Diabetes Complications and Management Quiz
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Questions and Answers

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?

  • Skeletal muscle
  • Liver
  • Adipose tissue
  • Renal tubules (correct)

    • 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?

    <p>Enhanced insulin signaling (A)</p> Signup and view all the answers

    What symptom is most commonly present at diagnosis in Type 1 Diabetes but is uncommon in Type 2 Diabetes?

    <p>Weight loss (A)</p> Signup and view all the answers

    Which of the following pathways are activated by the binding of AGEs to RAGE?

    <p>Pro-inflammatory signaling cascades (A)</p> Signup and view all the answers

    Which of the following is a characteristic that distinguishes Type 1 Diabetes from Type 2 Diabetes?

    <p>Presence of autoantibodies (D)</p> Signup and view all the answers

    Which of the following is a consequence of AGE accumulation in the blood?

    <p>Stimulation of pro-inflammatory pathways (A)</p> Signup and view all the answers

    What is the main difference between insulin resistance and insulin deficiency?

    <p>Insulin resistance is a condition where cells become less sensitive to insulin. (C)</p> Signup and view all the answers

    Which of the following complications is more likely to be present at or before diagnosis in Type 2 Diabetes compared to Type 1 Diabetes?

    <p>Macrovascular complications (D)</p> Signup and view all the answers

    What is the role of HbA1c in diabetes?

    <p>HbA1c is a marker of long-term blood glucose control. (C)</p> Signup and view all the answers

    What is a common characteristic of Type 2 Diabetes, but not Type 1 Diabetes?

    <p>Presence of insulin resistance (B)</p> Signup and view all the answers

    Which of the following is not a classic symptom of hyperglycemia associated with diabetes?

    <p>Polycythemia (A)</p> Signup and view all the answers

    Which of the following pairs of symptoms are commonly present at diagnosis for both Type 1 and Type 2 Diabetes?

    <p>Polydipsia and lethargy (C)</p> Signup and view all the answers

    Which of the following statements is true about the role of insulin in diabetes?

    <p>Insulin is always deficient in type 1 diabetes. (B)</p> Signup and view all the answers

    Which of the following statements regarding the role of renal sodium-glucose cotransporters (SGLT) in glucose homeostasis is FALSE?

    <p>SGLTs have a relatively low transport capacity, limiting their effectiveness in reabsorbing high levels of glucose. (D)</p> Signup and view all the answers

    Which of the following correctly describes the biological role of glucagon-like peptide-1 (GLP-1)?

    <p>GLP-1 is released from the small intestine in response to food intake and helps to regulate blood glucose levels by suppressing glucagon secretion and stimulating insulin secretion from the beta cells of the pancreas. (B)</p> Signup and view all the answers

    Which of the following processes occurs during the absorption of glucose from the small intestine?

    <p>Glucose requires active transport by sodium-glucose cotransporters (SGLT) to move from the intestinal lumen into the enterocytes. (B)</p> Signup and view all the answers

    Which of the following statements correctly describes the role of glucose metabolism in cellular respiration?

    <p>As the primary fuel source, glucose is broken down through glycolysis, the citric acid cycle, and oxidative phosphorylation to generate energy in the form of ATP. (B)</p> Signup and view all the answers

    Which of the following statements accurately describes the balance between catabolic and anabolic pathways in cellular respiration?

    <p>Catabolic pathways, such as glycolysis, break down complex molecules, while anabolic pathways utilize energy to build complex molecules from simpler ones. (A)</p> Signup and view all the answers

    Which of the following correctly describes the role of protein in the formation of energy?

    <p>Proteins can be broken down into amino acids, which can be used to generate ATP through the citric acid cycle, but this process is less efficient than the breakdown of glucose or fats. (D)</p> Signup and view all the answers

    Which of the following pathways is NOT involved in the metabolism of glucose?

    <p>Lipolysis (D)</p> Signup and view all the answers

    What is the primary function of glucose phosphorylation?

    <p>To prevent glucose from leaving the cell and to activate it for further metabolism. (A)</p> Signup and view all the answers

    What is the primary difference between basal and postprandial hyperglycemia?

