Podcast
Questions and Answers
Which of the following conditions is not a common chronic complication of diabetes?
Which of the following conditions is not a common chronic complication of diabetes?
- Nephropathy
- Polycystic ovary syndrome (correct)
- Premature atherosclerosis
- Stroke
In which of the following tissues is GLUT-2 primarily expressed?
In which of the following tissues is GLUT-2 primarily expressed?
- Skeletal muscle
- Adipose tissue
- Liver (correct)
- Renal tubules
What is the main reason for the cellular toxicity observed in tissues expressing GLUT-2 transporters during hyperglycemia?
What is the main reason for the cellular toxicity observed in tissues expressing GLUT-2 transporters during hyperglycemia?
- Increased gluconeogenesis
- Increased insulin sensitivity
- Excessive glucose uptake and accumulation (correct)
- Reduced glycolysis
What is not a consequence of elevated AGEs and glucose metabolites like sorbitol in cells?
What is not a consequence of elevated AGEs and glucose metabolites like sorbitol in cells?
What symptom is most commonly present at diagnosis in Type 1 Diabetes but is uncommon in Type 2 Diabetes?
What symptom is most commonly present at diagnosis in Type 1 Diabetes but is uncommon in Type 2 Diabetes?
Which of the following pathways are activated by the binding of AGEs to RAGE?
Which of the following pathways are activated by the binding of AGEs to RAGE?
Which of the following is a characteristic that distinguishes Type 1 Diabetes from Type 2 Diabetes?
Which of the following is a characteristic that distinguishes Type 1 Diabetes from Type 2 Diabetes?
Which of the following is a consequence of AGE accumulation in the blood?
Which of the following is a consequence of AGE accumulation in the blood?
What is the main difference between insulin resistance and insulin deficiency?
What is the main difference between insulin resistance and insulin deficiency?
Which of the following complications is more likely to be present at or before diagnosis in Type 2 Diabetes compared to Type 1 Diabetes?
Which of the following complications is more likely to be present at or before diagnosis in Type 2 Diabetes compared to Type 1 Diabetes?
What is the role of HbA1c in diabetes?
What is the role of HbA1c in diabetes?
What is a common characteristic of Type 2 Diabetes, but not Type 1 Diabetes?
What is a common characteristic of Type 2 Diabetes, but not Type 1 Diabetes?
Which of the following is not a classic symptom of hyperglycemia associated with diabetes?
Which of the following is not a classic symptom of hyperglycemia associated with diabetes?
Which of the following pairs of symptoms are commonly present at diagnosis for both Type 1 and Type 2 Diabetes?
Which of the following pairs of symptoms are commonly present at diagnosis for both Type 1 and Type 2 Diabetes?
Which of the following statements is true about the role of insulin in diabetes?
Which of the following statements is true about the role of insulin in diabetes?
Which of the following statements regarding the role of renal sodium-glucose cotransporters (SGLT) in glucose homeostasis is FALSE?
Which of the following statements regarding the role of renal sodium-glucose cotransporters (SGLT) in glucose homeostasis is FALSE?
Which of the following correctly describes the biological role of glucagon-like peptide-1 (GLP-1)?
Which of the following correctly describes the biological role of glucagon-like peptide-1 (GLP-1)?
Which of the following processes occurs during the absorption of glucose from the small intestine?
Which of the following processes occurs during the absorption of glucose from the small intestine?
Which of the following statements correctly describes the role of glucose metabolism in cellular respiration?
Which of the following statements correctly describes the role of glucose metabolism in cellular respiration?
Which of the following statements accurately describes the balance between catabolic and anabolic pathways in cellular respiration?
Which of the following statements accurately describes the balance between catabolic and anabolic pathways in cellular respiration?
Which of the following pathways is NOT involved in the metabolism of glucose?
Which of the following pathways is NOT involved in the metabolism of glucose?
What is the primary function of glucose phosphorylation?
What is the primary function of glucose phosphorylation?
What is the primary difference between basal and postprandial hyperglycemia?
What is the primary difference between basal and postprandial hyperglycemia?
Which of the following is NOT a factor that contributes to the release of insulin?
Which of the following is NOT a factor that contributes to the release of insulin?
Which of the following statements accurately describes the processing of insulin?
Which of the following statements accurately describes the processing of insulin?
Which of the following statements correctly describes the effect of epinephrine on glucose metabolism?
Which of the following statements correctly describes the effect of epinephrine on glucose metabolism?
Which of the following is NOT a function of glucagon?
Which of the following is NOT a function of glucagon?
Which of the following statements correctly describes the role of amylin in glucose regulation?
Which of the following statements correctly describes the role of amylin in glucose regulation?
Which of the following is a macrovascular complication associated with diabetes mellitus?
Which of the following is a macrovascular complication associated with diabetes mellitus?
Which of the following is a characteristic of type 1 diabetes mellitus?
Which of the following is a characteristic of type 1 diabetes mellitus?
What is the primary function of the acini in the pancreas?
What is the primary function of the acini in the pancreas?
Which of the following statements correctly describes the relationship between insulin and glucagon on glucose metabolism?
