Path 8 Diabetes Flashcards Preview

Test 9 > Path 8 Diabetes > Flashcards

Flashcards in Path 8 Diabetes Deck (27):
1

Type 2 diabetes definition

Progressive insulin secretory defect

2

Diabetes Dx

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

3

Prediabetes

Increased risk of CV disease

4

Proinsulin

Cleaved into insulin and c-peptide

5

Insulin anabolic functions

-Promote lipogenesis, inhibit lipolysis
-Promote AA uptake and protein synthesis
-Inhibit protein degradation

6

Glucose receptors

GLUT-2 on B cells for insulin production
GLUT-4 on normal cells stimulated by insulin

7

DM type I genetics

HLA-DR3 or DR4
-less genetic influence than in Type II

8

Insulin resistance

-Found 10-20 years before onset of DM
-Universal in obese diabetics

9

4 ways obesity contributes to Insulin Resistance

-FFA inhibit insulin signaling
-FFA engage inflammation
-Adipocytokinins (resistin)
-PPARy

10

B-cell dysfunction

Amylin deposition
Islet degeneration

11

Monogenetic DM

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

12

3 DM complication mechanisms

-Non-enzymatic glycosylation
-Protein Kinase C activation
-Intracellular hyperglycemia & polyol disturbance

13

AGEs

Advanced Glycosylation End Products
-Damage long lived proteins

14

PKC mechanism

Neovascularization (retinopathy)
-Intracellular hyperglycemia activates DAG -> PKC -> VEGF

15

Intracellular hyperglycemia & polyols mechanism

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

16

Diabetes islet infiltration

Type I - T lymphocytes (insulitis)
Type II - Amyloid

17

Alpha cells

Glucagon

18

Beta cells

Insulin

19

Delta cells

Somatostatin

20

Type I island histo

T lymphocytes
-No beta cells
-Normal alpha and delta

21

Diabetic atherosclerosis

Same as regular atherosclerosis
-MI is most common cause of death

22

Diabetic microangiopathy

Diffuse thickening of basement membranes

23

Diabetic glomeruli (3)

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

24

Diabetic renal damage (3)

-Hyalinization (mucopolysaccharides), thickening of aff/eff arterioles
-Renal papillary necrosis
-Recurrent pyelonephritis

25

Diabetic nephrotic syndrome cause

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

26

Chronic pyelonephritis histo

Thyroidization of the kidney tubules

27

Diabetic comas

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