    <p>Basal hyperglycemia refers to elevated blood sugar between meals, while postprandial describes elevated blood sugar after meals. (C)</p> Signup and view all the answers

    Which of the following is NOT a factor that contributes to the release of insulin?

    <p>Increased blood calcium levels (C)</p> Signup and view all the answers

    Which of the following statements accurately describes the processing of insulin?

    <p>Insulin is synthesized as a preprohormone, then cleaved to form proinsulin, and finally processed into active insulin by the removal of a C-peptide. (C)</p> Signup and view all the answers

    Which of the following statements correctly describes the effect of epinephrine on glucose metabolism?

    <p>Epinephrine promotes glycogenolysis and gluconeogenesis, leading to an increase in blood glucose levels. (B)</p> Signup and view all the answers

    Which of the following is NOT a function of glucagon?

    <p>Inhibition of insulin release from pancreatic beta cells. (B)</p> Signup and view all the answers

    Which of the following statements correctly describes the role of amylin in glucose regulation?

    <p>Amylin enhances insulin action by slowing gastric emptying and reducing glucagon secretion. (D)</p> Signup and view all the answers

    Which of the following is a macrovascular complication associated with diabetes mellitus?

    <p>Cardiovascular disease (D)</p> Signup and view all the answers

    Which of the following is a characteristic of type 1 diabetes mellitus?

    <p>Autoimmune destruction of beta cells (C)</p> Signup and view all the answers

    What is the primary function of the acini in the pancreas?

    <p>Production of digestive enzymes (A)</p> Signup and view all the answers

    Which of the following statements correctly describes the relationship between insulin and glucagon on glucose metabolism?

    <p>Insulin decreases blood glucose levels, while glucagon increases it. (C)</p> Signup and view all the answers

    Which of the following populations is at the highest risk for developing type 2 diabetes mellitus?

    <p>Individuals with a history of obesity and physical inactivity (B)</p> Signup and view all the answers

    Which metabolic process is primarily enhanced by insulin during the absorptive state?

    <p>Lipogenesis (D)</p> Signup and view all the answers

    What is the role of glucagon during fasting states?

    <p>Promotes gluconeogenesis in the liver (B)</p> Signup and view all the answers

    In which phase of glycolysis is ATP consumed?

    <p>Energy-Using Phase (D)</p> Signup and view all the answers

    What does the pentose phosphate pathway primarily produce?

    <p>Ribose-5-phosphate (C)</p> Signup and view all the answers

    Which GLUT transporter is responsible for insulin-independent glucose uptake?

    <p>GLUT-2 (D)</p> Signup and view all the answers

    Which condition leads to an increase in ketogenesis?

    <p>Low carbohydrate intake (B)</p> Signup and view all the answers

    During which biochemical process is glucose converted to glycogen?

    <p>Glycogenesis (C)</p> Signup and view all the answers

    What is the effect of ATP on phosphofructokinase-1 (PFK-1) during glycolysis?

    <p>Inhibits PFK-1 (B)</p> Signup and view all the answers

    Which substrate is NOT a precursor for gluconeogenesis?

    <p>Fatty acids (D)</p> Signup and view all the answers

    What is a primary outcome of excess ketone bodies in the bloodstream?

    <p>Ketoacidosis (C)</p> Signup and view all the answers

    What is the primary cause of hyperglycemia in diabetes mellitus?

    <p>Insufficient insulin secretion or insulin resistance (C)</p> Signup and view all the answers

    Which of the following complications is more commonly associated with chronic diabetes mellitus?

    <p>Diabetic nephropathy (C)</p> Signup and view all the answers

    In which population is Type 2 diabetes more prevalent?

    <p>Adults over 20 years, especially those with obesity (C)</p> Signup and view all the answers

    What is a significant characteristic of Type 1 diabetes mellitus?

    <p>Absolute insulin deficiency due to autoimmune destruction (D)</p> Signup and view all the answers

    Which macrovascular complication is directly related to diabetes mellitus?