Which of the following statements correctly describes the relationship between insulin and glucagon on glucose metabolism?
Which of the following populations is at the highest risk for developing type 2 diabetes mellitus?
Which of the following populations is at the highest risk for developing type 2 diabetes mellitus?
Which metabolic process is primarily enhanced by insulin during the absorptive state?
Which metabolic process is primarily enhanced by insulin during the absorptive state?
What is the role of glucagon during fasting states?
What is the role of glucagon during fasting states?
In which phase of glycolysis is ATP consumed?
In which phase of glycolysis is ATP consumed?
What does the pentose phosphate pathway primarily produce?
What does the pentose phosphate pathway primarily produce?
Which GLUT transporter is responsible for insulin-independent glucose uptake?
Which GLUT transporter is responsible for insulin-independent glucose uptake?
Which condition leads to an increase in ketogenesis?
Which condition leads to an increase in ketogenesis?
During which biochemical process is glucose converted to glycogen?
During which biochemical process is glucose converted to glycogen?
What is the effect of ATP on phosphofructokinase-1 (PFK-1) during glycolysis?
What is the effect of ATP on phosphofructokinase-1 (PFK-1) during glycolysis?
Which substrate is NOT a precursor for gluconeogenesis?
Which substrate is NOT a precursor for gluconeogenesis?
What is a primary outcome of excess ketone bodies in the bloodstream?
What is a primary outcome of excess ketone bodies in the bloodstream?
What is the primary cause of hyperglycemia in diabetes mellitus?
What is the primary cause of hyperglycemia in diabetes mellitus?
Which of the following complications is more commonly associated with chronic diabetes mellitus?
Which of the following complications is more commonly associated with chronic diabetes mellitus?
What is a significant characteristic of Type 1 diabetes mellitus?
What is a significant characteristic of Type 1 diabetes mellitus?
Which macrovascular complication is directly related to diabetes mellitus?
Which macrovascular complication is directly related to diabetes mellitus?
What risk factor is associated with gestational diabetes mellitus (GDM)?
What risk factor is associated with gestational diabetes mellitus (GDM)?
Which medication class may negatively affect macrovascular outcomes in Type 2 diabetes patients?
Which medication class may negatively affect macrovascular outcomes in Type 2 diabetes patients?
How does controlling blood glucose impact patients with Type 2 diabetes regarding microvascular complications?
How does controlling blood glucose impact patients with Type 2 diabetes regarding microvascular complications?
What proportion of diabetes cases does Type 1 diabetes mellitus represent?
What proportion of diabetes cases does Type 1 diabetes mellitus represent?
What is a potential long-term consequence for women diagnosed with gestational diabetes mellitus?
What is a potential long-term consequence for women diagnosed with gestational diabetes mellitus?
What occurs during the first 24 hours of fasting?
What occurs during the first 24 hours of fasting?
Which of the following best describes the effects of insulin?
Which of the following best describes the effects of insulin?
What key factor contributes to the development of insulin resistance in type 2 diabetes?
What key factor contributes to the development of insulin resistance in type 2 diabetes?
Which ketone body is primarily exhaled as a byproduct of metabolism?
Which ketone body is primarily exhaled as a byproduct of metabolism?
Which factor is not associated with type 1 diabetes mellitus?
Which factor is not associated with type 1 diabetes mellitus?
During prolonged fasting, what metabolic process is increased to maintain energy levels?
During prolonged fasting, what metabolic process is increased to maintain energy levels?
What happens to glucagon levels during type 2 diabetes mellitus due to beta-cell dysfunction?
What happens to glucagon levels during type 2 diabetes mellitus due to beta-cell dysfunction?
Which metabolic change is associated with increased levels of lipolysis?
Which metabolic change is associated with increased levels of lipolysis?
What is the biological role of increased ketone bodies during prolonged fasting?
What is the biological role of increased ketone bodies during prolonged fasting?
Which metabolic process is primarily suppressed by insulin?
Which metabolic process is primarily suppressed by insulin?
What is the primary role of amylin in glucose regulation?
What is the primary role of amylin in glucose regulation?
Which of the following accurately describes the function of the pancreatic duct?
Which of the following accurately describes the function of the pancreatic duct?
Which statement best describes the regulatory mechanisms that inhibit glucagon release?
Which statement best describes the regulatory mechanisms that inhibit glucagon release?
What is the main consequence of elevated epinephrine during stress on glucose metabolism?
What is the main consequence of elevated epinephrine during stress on glucose metabolism?
Which is a characteristic of β-cells in the Islets of Langerhans?
Which is a characteristic of β-cells in the Islets of Langerhans?
What is the role of sodium-glucose cotransporters (SGLT2) in glucose homeostasis?
What is the role of sodium-glucose cotransporters (SGLT2) in glucose homeostasis?
What metabolic processes are stimulated by glucagon binding to its receptors?
What metabolic processes are stimulated by glucagon binding to its receptors?
What is the significance of C-peptide in insulin secretion?
What is the significance of C-peptide in insulin secretion?
Which physiological change occurs as a result of insulin binding to insulin receptors?
Which physiological change occurs as a result of insulin binding to insulin receptors?
