Path 8 Diabetes Flashcards Preview

Test 9 > Path 8 Diabetes > Flashcards

Flashcards in Path 8 Diabetes Deck (27)
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1
Q

Type 2 diabetes definition

A

Progressive insulin secretory defect

2
Q

Diabetes Dx

A

Fasting plasma glucose > 126
HbA1C > 6.5%
Random glucose > 200

3
Q

Prediabetes

A

Increased risk of CV disease

4
Q

Proinsulin

A

Cleaved into insulin and c-peptide

5
Q

Insulin anabolic functions

A
  • Promote lipogenesis, inhibit lipolysis
  • Promote AA uptake and protein synthesis
  • Inhibit protein degradation
6
Q

Glucose receptors

A

GLUT-2 on B cells for insulin production

GLUT-4 on normal cells stimulated by insulin

7
Q

DM type I genetics

A

HLA-DR3 or DR4

-less genetic influence than in Type II

8
Q

Insulin resistance

A
  • Found 10-20 years before onset of DM

- Universal in obese diabetics

9
Q

4 ways obesity contributes to Insulin Resistance

A
  • FFA inhibit insulin signaling
  • FFA engage inflammation
  • Adipocytokinins (resistin)
  • PPARy
10
Q

B-cell dysfunction

A

Amylin deposition

Islet degeneration

11
Q

Monogenetic DM

A

MODY (maturity-onset diabetes of the young) caused by many individual mutations

12
Q

3 DM complication mechanisms

A
  • Non-enzymatic glycosylation
  • Protein Kinase C activation
  • Intracellular hyperglycemia & polyol disturbance
13
Q

AGEs

A

Advanced Glycosylation End Products

-Damage long lived proteins

14
Q

PKC mechanism

A

Neovascularization (retinopathy)

-Intracellular hyperglycemia activates DAG -> PKC -> VEGF

15
Q

Intracellular hyperglycemia & polyols mechanism

A

Lens, kidneys, blood vessels, nerves don’t require insulin for glucose transport
-Hyperglycemia -> Sorbitol (polyol via Aldose Reductase) -> Fructose -> Water influx, oxidative stress

16
Q

Diabetes islet infiltration

A

Type I - T lymphocytes (insulitis)

Type II - Amyloid

17
Q

Alpha cells

A

Glucagon

18
Q

Beta cells

A

Insulin

19
Q

Delta cells

A

Somatostatin

20
Q

Type I island histo

A

T lymphocytes

  • No beta cells
  • Normal alpha and delta
21
Q

Diabetic atherosclerosis

A

Same as regular atherosclerosis

-MI is most common cause of death

22
Q

Diabetic microangiopathy

A

Diffuse thickening of basement membranes

23
Q

Diabetic glomeruli (3)

A

-Capsular drops, fibrin caps, K-W lesions (mesangial matrix)

24
Q

Diabetic renal damage (3)

A
  • Hyalinization (mucopolysaccharides), thickening of aff/eff arterioles
  • Renal papillary necrosis
  • Recurrent pyelonephritis
25
Q

Diabetic nephrotic syndrome cause

A
Diffuse glomerulosclerosis (diffuse mesangial sclerosis)
-DIffuse BM thickening and mesangial matrix deposition
26
Q

Chronic pyelonephritis histo

A

Thyroidization of the kidney tubules

27
Q

Diabetic comas

A

Type I - ketoacidosis

Type II - hyperosmolar nonketotic coma (dehydration from sustained osmotic diuresis)