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APHY 201 Exam 5c
Ch. 19.4 - Diabetes Mellitus and Hypoglycemia (Section IV only)
| Question | Answer |
|---|---|
| What is diabetes mellitus characterized by? | Diabetes mellitus is characterized by chronic high blood glucose. |
| What does diabetes mellitus result from? | Diabetes mellitus results from inadequate secretion or action of insulin. |
| What are the major complications and health impacts of diabetes mellitus? | Diabetes mellitus is a major cause of kidney failure and limb amputation, the second leading cause of blindness, and a significant contributor to heart disease and stroke. |
| What are the other names for type 1 diabetes? | Type 1 diabetes is also called insulin-dependent diabetes or juvenile-onset diabetes. |
| What happens to beta cells and insulin production in type 1 diabetes? | In type 1 diabetes, beta cells are destroyed by an autoimmune disease, and insulin is not made. |
| What treatment is required to sustain life for someone with type 1 diabetes? | Injections of insulin are required for sustaining life. |
| Why is the term "juvenile-onset diabetes" no longer used as much? | The term is not used as much because many children are starting to develop type 2 diabetes. |
| What genetic component is type 1 diabetes associated with? | Type 1 diabetes is an autoimmune disease associated with MHC on chromosome 6. |
| What environmental factors play a triggering role in type 1 diabetes? | Viruses and bacteria play a triggering role as environmental factors. |
| Why are there more fatty acids in the blood in type 1 diabetes? | Due to reduced insulin secretion, more fatty acids remain in the blood because they are not taken into and stored in adipose tissue. |
| What happens to excess fatty acids in the liver of someone with type 1 diabetes? | These fatty acids are converted to ketone bodies in the liver. |
| What condition may be produced by an increase in ketone bodies? | Increases in ketone bodies may produce ketoacidosis. |
| How do increased glucose and ketone bodies in the urine affect the body? | Increased glucose and ketone bodies are secreted in the urine and act as osmotic diuretics, which leads to dehydration. |
| What are the severe consequences of excess dehydration, ketoacidosis, and electrolyte imbalance? | Excess dehydration, ketoacidosis, and electrolyte imbalance can lead to coma and death. |
| What hormone is secreted in abnormally high amounts in people with type 1 diabetes? | People with type 1 diabetes also have an abnormally high secretion of glucagon. |
| What is the effect of high glucagon secretion on the liver and blood glucose? | High glucagon secretion stimulates glycogenolysis in the liver, further raising blood glucose levels. |
| How does glucagon affect fatty acid metabolism? | It also stimulates the enzyme that converts fatty acids to ketone bodies. |
| Which specific cells destroy the beta cells in type 1 diabetes? | Autoreactive T cells, specifically helper and killer T cells, destroy the beta cells. |
| What role do autoantibodies play in type 1 diabetes? | Autoantibodies attack the beta cells. |
| What are the alternative names for type 2 diabetes? | Type 2 diabetes is also called insulin-independent diabetes or mature-onset diabetes. |
| How common is type 2 diabetes compared to other forms? | Type 2 diabetes is the most common form, accounting for 95% of cases. |
| What is the primary cause of type 2 diabetes? | It is caused by very low target cell sensitivity to insulin, which is also called insulin resistance. |
| Who is most likely to develop type 2 diabetes among those who inherit the tendency? | The tendency is inherited, but the disease is most likely to occur in obese people who have this tendency. |
| What substance links obesity to the development of type 2 diabetes? | The link between obesity and type 2 diabetes is due to adipokines. |
| Why is the incidence of type 2 diabetes rising in children? | The incidence in children is rising due to obesity. |
| What condition is synonymous with low target cell sensitivity to insulin? | Insulin resistance. |
| How does type 2 diabetes affect skeletal muscles and liver cells regarding glucose intake? | In type 2 diabetes, skeletal muscles and liver cells do not take in glucose. |
| How does type 2 diabetes affect the liver's release of glucose? | The liver is not inhibited from releasing glucose. |
| What can happen as a result of increased beta cell production trying to compensate for the loss of insulin sensitivity? | Increased production of beta cells to compensate for loss of sensitivity may lead to beta cell failure. |
| What is the clinical consequence of beta cell failure in type 2 diabetes? | Beta cell failure can cause a less severe case of diabetes to degenerate into a more severe case. |
| How have the rates of type 2 diabetes changed in the last 30 years? | Rates of type 2 diabetes have tripled in the last 30 years to match obesity rates. |
| How does a BMI greater than 30 affect the risk of developing diabetes compared to a BMI less than 25? | A person with a BMI > 30 is five times as likely to develop diabetes as someone with a BMI < 25. |
