Flashcards in DM/METABOLIC SYNDROME Deck (8)
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
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.
What Diabetes Mellitus complication causes
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)
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
What vascular changes are often seen in patients with diabetes?
Hyaline arteriosclerosis and Capillary Basement Membrane Thickening
How do cataracts develop in patients with Diabetes?
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
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