Type 2 Diabetes Flashcards Preview

Endocrine > Type 2 Diabetes > Flashcards

Flashcards in Type 2 Diabetes Deck (38)
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1
Q

glucose sources

A

intestinal absorption, glycogenolysis, gluconeogenesis

2
Q

In fasting state, glucagon levels increase/decrease

A

increase

3
Q

Glucagon

A

stimulates glycogenolysis and gluconeogenesis

4
Q

In fasting state, insulin levels increase/decrease

A

decrease

5
Q

During eating, insulin levels increase/decrease

A

increase

6
Q

Which tissues absorb glucose due to insulin?

A

muscle, liver, adipose

7
Q

Insulin resistance

A

reduced response to circulating insulin

8
Q

Insulin resistance hyperglycemia

A

liver, muscle, adipose glucose intake is low and liver glucose output is high –> hyperglycemia

9
Q

There is a _______ relationship between insulin secretion and insulin resistance

A

hyperbolic

10
Q

As one gains weight and becomes obese, it is possible to maintain glucose balance if ____

A

pancreas increases insulin output –> this ability drops off over time

11
Q

Prediabetes

A

impaired glucose tolerance, impaired fasting glucose

12
Q

Why do post-prandial sugars rise first after some years of prediabetes?

A

as ability to ensure high level of insulin secretion tapers off and starts declining, the body has a more difficult time coping with high carbohydrate load vs. simply shutting off liver glucose production –> post prandial sugars rise before fasting glucose

13
Q

First indicator of diabetes

A

rise in insulin

14
Q

By the time of diagnosis, ____% of beta cells are long gone.

A

50%

15
Q

normal fasting glucose

A

100 = more cardiovascular risk)

16
Q

2hr plasma glucose after 75gm CHO load

A

<140 mg/dL

17
Q

100<200 mg/dL

A

prediabetes

18
Q

T/F most people with prediabetes develop type 2 diabetes within 10 years

A

T

19
Q

First phase of insulin secretion

A

task is to take care of just-consumed CHO and shut down glucose production –> insulin in beta cell granules

20
Q

Second phase of insulin secretion

A

task is to maintain blood sugar that has been absorbed prior –> gradual increase in insulin

21
Q

___ phase of insulin secretion is missing in T2D.

A

first phase

22
Q

Deposition of ____ disrupts alpha/beta cell communication.

A

amyloid –> inappropriately high glucagon secretion stimulates liver production of glucose and therefore hyperglycemia

23
Q

intestinal hormones that are released in response to food ingestion

A

incretins

24
Q

Incretins

A

glucagon like peptide 1 (GLP1) and gastric inhibitory polypeptide (GIP) stimulate insulin secretion in the presence of glucose –> account for 60-70% of postprandial insulin response

25
Q

Incretin response

A

difference between insulin load from oral glucose and from iv glucose

26
Q

T/F response to GLP1 is preserved in diabetes

A

T

27
Q

GLP1 effect on glucagon

A

reduces glucagon –>reduces hepatic glucose output

28
Q

GLP1 effect on stomach

A

slows gastric emptying –> attenuates post-prandial hyperglycemia

29
Q

GLP1 effect on CNS

A

promotes satiety and reduction of appetite

30
Q

4 main defects in Type 2 Diabetes

A

decreased insulin action, decreased insulin secretion, inadequate glucagon suppression and excess hepatic glucose production, defective incretin response

31
Q

Risk factors for T2D

A

obesity, race, metabolic factors, lifestyle, genetics, gestational diabetes, intrauterine

32
Q

Nonspecific clinical presentation of T2D

A

fatigue, blurry vision, poor wound healing, dry mouth/skin, recurrent infections (candadiasis)

33
Q

Classic symptoms of T2D

A

polyuria/dipsia/phagia, unexplained weightloss

34
Q

Physical exam findings of T2D

A

obesity, skin changes, candidal infection, fundoscopic/neurologic (decreased sensation)/feet changes (ulcers)

35
Q

skin changes in T2D

A

acanthosis nigricans, skin tags, furuncles and carbuncles

36
Q

Diagnostic criteria for T2D

A

fasting glucose>126 on two separate occasions or random glucose>200 with classic sx or 2hr glucose test >200 or hba1c>6.5%

37
Q

_____ reflects average plasma glucose level over past 2-3 months

A

hemoglobin a1c

38
Q

After gastric bypass levels of _____ are highg

A

GLP1