Which of the following statements accurately describes the relationship between intensive glucose control and macrovascular complications in type 1 diabetes?
Which of the following statements accurately describes the relationship between intensive glucose control and macrovascular complications in type 1 diabetes?
A patient presents with symptoms of extreme thirst, frequent urination, and unexplained weight loss. Which of the following conditions is the most likely diagnosis based on this information?
A patient presents with symptoms of extreme thirst, frequent urination, and unexplained weight loss. Which of the following conditions is the most likely diagnosis based on this information?
Which of the following complications is most likely to be associated with chronic diabetes mellitus and is a direct consequence of damage to small blood vessels?
Which of the following complications is most likely to be associated with chronic diabetes mellitus and is a direct consequence of damage to small blood vessels?
A woman who is 28 weeks pregnant is diagnosed with diabetes. Which of the following types of diabetes is the most likely diagnosis in this scenario?
A woman who is 28 weeks pregnant is diagnosed with diabetes. Which of the following types of diabetes is the most likely diagnosis in this scenario?
What is the primary reason why individuals with gestational diabetes mellitus have an increased risk of developing type 2 diabetes mellitus later in life?
What is the primary reason why individuals with gestational diabetes mellitus have an increased risk of developing type 2 diabetes mellitus later in life?
Which of the following statements is true regarding the prevalence of type 1 and type 2 diabetes mellitus in the United States?
Which of the following statements is true regarding the prevalence of type 1 and type 2 diabetes mellitus in the United States?
Which of the following processes is NOT directly involved in the regulation of insulin release?
Which of the following processes is NOT directly involved in the regulation of insulin release?
Which of the following statements accurately describes the effects of epinephrine signaling on glucose metabolism?
Which of the following statements accurately describes the effects of epinephrine signaling on glucose metabolism?
Which of the following GLUT transporters plays a major role in insulin-independent glucose uptake in various tissues?
Which of the following GLUT transporters plays a major role in insulin-independent glucose uptake in various tissues?
Which of the following statements accurately describes the role of renal sodium-glucose cotransporters (SGLT) in glucose homeostasis?
Which of the following statements accurately describes the role of renal sodium-glucose cotransporters (SGLT) in glucose homeostasis?
Which of the following conditions is most directly associated with an increase in glucagon secretion?
Which of the following conditions is most directly associated with an increase in glucagon secretion?
Which of the following hormones directly inhibits the release of glucagon?
Which of the following hormones directly inhibits the release of glucagon?
Which of the following statements accurately describes the relationship between insulin and glucagon in regulating glucose metabolism?
Which of the following statements accurately describes the relationship between insulin and glucagon in regulating glucose metabolism?
Which of the following processes directly contributes to the effects of glucagon binding to its receptors on hepatocytes?
Which of the following processes directly contributes to the effects of glucagon binding to its receptors on hepatocytes?
In the context of glucose metabolism, which of the following is NOT a direct effect of insulin binding to its receptor?
In the context of glucose metabolism, which of the following is NOT a direct effect of insulin binding to its receptor?
What physiological process is primarily impaired as a result of beta-cell dysfunction in type 2 diabetes mellitus?
What physiological process is primarily impaired as a result of beta-cell dysfunction in type 2 diabetes mellitus?
Which of the following factors significantly exacerbates insulin resistance in type 2 diabetes mellitus?
Which of the following factors significantly exacerbates insulin resistance in type 2 diabetes mellitus?
Which complication is primarily associated with unmanaged hyperglycemia in type 2 diabetes mellitus?
Which complication is primarily associated with unmanaged hyperglycemia in type 2 diabetes mellitus?
What characteristic distinguishes type 2 diabetes mellitus from type 1 diabetes mellitus regarding insulin secretion?
What characteristic distinguishes type 2 diabetes mellitus from type 1 diabetes mellitus regarding insulin secretion?
Which of the following statements about glucagon in type 2 diabetes is true?
Which of the following statements about glucagon in type 2 diabetes is true?
What is the primary role of GLUT-4 in glucose metabolism?
What is the primary role of GLUT-4 in glucose metabolism?
During gluconeogenesis, which of the following substrates can be utilized?
During gluconeogenesis, which of the following substrates can be utilized?
What effect does insulin have on gluconeogenesis?
What effect does insulin have on gluconeogenesis?
In the fasted state, which metabolic pathway is primarily activated by glucagon?
In the fasted state, which metabolic pathway is primarily activated by glucagon?
What metabolic process occurs when there is an accumulation of acetyl-CoA due to low glucose availability?
What metabolic process occurs when there is an accumulation of acetyl-CoA due to low glucose availability?
Which of the following statements correctly describes the energy investment phase of glycolysis?
Which of the following statements correctly describes the energy investment phase of glycolysis?
What is the outcome of excessive ketone bodies in the blood?
What is the outcome of excessive ketone bodies in the blood?
What role does fructose-2,6-bisphosphate play in glycolysis?
What role does fructose-2,6-bisphosphate play in glycolysis?
Which statement correctly describes the balance between catabolic and anabolic pathways?
Which statement correctly describes the balance between catabolic and anabolic pathways?