| How can type 2 diabetics reduce the severity of their disease? | Research shows that type 2 diabetics can reduce the severity of the disease by losing weight. |
| Can weight reduction prevent type 2 diabetes? | Yes, weight reduction can also prevent the disease from developing. |
| How does adipose tissue contribute to insulin resistance? | Adipose tissue releases pro-inflammatory adipokines that reduce cell sensitivity to insulin. |
| What do lean people release that affects insulin sensitivity? | Lean people release an anti-inflammatory adipokine that increases insulin sensitivity. |
| In how many ways is exercise beneficial in mitigating the effects of diabetes? | Exercise is beneficial in mitigating the effects of diabetes in two ways. |
| How does increasing caloric expenditure through exercise help with diabetes? | By increasing caloric expenditure, it helps the person lose fat cells, which contributes to improving insulin resistance. |
| How does exercise affect GLUT4 channels and skeletal muscle sensitivity? | Exercise stimulates the production of GLUT4 channels in skeletal muscle cells independent of insulin and makes skeletal muscle more sensitive to insulin. |
| What is the result of exercise stimulating GLUT4 channels and increasing muscle sensitivity? | This helps remove glucose from the blood. |
| What happens early in the progression of type 2 diabetes that causes several metabolic effects? | Early in the progression of type 2 diabetes, there is an increased release of insulin. |
| What is one effect of the increased release of insulin early in type 2 diabetes regarding triglycerides? | It causes high plasma triglyceride levels. |
| What is one effect of the increased release of insulin early in type 2 diabetes regarding HDL? | It causes low HDL levels. |
| What cardiovascular risks are increased by the early release of insulin in type 2 diabetes? | It leads to increased hypertension and an increased risk for cardiovascular disease and stroke. |
| How does the increased amount of blood glucose in type 2 diabetes affect the body if it doesn't usually lead to ketoacidosis? | The increased amount of glucose in the blood damages blood vessels, leading to blindness and tissue damage such as gangrene. |
| What is the consequence of increased kidney activity to excrete extra glucose? | Increased kidney activity to excrete extra glucose leads to kidney failure. |
| What is another name for the glycated hemoglobin test? | The glycated hemoglobin test is also called the hemoglobin A1c test. |
| What does the hemoglobin A1c test measure, and is fasting required? | It measures average blood glucose levels over several months, and fasting is not required. |
| How does the accuracy of the A1c test compare to glucose tolerance tests? | The A1c is a more accurate test than glucose tolerance tests to determine blood glucose control. |
| What is considered a normal A1c percentage? | An A1c of 5% is normal. |
| What A1c range is considered prediabetic? | An A1c of 5.7% to 6.4% is prediabetic. |
| What A1c percentage indicates a person is diabetic? | An A1c over 6.5% is diabetic. |
| What is the most widely used drug to treat type II diabetes, and how does it work? | Metformin (Glucophage) is the most widely used drug used to treat type II diabetes, and it works by inhibiting hepatic gluconeogenesis. |
| How does the Sulfonylurea class of drugs work to treat diabetes? | The Sulfonylurea class of drugs closes ATP-gated K+ channels and stimulates insulin secretion. |
| What is the mechanism of action for SGLT2 inhibitors? | The SGLT2 inhibitors inhibit the sodium-glucose transporter type 2 and decrease the renal reabsorption of glucose, which increases glucose excretion via the urine. |
| How do Thiazolidinediones (like rosiglitazone and pioglitazone) treat type II diabetes? | The Thiazolidinedione drug class acts on the PPAR-γ receptor to reduce inflammation and insulin resistance. |
| What is hypoglycemia? | Hypoglycemia is abnormally low blood glucose levels. |
| What can cause insulin-shock and potentially lead to a coma? | Hypoglycemia can occur from an overdose of insulin, causing insulin-shock, which may lead to coma. |
| How can a carbohydrate-rich meal cause hypoglycemia? | Hypoglycemia can occur as an exaggerated response to increased insulin secretion after a carbohydrate-rich meal. |
| What is the term for hypoglycemia that occurs as an exaggerated response to a carbohydrate-rich meal? | It is also called reactive hypoglycemia. |
| In whom is reactive hypoglycemia most common? | Reactive hypoglycemia is most common in adults predisposed to developing type 2 diabetes. |
| How should individuals with reactive hypoglycemia adjust their diet? | These people should limit carbohydrate intake and eat frequent, small meals. |
| What are the symptoms of reactive hypoglycemia? | The symptoms include tremor, hunger, weakness, blurred vision, and mental confusion. |
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