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40 Cards in this Set

  • Front
  • Back
What is Diabetes Mellitus?
Too much sweet urine
What causes Type I DM?
Islet cell destruction
What causes Type II DM?
Insulin resistance
What is gestational diabetes?
Diabetes brought on by pregnancy hormones
What is Secondary hyperglycemia?
Hyperglycemia brought on by increased GH or Cortisol (acromegaly or Cushing's)
So what are 3 autoimmune endocrine disorders we know about now?
1. Hashimoto's thyroiditis
2. Grave's disease
3. T1DM - autoimmune destruction of the islet cells
What gets destroyed in Type I DM?
Everything - so no insulin, glucagon, SST, or anything!
What is thought to cause Type I DM?
-Environment/viral infections
-Genetic susceptibility
What is Diabetes insipidus?
Peeing inspid amounts of urine due to lack of ADH
What is Diabetes mellitus?
Peeing lots of sweet pea because glucose causes osmotic diuresis
What is the primary cause of Type II Diab mellitus?
A PRIMARY CELL DEFECT WHERE THERE IS DECREASED GLUCOSE UPTAKE; even in spite of hyperinsulinemia, it just isn't enough to cause glucose uptake.
Is there a lack of insulin in T2DM?
Why is insulin increased in T2dm?
Because blood sugar's increased
Why is blood sugar increased?
Because there is a problem with insulin so that glucose is not taken up by cells.
What results from the primary liver defect?
-Less hepatic glucose uptake
-Less inhibition of liver gluconeogenesis (anabolic) so it pumps out even more glucose into blood.
Is the liver the only site where there's less glucose uptake?
No; there's also a defect in muscle uptake of glucose.
Why does the insulin not go up enough to allow for adequete cell glucose uptake?
Because there is a primary beta cell defect
So what are the 4 defects in T2DM?
1. Primary cellular defect
2. Primary muscle defect
3. Primary liver defect
4. Relative beta cell defect
Sorry, start again, what is the PRIMARY defect in T2DM?
Failure of cells to take up glucose, resulting in hyperglycemia
What is the hyperglycemia a result of?
Insulin resistance with increased insulin, but decreased response to insulin
What happens after years of hyperglycemia and hyperinsulinemia in T2DM?
The beta cells poop out and stop making insulin; then you become hypoinsulinemic
Is beta cell failure reversible?
Yes; if you stop stimulating the beta cells with the high blood sugar.
Why is the beta cell defect in T2DM called RELATIVE?
Because there is less insulin released relative to the high blood sugar levels there are.
What are most of the people that have T2DM?
Fat - obese
What do we call this?
Why does Lipotoxicity contribute to T2DM?
Because the fat goes into interstitial spaces in skeletal muscle, liver, and islet beta cells; impares insulin action and release.
What is the best therapy for T2DM?
Diet and weight loss and exercise.
What is the therapy for T1DM?
Are diet/weight loss/exercise the most effective therapy for T2DM?
No; because there is noncompliance.
So what do we currently rely on for treating T2DM?
What do Sulfonylurea and Meglitinides do?
Increase insulin secretion
Why are sulfonylurea and meglitinides not preferable?
They hasten Beta cell exhaustion and cause weight gain.
What does Biguanide do?
Decreases hepatic gluconeogenesis - a good method.
What do Glitazones do?
Increase glucose uptake
What blocks starch breakdown?
Acarbose - like a tapeworm. But it causes gas.
What other type of drug is given for T2DM?
How much insulin do you have to give for T2DM?
A LOT - and it causes weight gain
What is the new up and coming drug for T2DM?
GLP - to increase insulin before the glucose gets absorbed - amplifies the insulin response.
What are 5 long term complications of DM?
-CV disease
-Skin/poor wound healing
-Pregnancy problems
What does Diabetes Mellitus do to a baby during pregnancy?
Increases the size of a baby bc glucose crosses the placenta and stimulates fetal insulin and makes fat.