What role does glucagon play in metabolic processes during fasting?
What role does glucagon play in metabolic processes during fasting?
Which of the following correctly describes the biological effects of insulin?
Which of the following correctly describes the biological effects of insulin?
What is a significant biological role of ketone bodies produced during prolonged fasting?
What is a significant biological role of ketone bodies produced during prolonged fasting?
In type 1 diabetes mellitus, what primarily leads to hyperglycemia?
In type 1 diabetes mellitus, what primarily leads to hyperglycemia?
Which factor contributes to insulin resistance in type 2 diabetes mellitus?
Which factor contributes to insulin resistance in type 2 diabetes mellitus?
What metabolic process predominantly occurs after the first 24 hours of fasting?
What metabolic process predominantly occurs after the first 24 hours of fasting?
Which metabolic pathway does NOT occur during the absorptive state following a meal?
Which metabolic pathway does NOT occur during the absorptive state following a meal?
Which factor is NOT a contributor to β-cell dysfunction in type 2 diabetes?
Which factor is NOT a contributor to β-cell dysfunction in type 2 diabetes?
What is the correct sequence of steps in the process of glycogenesis?
What is the correct sequence of steps in the process of glycogenesis?
Which enzyme is specifically activated by low glucose levels and plays a crucial role in glucagon secretion?
Which enzyme is specifically activated by low glucose levels and plays a crucial role in glucagon secretion?
Which enzyme is responsible for the rate-limiting step in the conversion of glucose into glycogen, a storage form of glucose?
Which enzyme is responsible for the rate-limiting step in the conversion of glucose into glycogen, a storage form of glucose?
Which enzyme is the rate-limiting step in the breakdown of glycogen, releasing glucose into the bloodstream?
Which enzyme is the rate-limiting step in the breakdown of glycogen, releasing glucose into the bloodstream?
Which enzyme is primarily responsible for the conversion of pyruvate to acetyl-CoA, a crucial step in connecting glycolysis to the TCA cycle?
Which enzyme is primarily responsible for the conversion of pyruvate to acetyl-CoA, a crucial step in connecting glycolysis to the TCA cycle?
Which enzyme plays a crucial role in the transport of long-chain fatty acids into the mitochondria for β-oxidation?
Which enzyme plays a crucial role in the transport of long-chain fatty acids into the mitochondria for β-oxidation?
Which enzyme is directly involved in the production of ketone bodies, particularly acetoacetate, from acetyl-CoA?
Which enzyme is directly involved in the production of ketone bodies, particularly acetoacetate, from acetyl-CoA?
Which enzyme is responsible for the rate-limiting step in the electron transport chain (ETC), where electrons are transferred to oxygen, generating ATP?
Which enzyme is responsible for the rate-limiting step in the electron transport chain (ETC), where electrons are transferred to oxygen, generating ATP?
Which enzyme is activated by insulin and facilitates glucose uptake into muscle and adipose tissue?
Which enzyme is activated by insulin and facilitates glucose uptake into muscle and adipose tissue?
Which of the following metabolic processes is directly inhibited by Malonyl-CoA, preventing futile cycling with fatty acid synthesis?
Which of the following metabolic processes is directly inhibited by Malonyl-CoA, preventing futile cycling with fatty acid synthesis?
Which of the following metabolic processes is regulated by both insulin and glucagon, with insulin activating and glucagon inhibiting the process?
Which of the following metabolic processes is regulated by both insulin and glucagon, with insulin activating and glucagon inhibiting the process?
Which of the following metabolic processes is directly inhibited by NADPH?
Which of the following metabolic processes is directly inhibited by NADPH?
Which of the following metabolic pathways is NOT directly involved in the production of ATP?
Which of the following metabolic pathways is NOT directly involved in the production of ATP?
Which enzyme, the rate-limiting step in glycolysis, is activated by AMP and Fructose-2,6-bisphosphate but inhibited by ATP and Citrate?
Which enzyme, the rate-limiting step in glycolysis, is activated by AMP and Fructose-2,6-bisphosphate but inhibited by ATP and Citrate?
Which of the following metabolic processes is activated by prolonged fasting and low insulin, leading to ketone body production?
Which of the following metabolic processes is activated by prolonged fasting and low insulin, leading to ketone body production?
Which enzyme is NOT involved in any of the rate-limiting steps of the metabolic pathways mentioned in the content?
Which enzyme is NOT involved in any of the rate-limiting steps of the metabolic pathways mentioned in the content?
Which of the following metabolic pathways leads to the production of both NADPH and Ribose?
Which of the following metabolic pathways leads to the production of both NADPH and Ribose?
Which of the following metabolic processes is directly inhibited by an excess of ATP?
Which of the following metabolic processes is directly inhibited by an excess of ATP?
Which enzyme, when activated in a fasting state, directly contributes to the release of glucose-1-phosphate from glycogen?
Which enzyme, when activated in a fasting state, directly contributes to the release of glucose-1-phosphate from glycogen?
What is the primary function of the Debranching Enzyme in glycogen metabolism?
What is the primary function of the Debranching Enzyme in glycogen metabolism?
