Diabetes pt 2 Flashcards
(117 cards)
1
Q
what does sulfonylureas do
A
increases insulin secretion in second phase
2
Q
what does alpha glucosidase inhibitors do
A
decrease carb absorption
3
Q
is glucagon catabolic or anabolic
A
catabolic - promotes breakdown
4
Q
what type of diabetes is more likely to have DKA
A
type 1
5
Q
how does birth weight correlate with t2d
A
the lower the BW, the more insulin resistant and glucose intolerant the adult
6
Q
a varient of what gene is one of the strongest associations between t2d
A
TCF7L2 gene
7
Q
what hypoglycemic drug increases peripheral insulin sensitivity
A
thiazolidinediones
8
Q
semaglutide drugs are what kind of drugs
A
glp-1 agonists
9
Q
what increases insulin secretion in second phase
A
sulfonylureas
10
Q
what increases release of catcholamines
A
infection, inflammation
anything that invokes fight of flight
11
Q
what is DKA
A
diabetic ketoacidosis
12
Q
how does diabetes cause nephropathy
A
injury to the glomerulus means you cant excrete waste and lack albumin - increases GFR
13
Q
is there fruity breath or kussmal breathing with hhs? why
A
no because there is no ketogenesis
14
Q
what are examples of catecholamines
A
epinephrine
norepinepherine
15
Q
what are polyagonist
A
nasically a bunch of gut hormones that are similar to incretins
16
Q
what does ectopic fat deposition with PCOS cause
A
hyperandrogenism (increased testosterone)
insulin resistance/hyperinsulinemia
ovarian disfunction
17
Q
what do incretins do
A
stimulates insulin production
18
Q
Name the different types of diabetes
A
gestational
PCOS
drug-induced
post-kidney transplant
LADA
19
Q
what does meglitinides do
A
increase insulin secretion in the first phase
20
Q
weight balance is controlled by what
A
the cns
21
Q
what has more intense hyperglycemia, dehydration and hyperosmolarity? dka or hhs
A
hhs
22
Q
what is MODY
A
maturity onset diabetes of the young
23
Q
what are the 3 types of islets that can be transplanted
A
fresh islets
xenotransplants (non-human)
engineered cells
24
Q
what does orlistat do, and what is it used for
A
inhibits lipase to stop fat digestion
used in obesity treatments
25
what is released with insulin and can cause fibrosis and destruction of the beta cells
amyloid proteins
26
defective signaling of high glucose can lead to what
a mild form of diabetes
27
name some microvascular complications of hhs
nephropathy
retinopathy
neuropathy
PAD
28
what does phentermine do and what is it used for
decreases appetite - for weight loss management
29
what are the two rapid acting insulins
lispro
aspart
30
how long does intermediate acting insulin last
about 12 hours, can be used as a basal insulin but might need to take it twice a day
31
what were found in genome wide scans of those with t2d (4)
variants in genes related to beta cell mass and function
gene variants related to melatonin receptor 2
genes associated with fat mass and obesity
clustering of gene variants
32
what is increased fetal fat deposition
macrosomia
33
what is kussmaul breathing
low pH makes people breath faster to get rid of some co2
34
Metabolic syndrome is more common in what type of diabetes
2
35
what do catecholamines have to do with blood sugar
they stimulate glycogenolysis and gluconeogenesis
36
what can cause nonenzymatic glycation
hyperglycemia with hhs
37
what are amyloid proteins
something released with insulinw
38
what hypoglycemic drug decreases carb absorption
alpha glucodiase inhibitors
39
what increase insulin secretion in the first phase
meglitinides
40
how do dpp IV inhibitors help extend the life of glp-1 agonists
prevents the breakwond of them via DPP IV
41
what syndrome is linked to insulin resistance (and therefore type 2 diabetes)
metabolic syndrome
42
how does hyperglycemia cause polyphagia
it increases proteolysis (protein and fat breakdown)
43
how can we extend the lifespan of glp-1 agonists
exenatide
couple it with fatty acids
44
is hhs more gradul or rapid
gradual
45
what is PAD
peripheral artery disease
46
what is retinopathy
disease of the retina
47
what drug eliminates glucose in urine to decrease it
sodium glucose cotransporter 2 inhibitors
48
what circuits in the brain modulate balance between nutrient intake and energy expenditure
cortical circuits
49
what promotes glucose uptake by the beta cell and the liver
glucokinase
50
what is the issue with glp-1 agonists
they have a very short half life
51
what is an anorexigenic pathway
satiety
52
what is the combination weight loss surgery
roux-en-y gastric bypass
53
what are the 5 other types of diabetes
gestational diabetes
polycystic ovary syndrome
drug-induced diabetes
post kidney transplant diabetes
latent autoimmune diabetes in adults
54
what form of diabetes if glucokinase associated with
MODY
55
what type of diabetes is more likely to have HHS
type 2
56
what is the only well established variant of diabetes based on mutation in a single gene
MODY
57
why are glp-1 agonists safer
they wont cause hypoglycemia
58
in genome wide scans, varients in genes related to what were the most important association with diabetes
beta cell mass and function
59
what is LADA
