Met 1: T2D Pathophys Flashcards
T2D is the leading cause of what 3 things?
T2D is the leading cause of
- Blindness
- Amputation
- End stage renal disease
Name 3 populations that should be screened for T2D
- Anyone over 45 yo
- Any non-white person over 20 yo
- Any overweight adult with one additional risk factor (inactive, poor diet, fhx, etc)
Define gestational diabetes.
Why does it occur?
Gestational Diabetes = high blood sugar that develops during pregnancy
Pregnant women naturally become more insulin resistant (so sugar gets sent to baby instead of mom), and this can be more severe in predisposed individuals
Name 3 potential complications of gestational diabetes
- Large baby syndrome
- Increased risk of child developing T2D
- Increased risk of mom developing T2D
How much glucose is normally floating around in blood (total)?
about 5g
What are the two primary components of T2D?
- Insulin resistance (decreased response to insulin)
- Decreased insulin production
Why does the pancreas secrete less insulin in T2D?
The excess sugar and fat in the blood are toxic to the beta cells.
Name three processes that contribute to hyperglycemia in T2D.
- Insulin resist -> liver keeps releasing glucose into blood
- Insulin resist -> muscle cells not taking glucose out of blood stream
- Defective insulin production by pancreas exacerbates the above two
Do T2D patients all require insulin?
T2D patients do not all require insulin at diagnosis.
However, if they live long enough, they will all require insulin b/c all the beta cells will eventually be destroyed
In T2D, are you resistant to all the effects of insulin?
NO. you only become resistant to the METABOLIC effects of insulin. You still respond to the growth effects.
Describe glucagon activity in T2D
T2D patients can still make glucagon.
They also make glucagon at the wrong times (eg. after a meal), contributing to high blood sugar.
What is the normal activity of GLP-1?
GLP-1 is secreted by GI tract during meals.
It potentiates insulin release and suppresses glucagon release.
Why do T2D pts lose first phase insulin release?
Consistent high blood sugar -> deplete vesicles in beta cells filled with ready-made insulin -> can’t quickly secrete a bunch of insulin
What is the best prevention for T2D?
Lifestyle changes