Which enzyme is primarily responsible for converting pyruvate to oxaloacetate, a crucial step in gluconeogenesis, particularly during fasting states?
Which enzyme is primarily responsible for converting pyruvate to oxaloacetate, a crucial step in gluconeogenesis, particularly during fasting states?
Which enzyme is responsible for converting pyruvate to acetyl-CoA, a key step in linking glycolysis to the TCA cycle?
Which enzyme is responsible for converting pyruvate to acetyl-CoA, a key step in linking glycolysis to the TCA cycle?
Which of the following enzymes is NOT directly involved in the regulation of blood glucose levels?
Which of the following enzymes is NOT directly involved in the regulation of blood glucose levels?
Which enzyme, activated by glucagon and epinephrine during periods of low blood glucose, plays a key role in glycogen breakdown?
Which enzyme, activated by glucagon and epinephrine during periods of low blood glucose, plays a key role in glycogen breakdown?
Which enzyme in gluconeogenesis is directly regulated by glucagon and cortisol?
Which enzyme in gluconeogenesis is directly regulated by glucagon and cortisol?
What is the primary physiological consequence of the inhibition of Fructose-1,6-Bisphosphatase by fructose-2,6-bisphosphate?
What is the primary physiological consequence of the inhibition of Fructose-1,6-Bisphosphatase by fructose-2,6-bisphosphate?
Which enzyme is primarily responsible for the final step of glycolysis, converting phosphoenolpyruvate (PEP) to pyruvate, and is regulated by phosphorylation in response to glucagon?
Which enzyme is primarily responsible for the final step of glycolysis, converting phosphoenolpyruvate (PEP) to pyruvate, and is regulated by phosphorylation in response to glucagon?
Which of the following enzymes is NOT directly involved in the breakdown of glycogen?
Which of the following enzymes is NOT directly involved in the breakdown of glycogen?
Which of the following enzymes is unique to the liver and allows for the release of free glucose into the bloodstream?
Which of the following enzymes is unique to the liver and allows for the release of free glucose into the bloodstream?
Which of the following serves as a rate-limiting enzyme in glycolysis, being allosterically regulated by ATP, AMP, and fructose-2,6-bisphosphate?
Which of the following serves as a rate-limiting enzyme in glycolysis, being allosterically regulated by ATP, AMP, and fructose-2,6-bisphosphate?
What is the specific physiological role of the enzyme Hexokinase in glucose metabolism?
What is the specific physiological role of the enzyme Hexokinase in glucose metabolism?
Which enzyme in gluconeogenesis is inhibited by fructose-2,6-bisphosphate and AMP?
Which enzyme in gluconeogenesis is inhibited by fructose-2,6-bisphosphate and AMP?
Which of the following enzymes is primarily responsible for converting oxaloacetate to phosphoenolpyruvate (PEP) in gluconeogenesis, and its activity is highly regulated by glucagon and cortisol?
Which of the following enzymes is primarily responsible for converting oxaloacetate to phosphoenolpyruvate (PEP) in gluconeogenesis, and its activity is highly regulated by glucagon and cortisol?
Which of the following statements accurately describes the functional difference between Glucokinase and Hexokinase?
Which of the following statements accurately describes the functional difference between Glucokinase and Hexokinase?
Which enzyme is primarily responsible for converting glucose-6-phosphate into free glucose, enabling glucose release from the liver, and is highly active during fasting states?
Which enzyme is primarily responsible for converting glucose-6-phosphate into free glucose, enabling glucose release from the liver, and is highly active during fasting states?
Which mechanism, associated with insulin, results in reduced glucose production from non-carbohydrate sources?
Which mechanism, associated with insulin, results in reduced glucose production from non-carbohydrate sources?
Which enzyme, whose activity is regulated by both insulin and glucagon, plays a critical role in glycogen breakdown?
Which enzyme, whose activity is regulated by both insulin and glucagon, plays a critical role in glycogen breakdown?
Which of the following statements accurately describes the impact of glucagon on the activity of hormone-sensitive lipase?
Which of the following statements accurately describes the impact of glucagon on the activity of hormone-sensitive lipase?
What is the primary effect of insulin on the activity of glycogen synthase and its downstream impact on glucose metabolism?
What is the primary effect of insulin on the activity of glycogen synthase and its downstream impact on glucose metabolism?
Which of the following statements correctly describes the mechanism by which glucagon influences gluconeogenesis?
Which of the following statements correctly describes the mechanism by which glucagon influences gluconeogenesis?
Which statement best explains the difference between the roles of insulin and glucagon regarding glycogen synthesis?
Which statement best explains the difference between the roles of insulin and glucagon regarding glycogen synthesis?
Flashcards
Renal sodium-glucose cotransporters
Renal sodium-glucose cotransporters
Transport proteins in the kidneys that help reabsorb glucose into the bloodstream.
GLP-1 and GIP
GLP-1 and GIP
Hormones that enhance insulin secretion and regulate glucose metabolism after meals.
Glycolysis
Glycolysis
The process of breaking down glucose to produce energy, resulting in pyruvate.