latent autoimmune diabetes in adults
60
wht are the benefits of intraperitoneal insulin infusion
targets liver directly
faster absorption
less hypoglycemia
61
name two things from natural history that could cause t2d
thrifty genes
maternal low protein diet
62
what do amylin mimetics do (2)
inhibits gastric emptying
weight loss
63
what is the big difference between hhs and dka
hhs wont lead to ketogenesis
64
what kind of drugs are tirzepatide
dual glp-1 and gip receptor agonists
65
what do pre and probiotics do
affect microbiome metabolism
66
why is the absorption of regular insulin delayed
because it takes time for the hexamers to dissolve
67
what do thiazolidinediones do
increase peripheral insulin sensitivity
68
name 4 types of treatment for type 1 diabetes
insulin replacement therapy
glucose monitoring
diet/exercise
education/stress management
69
what can amyloid proteins cause
fibrosis and destruction of the beta cells
70
how can ketone bodies lower the pH of your blood
they are acidic
71
what is the basis of the thrifty gene association with t2 diabetes
hunter-gatherers
had a gene to store energy for later - didnt know when the next meal would be; dont need that now, just causes obesity
72
when is the best time to give rapid acting insulin
during meals
73
what are the two types of insulin replacement therapy
subcutaneous insulin injections
continuous subcutaneous insulin infusion
74
what breaks down glp-1 in circulation
DPP IV
75
Describe DKA
ketoacidosis occurs and ketone bodies build up in the blood
76
how does hyperglycemia cause polydipsia
causes a higher somolarity
stimulates hypothalamic thirst center
77
variants in genes related to what were the most important associations with diabetes
beta cell mass and funciton
78
when is short acting insulin typically used
hyperglycemic crisis
79
why are closed loop systmes not perfect
there are delays in sensing glucose levels and insulin availability
80
some t2d mutations mediates what kind of effect on incretins
a reduced incretin effect
81
what is HHS
hyperglycemic hyperosmolar syndrome
82
what kind of diabetes is LADA
slow progessive form of t1d
83
what is a symptom os hhs that you wont find in dka
confusion and delirium
84
what are hard exudates
little lesions on the outside of vessels
85
what does topiramate do in conjuction with another drug
increases the effect of phentermine for a longer period of time
86
what is proteolysis
protein and fat breakdown
87
why is glucokinase important
if you dont have uptake of glucose by the beta cells, you cannot signal high glucose levels to the cell
88
why wont hhs lead to ketogeneis
still enough insulin to use some glucose
89
how does hyperglycemia cause polyuria
it increases osmotic duresis
90
what is the rapid breathing associated with t1d called
kussmaul breathing
91
name the 4 second line of oral ypoglycemic drugs
sulfonylureas
meglitinides
aplha glucosidase inhibitors
thiazolidinediones
92
what were the first MODY mutations to be identified
glucokinase
93
what is nonenzymatic gylcation
taking proteins and lipids and binding glucose to them
94
describe ketoacidosis
body must break down fats
lipids broken down in liver
beta oxidation turns fatty acids to acetyl-CoA
acetyl-CoA gets converted to ketone bodies
95
which type of diabetes has a strong genetic component
type 2
96
adding what to phentermine will increase the length of the effects
topiramate
97
what is IUGR
intrauterine growth retardation
98
what is an orexigenic pathway
hunger pathway
99
what is a basal-bolus insulin regine
its used to mimic the body's natural insulin production as closely as possible
100
what are the two kinds of gastric weight loss surgery
adjustable gastric banding
vertical sleeve gastrectomy
101
what does glucokinase do
promotes glucose uptake by the beta cell and by the liver
102
what was found with fresh islet transplants
did not work out long term
103
waht is nephropathy
deterioration of kidney function
104
name some macrovascular complications of hhs
nonenxymatic glycation
atherosclerosis
myocardial infarction
coronary artery disease
105
will HHS lead to ketogenesis
nope
106
what does it mean for something to be polygenic
based on mutations/changes in several genes
107
what is PCOS characterized by
ectopic fat deposition
108
is dka more gradual or rapid
rapid
109
what is the first line of hypoglycemic drugs (oral)
metformin
110
what is microangiopathy
a disease of the capillaries - they become too thick and weak that they bleed
111
what is macroangiopathy
accelerated atherosclerosis - a quick build up of plaque and fatty material on the inner walls of arteries
112
what do sodium glucose cotransporter 2 inhibitors do
eliminates glucose in urine to decrease it
113
what is macrosomia
increased fetal fat deposition
114
what is GLP-1
the main incretin
115
name 5 typical symptoms of metabolic syndrome
lower hdl
high triglycerides
high bp
high glucose
large waist circumferece
116
high glucose can pull ____ out of cells
potassium
117
Name 3 things GLP-1 agonists do
enhance insulin secretion
supresses glucagon
inhibits stomach emptying to slow absorption of glucose
