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