    <p>Cerebrovascular disease (stroke) (B)</p> Signup and view all the answers

    What risk factor is associated with gestational diabetes mellitus (GDM)?

    <p>Hormonal changes leading to insulin resistance (C)</p> Signup and view all the answers

    Which medication class may negatively affect macrovascular outcomes in Type 2 diabetes patients?

    <p>Thiazolidinediones (D)</p> Signup and view all the answers

    How does controlling blood glucose impact patients with Type 2 diabetes regarding microvascular complications?

    <p>It significantly reduces the risk of neuropathy (D)</p> Signup and view all the answers

    What proportion of diabetes cases does Type 1 diabetes mellitus represent?

    <p>Around 5-10% (D)</p> Signup and view all the answers

    What is a potential long-term consequence for women diagnosed with gestational diabetes mellitus?

    <p>Higher odds of developing Type 2 diabetes later (A)</p> Signup and view all the answers

    What occurs during the first 24 hours of fasting?

    <p>Increased glycogenolysis (D)</p> Signup and view all the answers

    Which of the following best describes the effects of insulin?

    <p>Stimulates protein and fat synthesis while decreasing gluconeogenesis (B)</p> Signup and view all the answers

    What key factor contributes to the development of insulin resistance in type 2 diabetes?

    <p>Chronic hyperglycemia leading to glucotoxicity (D)</p> Signup and view all the answers

    Which ketone body is primarily exhaled as a byproduct of metabolism?

    <p>Acetone (B)</p> Signup and view all the answers

    Which factor is not associated with type 1 diabetes mellitus?

    <p>Insulin resistance (B)</p> Signup and view all the answers

    During prolonged fasting, what metabolic process is increased to maintain energy levels?

    <p>Gluconeogenesis (B)</p> Signup and view all the answers

    What happens to glucagon levels during type 2 diabetes mellitus due to beta-cell dysfunction?

    <p>Progressively higher secretion despite elevated glucose (D)</p> Signup and view all the answers

    Which metabolic change is associated with increased levels of lipolysis?

    <p>Increased fatty acid release for energy (D)</p> Signup and view all the answers

    What is the biological role of increased ketone bodies during prolonged fasting?

    <p>To serve as an alternative energy source for non-carb metabolizing tissues (C)</p> Signup and view all the answers

    Which metabolic process is primarily suppressed by insulin?

    <p>Gluconeogenesis (B)</p> Signup and view all the answers

    What is the primary role of amylin in glucose regulation?

    <p>Slows gastric emptying and reduces postprandial glucose spikes (B)</p> Signup and view all the answers

    Which of the following accurately describes the function of the pancreatic duct?

    <p>Secretes digestive enzymes into the duodenum (A)</p> Signup and view all the answers

    Which statement best describes the regulatory mechanisms that inhibit glucagon release?

    <p>Inhibited by high blood glucose (A)</p> Signup and view all the answers

    What is the main consequence of elevated epinephrine during stress on glucose metabolism?

    <p>Stimulates gluconeogenesis and glycogenolysis (C)</p> Signup and view all the answers

    Which is a characteristic of β-cells in the Islets of Langerhans?

    <p>Secrete insulin to lower blood glucose (A)</p> Signup and view all the answers

    What is the role of sodium-glucose cotransporters (SGLT2) in glucose homeostasis?

    <p>Promotes reabsorption of glucose in the kidneys (C)</p> Signup and view all the answers

    What metabolic processes are stimulated by glucagon binding to its receptors?

    <p>Glycogenolysis and gluconeogenesis (D)</p> Signup and view all the answers

    What is the significance of C-peptide in insulin secretion?

    <p>It indicates endogenous insulin production (A)</p> Signup and view all the answers

    Which physiological change occurs as a result of insulin binding to insulin receptors?

    <p>Enhances GLUT-4 translocation and glucose uptake (A)</p> Signup and view all the answers

    Which of the following populations is at the highest risk for developing type 2 diabetes mellitus, based on the given information?

    <p>Children and young adults who are obese (A)</p> Signup and view all the answers

    Which of the following statements accurately describes the relationship between intensive glucose control and macrovascular complications in type 1 diabetes?

