Diabetes mellitus

Question 1

what is diabetes?

Answer 1

the inability of the body to regulate blood glucose through insulin

Question 2

type I diabetes

Answer 2

insulin dependent
auto immune; loss of insulin producing beta cells
genetically linked
triggered environmentally

Question 3

type II diabetes

Answer 3

non-insulin-dependent
insensitivity to insulin
lifestyle and genetics
adult onset, though becoming more prevalent in juveniles

Question 4

gestational

Answer 4

develops during pregnancy
40% increased likelihood of developing type II later
-fetus-induces changes in metabolism

Question 5

what percent of the population has diabetes?

Answer 5

10%

Question 6

do more people have type I or type II?

Answer 6

type II

Question 7

how many are type I diabetics?

Answer 7

2 million

Question 8

when you have a spike in glucose levels what else spikes?

Answer 8

insulin

Question 9

if you eat sucrose rich foot compared to starch rich foods what is different?

Answer 9

the level of glucose and insulin released is higher

Question 10

what are signs of diabetes?

Answer 10

polyuria and thirst
weakness or fatigue
polyphagia(excessive hunger) and weight loss
blurred vision
peripheral neuropathy
nocturnal enuresis

Question 11

what are some other signs of diabetes?

Answer 11

sweet smelling breath
sweet smelling urine
impaired wound-healing

Question 12

type I key characteristics

Answer 12

insulin absent
elevated glucagon
glucose, fats, and AAs released into and
improper fatty acid metabolism
increases in ketone production and release

Question 13

lack of insulin leads to what?

Answer 13

dysregulated metabolic state of extreme fasting and starvation

Question 14

autoimmune targeting of beta cells drives type I how?

Answer 14

it is currently unknown
95% of cases are immune medated
5% idopathic 
strong genetic predisposition
environmental trigger

Question 15

pathogenesis of type I diabetes

Answer 15

loss of insulin signaling
system mimicry of prolonged fasting
loss of glucose transporters on membrane
thus no glycolysis in cells leading to FA metabolism

Question 16

adipose tissue is starved of triglycerides due to glucose not being able to enter cells. this leads to what in leptin?

Answer 16

a decrease, so you are hungry all the time leading the hyperglycemia
decrease in insulin leads to decrease in leptin

Question 17

with insulin deficiency fatty acid oxidation is increased which leads to an increase in ketone bodies. what are the ketone bodies?

Answer 17

acetone - toxic
beta hydroxybutyrate - metabolized
acetoacetate
l

Question 18

elevated blood ketones leads to what?

Answer 18

osmotic diuresis->dehydration->reduced blood flow->coma and tachycardia

Question 19

type I diabetes requires what 3 things?

Answer 19

insulin administration
glucose monitoring
diet control

Question 20

what is the goal of insulin administration

Answer 20

maintain blood glucose between 80-140 mg/dl

Question 21

what are the two ways to give insulin?

Answer 21

injection

pump-more control over injection

Question 22

basal insulin does what?

Answer 22

maintains low-level systemic insulin

long half life

Question 23

what does bolus insulin do

Answer 23

given when food is consumed

Question 24

hypoglycemia neuroglycopenic symptoms

Answer 24

exhaustion
loss of lucidity
irritibility
blurred vision
dizziness
headache
loss of speech
coma and death

Question 25

hypoglycemia autonomic symptoms

Answer 25

``` increased heart rate sweating trembling nausea hunger ```

Question 26

causes of hypoglycemia

Answer 26

excess insulin too much activity insufficient food illness

Question 27

treatment for hypoglycemia

Answer 27

``` immediate sugar glucagon test blood sugar repeatedly test call 911 if necessary ```

Question 28

hyperglycemia signs

Answer 28

``` headache nausea thirst dry mouth excessive urnination ketones blurred vision ```

Question 29

causes of hyperglycemia

Answer 29

``` high blood sugar lack of insulin inactivity excess food illness ```

Question 30

treatment of hyperglycemia

Answer 30

insulin oral hypoglycemic activity diet

Question 31

long term diabetic complications

Answer 31

``` cardiovascular disease blindness kidney disease neuropathy impaired wound healing and amputation ```

Question 32

type II diabetes

Answer 32

progressive increase in fasting glucose due to reduced insulin sensitivity followed by a degeneration of insulin production (destroyed beta cells)

Question 33

possible mechanisms for insensitivity

Answer 33

adipokine signaling extopic lipid storage inflammatory signaling

Question 34

what is macrophage chemotaxis protein (MCP-1)

Answer 34

released by adipose tissue and recruit macs once they reach a certain capacity of fat

Question 35

what do macs release once they get to the adipose tissue

Answer 35

TNF alpha which releases fatty acids from adipose tissue, which makes muscles use fatty acids for energy and not glucose, thus insensitivity to glucose

Question 36

treatment for type II diabetes

Answer 36

lifestyle changes oral hypoglycemics insulin once beta cell masses degenerate, reversible

Question 37

what do oral hypoglycemics do? 3 things

Answer 37

increase insulin increase insulin sensitivity decrease carb absorption

Question 38

type II drugs to treat hyperglycemia

Answer 38

metformin sulfonylureas peroxisome proliferator-activated receptor agonists alpha-glucosidase inhibitors

Question 39

what are the five ways to detect diabetes

Answer 39

``` urinalysis glucose monitoring (fasting) HGA1c glucose tolerance test C-peptide test ```

Question 40

**what is the glucose tolerance test**

Answer 40

known amount of glucose is given (100grams) levels are tested at 30 min and 90-120 min if glucose levels stay high then they may have diabetes, BUT DOES NOT TELL YOU WHICH TYPE THEY HAVE

Question 41

**what is a C-peptide test **

Answer 41

done to determine type I or type II * *if you have no C-peptide then you have no insulin being produced and thus you are type I * *if you have C-peptide then you have type II