucose
Also stimulates glyconeogenesis
Conversion of AA to glucose

A

Glucagon

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11
Q

Hormones that increase blood glucose what are they?

Glucagon
____________
_______________

A

Epinephrine, Cortisol

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12
Q

Why and when

A
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13
Q

Insulin only hormone to lower blood glucose

3 major actions

Promotes glucose ________by target cells
Prevents fat and glucoygen breakdown!
Inhibits _______________

A

gluconeogenesis

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14
Q

Important biomarkers

_____________

-Slower clearance than insulin
-Helps getermine insulin dysfunction
-If normal but insulin low=downstream reason for low insulin levels

_____________
-Hemoglobin can be glycoslated
-Increases with blood glucose levels
-Gives level over 3 month time

A

C-peptide

HbA1c

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15
Q

Insulin has 3 major cell types in the pancreas: beta cells,delta,and alpha cells

A
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16
Q

Beta cells release __________

A

insulin

17
Q

Acini are the more exocrine function of the pancreas

A
18
Q

Endocrine function is through islets of langerhans

A
19
Q

Tissue types and functions of the pancreas
_________
-Secrete digestive juices into the duodenum

A

Acini

20
Q

Islets of Langerhans
-Secrete hormones into the blood
Composed of beta cells that secrete _______

alpha cells that secrete _______

delta cells that secrete _________
-Inhibits release of growth hormone
-Inhibits release of thyroid stimulating hormones

A

insulin

glucagon

somatostatin

21
Q

Insulin release

released into bloodstream
through ________

50% of insulin lost in 1st pass metabolism

Half life is 3-5 minutes
-Rest is degradated after binding to receptor

A

portal vein

22
Q

Diabetes Mellitus
Diabetes- Greek for going through
Mellitus-Latin for honey or sweet

Diabete really means you have too much sugar in your urine and it tastes like honey

A
23
Q

Diabetes Mellitus can represent an absolute insulin deficiency meaning no insulin
Impaired release of insulin by the pancreatic beta cells
-Inadequate or defective insulin receptors
-Production of inactive insulin or insulin that is destroyed before it acts

A
24
Q

________results from:
-Loss of beta cell function
-An absolute insulin deficiency

A

Type 1

25
Q

How does type 1 diabetes generally occur?

A

Autoimmune (Beta cells are being destroyed by the body…its attacking the pancreas)

26
Q

__________don’t have insulin

A

Type 1 diabetes

27
Q

__________you don’t have enough insulin

A

Type 2 diabetes

28
Q

_______ results from: Impaired ability of tissues to use insulin
-A relative lack of insulin
-Impaired release relative to glucose levels

A

Type 2 diabetes

29
Q

Type 1 used to be called juvenile diabetes
-Occurs most commonly in young people

Possible causes of Type 1
Predispostion (diabetogenic genes)
Immunologically mediated beta cell destruction

A
30
Q

___________

Hyperglycemia with releative insulin deficiency
Most people with type 2 are
-Older
-Overweight
-However large spike in childhood incidence!

A

Type 2 diabetes

31
Q

Factors in Progressive Impairment of Beta Cell Function
Family history
Metabolic abnormalities such as insulin resistance, deranged secretion of insulin, increased glucose production

A
32
Q

Insulin resistance means the skeletal muscle no longer responds as effectively to signals that it needs to take up glucose

A
33
Q

Causes of Beta Cell dysfunction
Decrease in ________
-An initial decrease in the beta cell mass
-Increased apoptosis/decreased regeneration

Decreased __________
-Chronic insulin resistance, leads to exhausation
-Chronic hyperglycemia can induce desensitization

A

decrease in beta cell number

Decrease response

34
Q

_______________
Any degree of glucose intolerance during pregnancy

Occurs up to 15% of pregnancies

A

Gestational diabetes

35
Q

Risk factors for gestational diabetes
Persons with family history of diabetes
* History of stillbirth or spon abortion
* Previous fetal abnormalities
* Previous large or heavy for date infant
* Obese
* Advanced maternal age
* Five or more pregnancies

A
36
Q

Gestational Diabetes
* Most women return to normoglycemia
postpartum
* Upto 50% develop type 2 DM or glucose
intolerance later in life.

A
37
Q
A

Third Exam for Patho (16 decks)

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