Pentose phosphate pathway
Pentose phosphate pathway
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Gluconeogenesis
Gluconeogenesis
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Insulin vs Glucagon
Insulin vs Glucagon
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Energy balance in cellular respiration
Energy balance in cellular respiration
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Glycogenesis vs Glycogenolysis
Glycogenesis vs Glycogenolysis
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Diabetes Mellitus (DM)
Diabetes Mellitus (DM)
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Type 1 Diabetes Mellitus
Type 1 Diabetes Mellitus
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Type 2 Diabetes Mellitus
Type 2 Diabetes Mellitus
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Gestational Diabetes
Gestational Diabetes
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Macrovascular complications
Macrovascular complications
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Microvascular complications
Microvascular complications
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Insulin
Insulin
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Glucagon
Glucagon
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Islets of Langerhans
Islets of Langerhans
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Amylin
Amylin
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A1c
A1c
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eAG
eAG
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eAG formula
eAG formula
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Basal hyperglycemia
Basal hyperglycemia
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Postprandial hyperglycemia
Postprandial hyperglycemia
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A1c goal for most
A1c goal for most
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Impact of A1c levels
Impact of A1c levels
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Low A1c effect
Low A1c effect
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High A1c effect
High A1c effect
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Individual A1c goals
Individual A1c goals
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T2DM
T2DM
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Advanced Glycation End-Products (AGEs)
Advanced Glycation End-Products (AGEs)
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Chronic diabetes complications
Chronic diabetes complications
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GLUT-2 transporters
GLUT-2 transporters
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Cellular toxicity
Cellular toxicity
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Glycated hemoglobin (HbA1c)
Glycated hemoglobin (HbA1c)
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The 3 Ps of hyperglycemia
The 3 Ps of hyperglycemia
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Hyperglycemia symptoms
Hyperglycemia symptoms
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Reactive oxygen species
Reactive oxygen species
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Type 1 Diabetes Mellitus Characteristics
Type 1 Diabetes Mellitus Characteristics
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Type 2 Diabetes Mellitus Characteristics
Type 2 Diabetes Mellitus Characteristics
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Insulin Resistance
Insulin Resistance
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Diabetic Ketoacidosis (DKA)
Diabetic Ketoacidosis (DKA)
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Hyperosmolar Hyperglycemic Syndrome (HHS)
Hyperosmolar Hyperglycemic Syndrome (HHS)
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Type 1 DM characteristics
Type 1 DM characteristics
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Type 2 DM characteristics
Type 2 DM characteristics
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Gestational DM
Gestational DM
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Benefits of glucose control (T1DM)
Benefits of glucose control (T1DM)
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Benefits of glucose control (T2DM)
Benefits of glucose control (T2DM)
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Prevalence of Type 1 vs Type 2 DM
Prevalence of Type 1 vs Type 2 DM
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Coronary Heart Disease (CHD)
Coronary Heart Disease (CHD)
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Diabetic Retinopathy
Diabetic Retinopathy
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Insulin function
Insulin function
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Glucagon function
Glucagon function
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α-cells vs β-cells
α-cells vs β-cells
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Insulin release process
Insulin release process
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Epinephrine effects on insulin
Epinephrine effects on insulin
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Functions of amylin
Functions of amylin
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Renal glucose reabsorption
Renal glucose reabsorption
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Processing of insulin
Processing of insulin
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GLP-1 role
GLP-1 role
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Glucagon receptor effects
Glucagon receptor effects
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Absorption of Glucose
Absorption of Glucose
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Krebs Cycle
Krebs Cycle
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Energy Balance
Energy Balance
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Insulin's Role
Insulin's Role
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Glucagon's Role
Glucagon's Role
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Glycogenesis Process
Glycogenesis Process
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Gluconeogenesis Process
Gluconeogenesis Process
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Ketogenesis
Ketogenesis
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Glycogenesis
Glycogenesis
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Fasting state metabolism
Fasting state metabolism
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Insulin and glucagon comparison
Insulin and glucagon comparison
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Ketone bodies
Ketone bodies
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Type 1 Diabetes Mellitus (T1DM)
Type 1 Diabetes Mellitus (T1DM)
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Type 2 Diabetes Mellitus (T2DM)
Type 2 Diabetes Mellitus (T2DM)
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Insulin resistance factors
Insulin resistance factors
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β-cell dysfunction in T2DM
β-cell dysfunction in T2DM
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Ketoacidosis
Ketoacidosis
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Beta-cell dysfunction in T2DM
Beta-cell dysfunction in T2DM
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Complications of diabetes
Complications of diabetes
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Effects of insulin
Effects of insulin
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Glucose Digestion
Glucose Digestion
