Type 2 Diabetes Flashcards Preview

Endocrine > Type 2 Diabetes > Flashcards

Flashcards in Type 2 Diabetes Deck (38):
1

glucose sources

intestinal absorption, glycogenolysis, gluconeogenesis

2

In fasting state, glucagon levels increase/decrease

increase

3

Glucagon

stimulates glycogenolysis and gluconeogenesis

4

In fasting state, insulin levels increase/decrease

decrease

5

During eating, insulin levels increase/decrease

increase

6

Which tissues absorb glucose due to insulin?

muscle, liver, adipose

7

Insulin resistance

reduced response to circulating insulin

8

Insulin resistance hyperglycemia

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

9

There is a _______ relationship between insulin secretion and insulin resistance

hyperbolic

10

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

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

11

Prediabetes

impaired glucose tolerance, impaired fasting glucose

12

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

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

First indicator of diabetes

rise in insulin

14

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

50%

15

normal fasting glucose

100 = more cardiovascular risk)

16

2hr plasma glucose after 75gm CHO load

<140 mg/dL

17

100<200 mg/dL

prediabetes

18

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

T

19

First phase of insulin secretion

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

20

Second phase of insulin secretion

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

21

___ phase of insulin secretion is missing in T2D.

first phase

22

Deposition of ____ disrupts alpha/beta cell communication.

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

23

intestinal hormones that are released in response to food ingestion

incretins

24

Incretins

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

Incretin response

difference between insulin load from oral glucose and from iv glucose

26

T/F response to GLP1 is preserved in diabetes

T

27

GLP1 effect on glucagon

reduces glucagon -->reduces hepatic glucose output

28

GLP1 effect on stomach

slows gastric emptying --> attenuates post-prandial hyperglycemia

29

GLP1 effect on CNS

promotes satiety and reduction of appetite

30

4 main defects in Type 2 Diabetes

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

31

Risk factors for T2D

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

32

Nonspecific clinical presentation of T2D

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

33

Classic symptoms of T2D

polyuria/dipsia/phagia, unexplained weightloss

34

Physical exam findings of T2D

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

35

skin changes in T2D

acanthosis nigricans, skin tags, furuncles and carbuncles

36

Diagnostic criteria for T2D

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

37

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

hemoglobin a1c

38

After gastric bypass levels of _____ are highg

GLP1