    <p>Intensive glucose control significantly reduces the risk of macrovascular complications but only in type 1 diabetes, not type 2. (D)</p> Signup and view all the answers

    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?

    <p>Type 1 diabetes mellitus (A)</p> Signup and view all the answers

    What is the primary difference between type 1 and type 2 diabetes mellitus in terms of the underlying cause?

    <p>Type 1 diabetes is caused by insulin deficiency, while type 2 diabetes is caused by insulin resistance. (C)</p> Signup and view all the answers

    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?

    <p>Diabetic nephropathy (C)</p> Signup and view all the answers

    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?

    <p>Gestational diabetes mellitus (C)</p> Signup and view all the answers

    What is the primary reason why individuals with gestational diabetes mellitus have an increased risk of developing type 2 diabetes mellitus later in life?

    <p>Hormonal changes during pregnancy can make the body more susceptible to insulin resistance, which can persist after pregnancy. (C)</p> Signup and view all the answers

    Which of the following statements is true regarding the prevalence of type 1 and type 2 diabetes mellitus in the United States?

    <p>Type 2 diabetes is more prevalent than type 1 diabetes, accounting for around 90% of cases. (D)</p> Signup and view all the answers

    Which of the following processes is NOT directly involved in the regulation of insulin release?

    <p>Inhibition of glucagon secretion from α-cells (A)</p> Signup and view all the answers

    Which of the following statements accurately describes the effects of epinephrine signaling on glucose metabolism?

    <p>Epinephrine promotes glycogenolysis and lipolysis, increasing glucose and fatty acid availability. (D)</p> Signup and view all the answers

    Which of the following GLUT transporters plays a major role in insulin-independent glucose uptake in various tissues?

    <p>GLUT-1 (B)</p> Signup and view all the answers

    Which of the following statements accurately describes the role of renal sodium-glucose cotransporters (SGLT) in glucose homeostasis?

    <p>SGLT2 inhibitors block glucose reabsorption in the kidneys, increasing glucose excretion and lowering blood glucose. (D)</p> Signup and view all the answers

    Which of the following conditions is most directly associated with an increase in glucagon secretion?

    <p>Low blood glucose levels (B)</p> Signup and view all the answers

    Which of the following hormones directly inhibits the release of glucagon?

    <p>Insulin (B)</p> Signup and view all the answers

    Which of the following statements accurately describes the relationship between insulin and glucagon in regulating glucose metabolism?

    <p>Insulin and glucagon act antagonistically, with insulin promoting glucose uptake and storage, while glucagon promotes glucose production and release. (A)</p> Signup and view all the answers

    Which of the following processes directly contributes to the effects of glucagon binding to its receptors on hepatocytes?

    <p>Increased production of cyclic AMP (cAMP) and activation of protein kinase A (PKA). (A)</p> Signup and view all the answers

    In the context of glucose metabolism, which of the following is NOT a direct effect of insulin binding to its receptor?

    <p>Stimulation of gluconeogenesis in the liver (C)</p> Signup and view all the answers

    What physiological process is primarily impaired as a result of beta-cell dysfunction in type 2 diabetes mellitus?

    <p>First-phase insulin secretion (B)</p> Signup and view all the answers

    Which of the following factors significantly exacerbates insulin resistance in type 2 diabetes mellitus?

    <p>Elevated free fatty acids (B)</p> Signup and view all the answers

    Which complication is primarily associated with unmanaged hyperglycemia in type 2 diabetes mellitus?

    <p>Diabetic nephropathy (C)</p> Signup and view all the answers

    What characteristic distinguishes type 2 diabetes mellitus from type 1 diabetes mellitus regarding insulin secretion?

    <p>Impaired first-phase insulin secretory response (B)</p> Signup and view all the answers

    Which of the following statements about glucagon in type 2 diabetes is true?

    <p>Inadequate suppression occurs despite high blood glucose levels (D)</p> Signup and view all the answers

    What is the primary role of GLUT-4 in glucose metabolism?