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Glucose Absorption
Glucose Absorption
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Glycolysis Products
Glycolysis Products
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Krebs Cycle Overview
Krebs Cycle Overview
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Insulin Effects
Insulin Effects
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Glucagon Effects
Glucagon Effects
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Ketogenesis Formation
Ketogenesis Formation
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Gestational Diabetes Mellitus (GDM)
Gestational Diabetes Mellitus (GDM)
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Benefits of Glucose Control in DM
Benefits of Glucose Control in DM
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Prevalence of Diabetes Types
Prevalence of Diabetes Types
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At-risk ethnic groups
At-risk ethnic groups
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Exocrine pancreas
Exocrine pancreas
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Endocrine pancreas
Endocrine pancreas
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Insulin release mechanism
Insulin release mechanism
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Role of amylin
Role of amylin
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Epinephrine effects
Epinephrine effects
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Glycogenolysis
Glycogenolysis
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Ketolysis
Ketolysis
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Rate-Limiting Step in Ketolysis
Rate-Limiting Step in Ketolysis
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SCOT Enzyme
SCOT Enzyme
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Insulin Secretion
Insulin Secretion
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Rate-Limiting Step in Insulin Secretion
Rate-Limiting Step in Insulin Secretion
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Glucagon Secretion
Glucagon Secretion
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Rate-Limiting Step in Glucagon Secretion
Rate-Limiting Step in Glucagon Secretion
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SGLT-2 Function
SGLT-2 Function
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GLUT-4 Translocation
GLUT-4 Translocation
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Protein Metabolism Rate-Limiting Step
Protein Metabolism Rate-Limiting Step
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Glycolysis Rate-Limiting Step
Glycolysis Rate-Limiting Step
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Gluconeogenesis Enzyme
Gluconeogenesis Enzyme
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Glycogenesis Key Enzyme
Glycogenesis Key Enzyme
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Glycogenolysis Process
Glycogenolysis Process
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Pentose Phosphate Pathway Activation
Pentose Phosphate Pathway Activation
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TCA Cycle Rate-Limiting Step
TCA Cycle Rate-Limiting Step
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Electron Transport Chain Main Enzyme
Electron Transport Chain Main Enzyme
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Fatty Acid Synthesis Rate-Limiting Step
Fatty Acid Synthesis Rate-Limiting Step
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Fatty Acid β-Oxidation Enzyme
Fatty Acid β-Oxidation Enzyme
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Ketogenesis Enzyme
Ketogenesis Enzyme
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Hexokinase
Hexokinase
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Glucokinase
Glucokinase
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Phosphofructokinase-1 (PFK-1)
Phosphofructokinase-1 (PFK-1)
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Pyruvate Kinase
Pyruvate Kinase
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Glycogen Phosphorylase
Glycogen Phosphorylase
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Pyruvate Carboxylase
Pyruvate Carboxylase
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Phosphoenolpyruvate Carboxykinase (PEPCK)
Phosphoenolpyruvate Carboxykinase (PEPCK)
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Fructose-1,6-Bisphosphatase
Fructose-1,6-Bisphosphatase
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Glucose-6-Phosphatase
Glucose-6-Phosphatase
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Glycogen Synthase
Glycogen Synthase
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Branching Enzyme
Branching Enzyme
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Debranching Enzyme
Debranching Enzyme
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Phosphoglucomutase
Phosphoglucomutase
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Pyruvate Dehydrogenase (PDH) Complex
Pyruvate Dehydrogenase (PDH) Complex
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Citrate Synthase
Citrate Synthase
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Isocitrate Dehydrogenase
Isocitrate Dehydrogenase
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Glucose-6-Phosphate Dehydrogenase (G6PD)
Glucose-6-Phosphate Dehydrogenase (G6PD)
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Effects of Insulin vs Glucagon
Effects of Insulin vs Glucagon
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Study Notes
Diabetes Mellitus Part 1 Learning Objectives
- Define diabetes mellitus (DM), type 1 DM, type 2 DM, and gestational DM.
- List the macrovascular and microvascular complications associated with DM.
- Describe the benefits of controlling blood glucose in patients with type 1 DM and type 2 DM regarding macrovascular and microvascular complications.
- Differentiate the prevalence of type 1 DM and type 2 DM.
- Identify populations at highest risk for developing type 2 DM.
- Describe the opposing regulatory effects of insulin and glucagon on glucose metabolism.
- List the exocrine and endocrine functions of the pancreas.
- Describe the functions of key anatomical structures of the pancreas (acini, islets of Langerhans, pancreatic duct).
- Differentiate between α- and β-cells.
- List and describe the processes that regulate the release of insulin.
- Illustrate the cellular processes involved in insulin release.
- Describe the structure and processing of insulin.
- Define the effects of epinephrine signaling on glucose metabolism.
- Describe the effects of insulin binding to insulin receptors.
- List and describe the processes that regulate the release of glucagon.
- Describe the structure and processing of glucagon.
- Describe the effects of glucagon binding to glucagon receptors.
- Explain the biological role of amylin.
- Describe the role of renal sodium-glucose cotransporters in glucose homeostasis.
- Explain the biological role of GLP-1 and GIP.
- Describe the processes involved in the digestion, absorption, and transport of glucose.
- Define cellular respiration and describe the balance between catabolic and anabolic pathways.
- Outline the role of glucose, fats, and protein in the formation of energy.
- List and describe the metabolic pathways involving glucose.
- Describe the role of glucose phosphorylation.
- Differentiate between hexokinase and glucokinase regarding enzyme activity, tissue distribution, and regulation, and each enzyme's role in glucose metabolism.
- Describe glycolysis.
