Diabetes Pre-Lecture Hockerman Flashcards
high blood glucose →glucose in urine/excess water loss →excessive ___
Inability to utilize glucose as fuel → decrease body weight → excessive ___
- thirst/dehydration (polydipsia, polyuria)
- hunger (polyphagia)
Diagnosis Criteria
- A1C greater than or equal to ___ % OR
- Fasting plasma glucose (FPG) greater than or equal to ___ mg/dL ( ___ mmol/L) OR
- 2-h plasma glucose greater than or equal to ___ mg/dL ( ___ mmol/L) during an OGTT OR
- a random plasma glucose greater than or equal to ___ mg/dL ( ___ mmol/L) with symptoms of diabetes
OGTT = oral glucose tolerance test
- 6.5%
- 126 mg/dL, 7.0 mmol/L
- 200 mg/dL, 11.1 mmol/L
- 200 mg/dL, 11.1 mmol/L
Type I - Insulin Dependent Diabetes Mellitus (IDDM)
- ___ % of diabetic population
- ___ intolerant
- no functional ___ ; near complete loss of ___
- dependency on ___ insulin and tendency toward ___
- early age onset ( ___ yo)
- autoimmune response that specifically targets ___
- may be triggered by ___ , chemicals , etc. in genetically predisposed pts
- family history often ___
- also called ___ (JODM)
- 10
- glucose, insulin-secretion, pancreatic beta cells
- exogenous, ketoacidosis
- 12
- pancreatic beta cells
- viruses
- negative
- juvenile onset diabetes mellitus
Loss of Beta Cell Mass (BCM) in Type I Diabetes
- loss of BCM is ___
- FBG is normal until ___ % of BCM is lost
- ___ (a product of insulin processing) is a marker for insulin secretion in the presence of exogenous insulin
- gradual
- 70%
- C-peptide
Autoantigens assocaited with Type I
islet antigen 2 ( ___ )
- ___% of non-diabetics who have it will develop type 1 diabetes
__% of type 1 diabetics have antibodies
- antibodies against one or more ___ proteins signals an increased risk for developing Type 1 diabetes
IA-2
- 57%
99%
- beta cell
Examples of autoantigens assocaited with Type I
- insulin
- islet antigen 2 (IA-2)
- phogrin (IA-2B)
- Zn Transporter (ZnT-8)
- Glutamic acid decarboxylase (GAD65)
- Voltage-gated Ca2+ (Cav 1.3)
- Vesicle associated membrane protein-2 (VAMP-2)
Type 2 Diabetes NIDDM
Non-obese
Cause: ___ %
- Incidence: ___
- age of onset: often under ___ (MODY)
- family history: ___
- Insulin secretion in response to glucose: ___
- mutations in specific ___
mutations in specific proteins
- 10%
- 25, maturity onset diabetes of the young
- yes
- low
- proteins
Type 2 Diabetes NIDDM
obese
Cause:
- Incidence: ___ %
- age of onset: usually over ___
- family history:
- Insulin secretion in response to glucose: ___
- insulin resistance/ decreased ___
- 80%
- usually over 35
- Yes
- low for body mass
- BCM
Patho - consequances of a lack of insulin
Hyperglycemia
- decreased glucose uptake in cells where glucose uptake is ___-dependent
- decreased ___ synthesis
- increased conversion of ___ to glucose
Glucosuria
- due to high ___
Hyperlipidemia
- increased ____ mobilization from fat cells
- increased fatty acid oxidation - ___
Uninhibited glucagon
- increased glucagon levels in the presence of increased ___ levels
- insulin
- glycogen
- amino acids
- blood glucose
- fatty acid
- ketoacidosis
- blood glucose
Complications
Cardiovascular
- micro and macro ___
Neuropathy
- high blood glucose levels increase utilization of the ___ pathway
- ___ reductase
- Water accumulation in neurons/reduced protection from ____ damage
Nephropathy
- renal ___ changes and changes in ___ basement membrane
Ocular
- ___, retinal microaneurysms, and hemorrhage
Increase susceptibility to ___
- angiopathies
- polyol
- aldose
- oxidative
- vascular, glomerular
- cataracts
infections
Goals of insulin therapy and monitoring
reduce acute symptoms: ___ , ___ , and ___
Current insulin therapy goals
- keep avg blood glucose levels below ___ mg/dL
- prevent/delay onset of complications
- increased risk of ___
Ideal A1c: less than or equal to ___ %
Goal A1c: less then ___%
polyuria, dehydration, and ketoacidosis
- 150 mg/dL
- hypoglycemia
6%
7%