    <p>Mediates glucose uptake in muscle and adipose tissue in response to insulin (A)</p> Signup and view all the answers

    During gluconeogenesis, which of the following substrates can be utilized?

    <p>Lactate, glycerol, and amino acids (B)</p> Signup and view all the answers

    What effect does insulin have on gluconeogenesis?

    <p>Inhibits gluconeogenesis, promoting storage of glucose (C)</p> Signup and view all the answers

    In the fasted state, which metabolic pathway is primarily activated by glucagon?

    <p>Glycogenolysis (D)</p> Signup and view all the answers

    Which enzyme plays a key role in the regulation of the pentose phosphate pathway?

    <p>Glucose-6-phosphate dehydrogenase (A)</p> Signup and view all the answers

    What metabolic process occurs when there is an accumulation of acetyl-CoA due to low glucose availability?

    <p>Ketogenesis (D)</p> Signup and view all the answers

    Which of the following statements correctly describes the energy investment phase of glycolysis?

    <p>It consumes ATP to phosphorylate glucose (D)</p> Signup and view all the answers

    What is the outcome of excessive ketone bodies in the blood?

    <p>Ketoacidosis leading to lower blood pH (D)</p> Signup and view all the answers

    What role does fructose-2,6-bisphosphate play in glycolysis?

    <p>Activates phosphofructokinase-1 (B)</p> Signup and view all the answers

    Which statement correctly describes the balance between catabolic and anabolic pathways?

    <p>The balance is regulated based on energy demands and hormonal signals (C)</p> Signup and view all the answers

    What role does glucagon play in metabolic processes during fasting?

    <p>Elevates glycogenolysis and gluconeogenesis (C)</p> Signup and view all the answers

    Which of the following correctly describes the biological effects of insulin?

    <p>Stimulates protein and fat synthesis while reducing lipolysis (B)</p> Signup and view all the answers

    What is a significant biological role of ketone bodies produced during prolonged fasting?

    <p>Serve as an alternative fuel for the brain, heart, and muscles (A)</p> Signup and view all the answers

    In type 1 diabetes mellitus, what primarily leads to hyperglycemia?

    <p>Absolute insulin deficiency due to β-cell destruction (D)</p> Signup and view all the answers

    Which factor contributes to insulin resistance in type 2 diabetes mellitus?

    <p>Reduction in muscle GLUT-4 expression (C)</p> Signup and view all the answers

    What metabolic process predominantly occurs after the first 24 hours of fasting?

    <p>Increased gluconeogenesis (D)</p> Signup and view all the answers

    What consequence arises from excess ketone bodies in the bloodstream?

    <p>Ketoacidosis leading to lower blood pH (C)</p> Signup and view all the answers

    Which metabolic pathway does NOT occur during the absorptive state following a meal?

    <p>Lipolysis (C)</p> Signup and view all the answers

    Which factor is NOT a contributor to β-cell dysfunction in type 2 diabetes?

    <p>Excessive physical activity leading to β-cell fatigue (C)</p> Signup and view all the answers

    What is the correct sequence of steps in the process of glycogenesis?

    <p>Glucose → G6P → G1P → UDP-glucose → Glycogen (D)</p> Signup and view all the answers

    Which rate-limiting enzyme is directly involved in converting ketone bodies into a usable form of energy in the mitochondria?

    <p>Succinyl-CoA: Acetoacetate Transferase (D)</p> Signup and view all the answers

    Which enzyme is specifically activated by low glucose levels and plays a crucial role in glucagon secretion?

    <p>AMP-activated Protein Kinase (D)</p> Signup and view all the answers

    Which enzyme is responsible for the rate-limiting step in the conversion of glucose into glycogen, a storage form of glucose?

    <p>Glycogen Synthase (C)</p> Signup and view all the answers

    Which enzyme is the rate-limiting step in the breakdown of glycogen, releasing glucose into the bloodstream?

    <p>Glycogen Phosphorylase (D)</p> Signup and view all the answers

    Which enzyme is primarily responsible for the conversion of pyruvate to acetyl-CoA, a crucial step in connecting glycolysis to the TCA cycle?