- Describe the tricarboxylic acid cycle and oxidative phosphorylation and their role in cellular respiration.
- Describe the function of glucose-6-phosphate, pyruvate, acetyl CoA, and NADH and FADH₂.
- Differentiate between glycogenesis and glycogenolysis.
- Describe gluconeogenesis and its role in glucose metabolism.
- Define the pentose phosphate pathway.
- Discuss allosteric regulation of major glucose metabolic pathways.
- Discuss hormonal regulation of major glucose metabolic pathways.
- Identify energy-using and energy-producing steps of glucose metabolic pathways.
- Compare and contrast the metabolic changes in each tissue (liver, adipose, skeletal muscle) under the absorptive state and fasting state.
- Compare and contrast the biological effects of insulin and glucagon on glucose uptake, glycogen synthesis, gluconeogenesis, gluconeolysis, and lipolysis.
- Describe ketone body formation and define their role.
- Compare and contrast pathophysiological elements of type 1 DM with type 2 DM.
- Describe factors that contribute to insulin resistance.
- Compare and contrast the acute and chronic complications of type 1 DM with type 2 DM (e.g., glycation, DKA, HHS).
- Understand the role of AGEs and RAGE in pro-inflammatory mechanisms.
Diabetes Mellitus Part 2 & 3 Learning Objectives
- Explain the classic symptoms presented in individuals with undiagnosed diabetes.
- Differentiate between the general characteristics of T1DM versus T2DM.
- Determine if an individual is presenting with diabetes or is at risk for diabetes based on their A1c.
- Define A1c or HbA1c for patients and caregivers.
- Provide the A1c goal for the majority of individuals living with DM.
- Explain factors that would establish a patient for a more stringent A1c (e.g., <6.5%).
- Explain factors that would indicate an individual suitable for a less stringent A1c (e.g., <8%).
- Calculate the estimated average glucose given an individual's A1c.
- Determine the point at which an individual should be tested for gestational DM.
- Explain why A1c is not an ideal monitoring goal in the setting of GDM.
- Explain how often an individual wearing a continuous glucose monitor should be in range with their blood glucose.
- Differentiate between pre-prandial and 2-hour post-prandial blood glucose goals.
- Explain how nutrition recommendations have changed from macro-micro nutrient focus.
- Provide exercise counseling with proven benefit in the setting of diabetes.
- Explain the mechanism of action for metformin.
- List the advantages of using metformin in type 2 DM.
- Explain the range of A1c reduction that can be expected with metformin.
- Identify methods for improving tolerance and/or managing side effects of metformin therapy.
- Identify individuals not appropriate for metformin therapy.
- Explain the mechanism of action for sodium-glucose co-transport inhibitors.
- List SGLT1i and SGLT2i inhibitors by name.
- Identify all approved SGLT inhibitors by brand and generic names.
- Explain the average A1c reduction expected with SGLT inhibitor therapy for T2DM.
- Differentiate between SGLTi's that provide kidney and heart benefit and those not yet determined to have those benefits.
- Identify individuals at higher risk for DKA when using SGLT therapy.
- List adverse events to be monitored for on SGLT therapy.
- Provide the FDA boxed warnings for SGLT inhibitors.
- Explain how to monitor for DKA at home.
- Explain the mechanism of action for GLP-1 RAs.
- Identify GLP-1 RA and GLP-1/GIP by brand and generic names approved for use in T2DM.
- Explain the average A1c reduction expected with GLP-1/GIP RA therapy for T2DM.
- Explain the cardiovascular benefits identified with these GLP-1 RAs.
- Differentiate between GLP-1 RAs that provide CV benefit and those that do not.
- Explain the side effects expected with GLP-1 RA therapy and how to minimize these side effects.
- Explain differences in administration methods of GLP-1 RAs (i.e., subcutaneous vs. oral, once weekly vs. once daily).
- Explain surgical precautions with GLP-1 RAs and GLP-1/GIP RAs.
- Explain the mechanism of action for DPP4 inhibitors.
- Explain why DPP4i's may not provide additional benefit to those taking GLP-1 RAs.
- Explain the average A1c reduction provided with DPP4i therapy.
- Review cautions for use of DPP4i's.
- Identify the DPP4i with most caution or concern regarding use in HF.
- Explain the role of insulin for T1DM and T2DM.
- List the different terminologies used to describe "mealtime" insulin versus "basal" insulin.
- Distinguish blood glucose concentrations in hypoglycemia.
- Explain the mechanism of action for sulfonylureas.
- Identify sulfonylureas by generic names.
- Explain adverse effects of sulfonylureas and monitoring parameters.
- Explain the mechanism of action for TZDs.
- Explain adverse effects of TZDs and how this may cause/exacerbate heart failure.
- Identify individuals who should use pioglitazone cautiously.
Further Topics
- Different aspects of diabetes mellitus are covered such as insulin structure and actions, different aspects of glucogenesis and glycogenolysis, gluconeogenesis, glucose metabolism, and insulin function and regulation. Renal and kidney function are also included in the notes.
- Includes a breakdown of normal glucose tolerance, glucose production and degradation, and the action of glucagon, GLP-1, and GIP.
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