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60 Cards in this Set

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what are the other names for T2 DM?
adult-onset and non-insulin dependent diabetes
diabetes is a chronic condition that affects the ability of the body to ________.
metabolize glucose
is diabetes curable?
no
when is diabetes managable?
throughout, especially in the early stages
T2 DM accounts for ____ of diabetes cases.
90%
what are the other 2 types of diabetes?
type 1 DM and gestational diabetes
what tissues are affected by T2 DM?
- skeletal muscle
- pancreas
- adipose tissue
- GI tract
- brain
and more
what effect does T2 DM have on the pancreas?
decreased insulin secretion
what effect does T2 DM have on the kidney?
increased glucose reabsorbtion
what effect does T2 DM have on the brain?
neurotransmitter dysfunction
what effect does T2 DM have on adipose tissue?
increased lipolysis
what effect does T2 DM have on the digestive system?
decreased incetin effect
what effect does T2 DM have on the liver?
increased hepatic glucose production and decreased hepatic glucose uptake
what effect does T2 DM have on the musce tissue?
decreased glucose uptake
what effect does T2 DM have on Islet-a cells?
increased glucagon secretion
what is the main effect of T2 DM on the entire body?
hyperglycemia
what are the clinical syndromes of T2 DM
- metabolic syndrome
- insulin resistance
- high fasting glucose
- high fasting insulin
- dyslipidemia
- impaired glucose tolerance
- hypertention
what are the risk factors of T2 DM?
- obesity
- inactivity
- abdominal obesity
- family history/ Genetics
- race/ age
what ar the complications of T2 DM?
- cardiovascular disease
- neuropathy (amputation)
- Nepropathy (kidney failure)
- retinopathy (blindness)
- alzheimer's disease
what guidelines are used to diagnosed T2 DM?
WHO
what is the range for fasting glucose for impaired glucose intolerance?
6.1 - 7 mmol/L
what is the range for 2h - glucose for impaired glucose intolerance?
7 - 11.1 mmol/L
what is HbA1c ?
glycosylated hemoglobin
what is the range for fasting glucose for diabetes?
> 7 mmol/L
what is the range for 2h - glucose for diabetes?
> 11.1 mmol/L
what does HbA1c measure?
the amount of hemoglobin that is bound by glucose (%)
what does the level of HbA1c represent?
the average blood glucose over a 2-3 month period (long term glucoregulation)
what are the pros to HbA1c test?
- no need to fast
- good correlation with diabetes severity
- can be used as a monitoring tool
what are the cons to HbA1c test?
- technically difficults test (not available in developing countries)
- results influenced by anemia, alcoholism, age, ethnicity and pregnancy
why is 2h-glucose needed?
- fasting plasma glucose fails to diagnose T2 DM in 30% of cases
how long do humans spend in postprandial state?
18 hours daily
what is the oral glucose tolerance test (OGTT)?
consumption of 50g of glucose and monitoring over 2 h.
what is the treatment of T2 DM?
control of glucose hormones
what hormones are involved in the treatment of T2 DM?
insulin and plamsa glucose
where is glucose input in the fasting state in T2 DM?
- hepatic glucose production
in fasting, where is glucose utilization?
- brain glucose uptake (+++)
- skeletal muscle glucose uptake (+/-)
in fasting, the level of insulin is ______?
- independent
in T2 DM, heptic glucose production is _______ and can explain the elevated fasting glucose and insulin levels.
increased
in postprandial state, glucose input comes from?
- glucose from meal (+)
- hepatic glucose production
in postprandial state, where is the glucose utilization?
- skeletal muscle glucose uptake (+++)
- glucose uptake by other tissues (adipose tissue and liver)
in postprandial state, the level of insulin is ________.
dependent
in T2 DM, postprandial hyperglycemia can be explained by?
1. impaired suppression of hepatic glucose production
2. decreased glucose uptake by SM and other tissues
what happens during postprandial metabolism in the liver in full blown T2DM?
decreased suppression of endogenous glucose production after a meal
what happens during postprandial metabolism in the skeletal muscel in full blown T2DM?
decreased insulin-stimulated glucose disposal
in T2DM insulin secretion is _______ and ______.
decreased and delayed
in full blown T2DM, beta cell mass is _______, probably due to increased apoptosis. this leades to reduction in insulin secretion.
decreased
when is medication necessary for T2 DM?
when imparied glucose tolerance becomes diabetes
what is the prevalence of T2DM in North Americans, Europeans and Africans?
2%
what is the prevalence of T2DM in Pima Indians, Pacific Islanders (Nauru)?
41 - 50%
what is the prevalence of T2DM in chinese and Japanese?
6-25%
what is the obesity prevalence in diabetic population of north americans, europeans and africans
60-80%
what is the obesity prevalence in diabetic popultion in pima indians, pacific islanders (Nauru)?
100%
what is the obesity prevalence in diabetic population in chinese and japanese?
30%
if 1 of your siblings have T2DM, you risk of having T2DM increases by...?
4 fold
if 1 or your parents have T2DM, your risk of having T2DM increases by...?
3.4-3.5 fold
if both of your parents have T2DM, your risk of having T2DM increases by...?
6.1 fold
what is the concordance rates for T2DM for monozygotic twins?
0.29 - 1.00
what in the concordance rates for T2DM for dizygotic twins?
0.10 - 0.43
what are the envirnomental factors associated with the risk of T2DM?
- nutrition (resistant starch, fatty acids, coffee/caffeine, reservatrol)
- minerals and vitamin intake
- physical inactivity/exercise
- sleep patterns
- stress/glucocorticoids hormones
- heavy metals and pesticides
intrauterine environment
- lots more
what is the definition of dietary fibre?
carbohydrates polymers (10+ units) that are not hydrolyzed by the endogenous enzymes of the small intestines of humans.