DM/METABOLIC SYNDROME Flashcards Preview

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Flashcards in DM/METABOLIC SYNDROME Deck (8)
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1

What does the clinical onset of T1DM often coincide with? its characteristic early lesion is?

Other acute illnesses such as a febrile viral or bacterial infection.

The most characteristic early lesion in the pancreas is a lymphocytic infiltrate in the islets (insulitis), sometimes accompanied by a few macrophages and neutrophils

2

What is the fundamental pathology of T1DM?

Cell-mediated immune mechanisms. Cytotoxic T lymphocytes sensitized to beta-cells in t1dm persist indefinitely

Circulating antibodies against components of the beta-cells of the islets including insulin itself are identified in most newly diagnosed patients with diabetes however they are a response to beta-cell injury rather that the initial cause of beta-cell depletion.

3

What Diabetes Mellitus complication causes
Claudication?

Atherosclerosis

The extent and severity of atherosclerotic lesions in medium-sized and large arteries are increased in patients with long-standing diabetes.

Leg pain during walking or exercise, forces the patient to stop or limp (intermittent claudication)

4

How does amyloid accumulate in diabetic patients?

Diabetic patients over 60 years of age often have amyloid present within the islets of Langerhans.

This type of amyloid derives from a polypeptide molecule known as amylin, which is secreted with insulin by the beta-cell

5

What vascular changes are often seen in patients with diabetes?

Hyaline arteriosclerosis and Capillary Basement Membrane Thickening

6

How do cataracts develop in patients with Diabetes?

Pathogenesis:
The Aldose Reductase Pathway

Glucose is converted to sorbitol (sugar alcohol) which can be cytotoxic.

Also associated with complications in other tissues such as peripheral nerves, retina, lens, and kidney

7

How does DM in a mother affect her fetus?

Fetuses exposed to Hyperglycemia in utero may develop hyperplasia of the pancreatic beta-cells, which may secrete insulin autonomously and cause hypoglycemia at birth and in the early neonatal period.

Other consequences: developmental abnormalities, increased birth weight

8

What is a common complication of obesity?

Degenerative joint disease (osteoarthritis) of weight-bearing joints (especially hips and knees)