    <p>Pyruvate Dehydrogenase Complex (C)</p> Signup and view all the answers

    Which enzyme is responsible for the first committed step in fatty acid synthesis, converting acetyl-CoA to malonyl-CoA?

    <p>Acetyl-CoA Carboxylase (D)</p> Signup and view all the answers

    Which enzyme plays a crucial role in the transport of long-chain fatty acids into the mitochondria for β-oxidation?

    <p>Carnitine Acyltransferase I (C)</p> Signup and view all the answers

    Which enzyme is directly involved in the production of ketone bodies, particularly acetoacetate, from acetyl-CoA?

    <p>HMG-CoA Synthase (C)</p> Signup and view all the answers

    Which enzyme is responsible for the rate-limiting step in the electron transport chain (ETC), where electrons are transferred to oxygen, generating ATP?

    <p>Cytochrome C Oxidase (B)</p> Signup and view all the answers

    Which enzyme is activated by insulin and facilitates glucose uptake into muscle and adipose tissue?

    <p>GLUT-4 (A)</p> Signup and view all the answers

    Which enzyme is the rate-limiting step in fatty acid synthesis and is activated by insulin and citrate?

    <p>Acetyl-CoA Carboxylase (ACC) (B)</p> Signup and view all the answers

    Which of the following metabolic processes is directly inhibited by Malonyl-CoA, preventing futile cycling with fatty acid synthesis?

    <p>HMG-CoA Synthase (D)</p> Signup and view all the answers

    Which of the following metabolic processes is regulated by both insulin and glucagon, with insulin activating and glucagon inhibiting the process?

    <p>Glycogenesis (A)</p> Signup and view all the answers

    Which of the following metabolic processes is directly inhibited by NADPH?

    <p>Pentose Phosphate Pathway (C)</p> Signup and view all the answers

    Which of the following metabolic pathways is NOT directly involved in the production of ATP?

    <p>Pentose Phosphate Pathway (B)</p> Signup and view all the answers

    Which enzyme, the rate-limiting step in glycolysis, is activated by AMP and Fructose-2,6-bisphosphate but inhibited by ATP and Citrate?

    <p>Phosphofructokinase-1 (PFK-1) (C)</p> Signup and view all the answers

    Which of the following metabolic processes is activated by prolonged fasting and low insulin, leading to ketone body production?

    <p>Ketogenesis (B)</p> Signup and view all the answers

    Which enzyme is NOT involved in any of the rate-limiting steps of the metabolic pathways mentioned in the content?

    <p>Pyruvate Kinase (C)</p> Signup and view all the answers

    Which of the following metabolic pathways leads to the production of both NADPH and Ribose?

    <p>Pentose Phosphate Pathway (PPP) (C)</p> Signup and view all the answers

    Which of the following metabolic processes is directly inhibited by an excess of ATP?

    <p>Electron Transport Chain (B)</p> Signup and view all the answers

    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.
    • 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 that are not yet determined to have those benefits.
    • Identify individuals at higher risk for DKA when using SGLT therapy.
    • List the adverse events to be monitored for while 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 the difference in administration methods of GLP-1 RAs (e.g., 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 the 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.
    • List the different terminologies used to describe "basal" insulin.
    • Discuss if an insulin is short- or long-acting.
    • Distinguish blood glucose concentrations in hypoglycemia.
    • Explain the mechanism of action for sulfonylureas.
    • Identify sulfonylureas by generic names.
    • Explain the adverse effects of sulfonylureas and monitoring parameters.
    • Explain the mechanism of action for TZDs.
    • Explain the adverse effects of TZDs and how this may cause/exacerbate heart failure (HF).
    • 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, GLP1, and GIP.

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    P3 DM 2025 Notes PDF

    Description

    Test your knowledge on diabetes, focusing on its chronic complications, the role of glucose transporters like GLUT-2, and key differences between Type 1 and Type 2 Diabetes. This quiz covers essential aspects of diabetes diagnosis and management, including the significance of HbA1c levels.

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