Diabetes Mellitus Overview
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Questions and Answers

What is the primary characteristic that defines diabetes mellitus?

  • Excessive protein synthesis
  • Low blood sugar levels
  • Increased insulin production
  • Impaired glucose metabolism (correct)

    • Which of the following factors are NOT typically considered a cause of diabetes mellitus?

  • Genetic predisposition
  • Environmental factors
  • Autoimmune response
  • Vitamin deficiency (correct)

    • What are the two most prevalent types of diabetes mellitus?

  • Type 1 and MODY
  • Type 2 and Gestational
  • MODY and Gestational
  • Type 1 and Type 2 (correct)

    • Where is insulin produced in the body?

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

    What is the approximate normal range for blood glucose levels in mg/dL?

    <p>74-106 mg/dL (A)</p> Signup and view all the answers

    What is the primary function of insulin in the body?

    <p>To facilitate glucose uptake by cells (C)</p> Signup and view all the answers

    Which of the following is NOT a storage form of glucose in the body?

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

    What happens to the insulin level in the body during overnight fasting?

    <p>It decreases significantly (D)</p> Signup and view all the answers

    Which of the following tissues are considered insulin-dependent?

    <p>Skeletal muscle and adipose tissue (C)</p> Signup and view all the answers

    What is the primary function of the pancreas in relation to diabetes mellitus?

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

    What are the 2 main adipokines that are thought to affect insulin sensitivity?

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

    What is one of the main factors that is thought to contribute to the development of type 2 diabetes?

    <p>Increased production of adipokines by adipose tissue (D)</p> Signup and view all the answers

    How is the onset of Type 2 Diabetes generally described?

    <p>Slow and gradual with few initial symptoms (C)</p> Signup and view all the answers

    What is a key characteristic of metabolic syndrome?

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

    What happens to the alpha-cells of the pancreas in people who are developing type 2 diabetes?

    <p>They increase production of glucagon (D)</p> Signup and view all the answers

    What is the typical time period that a person has had type 2 diabetes before diagnosis?

    <p>6.5 years (D)</p> Signup and view all the answers

    What is the main role of the beta-cells in the pancreas in relation to glucose regulation?

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

    What percentage of beta-cells are typically no longer secreting insulin when a person develops symptoms of hyperglycemia?

    <p>50-80% (D)</p> Signup and view all the answers

    What is the potential consequence of the liver's dysregulation of glucose release in type 2 diabetes?

    <p>Elevated blood sugar levels (D)</p> Signup and view all the answers

    What are the two main factors that are thought to contribute to the failure of beta-cells to adapt in type 2 diabetes?

    <p>Chronic hyperglycemia and high circulating free fatty acids (C)</p> Signup and view all the answers

    How does insulin affect glucose transport in the body?

    <p>Insulin directly facilitates glucose transport into most tissues, with exceptions like the brain and liver. (D)</p> Signup and view all the answers

    What is the primary physiological effect of counterregulatory hormones?

    <p>They promote glucose production and release from the liver. (B)</p> Signup and view all the answers

    Which of the following best describes the role of C-peptide in diabetes management?

    <p>C-peptide levels can be used to assess the function of pancreatic beta cells. (B)</p> Signup and view all the answers

    What is the defining characteristic that distinguishes type 1 diabetes from type 2 diabetes?

    <p>The presence of endogenous insulin. (B)</p> Signup and view all the answers

    Which of the following is NOT a risk factor for developing type 2 diabetes?

    <p>Being under 18 years of age. (D)</p> Signup and view all the answers

    What is the primary mechanism underlying insulin resistance in type 2 diabetes?

    <p>Unresponsiveness or insufficient number of insulin receptors in target tissues. (D)</p> Signup and view all the answers

    What is the typical progression of type 1 diabetes from onset?

    <p>Rapid onset of symptoms, followed by a period of remission, and eventual insulin dependence. (C)</p> Signup and view all the answers

    What is the primary role of human leukocyte antigens (HLAs) in type 1 diabetes?

    <p>They influence susceptibility to autoimmune destruction of beta cells. (C)</p> Signup and view all the answers

    Which of the following is characteristic of latent autoimmune diabetes in adults (LADA)?

    <p>It is a slowly progressing form of type 1 diabetes, often misdiagnosed as type 2 diabetes. (B)</p> Signup and view all the answers

    What is the main distinction between idiopathic diabetes and other forms of type 1 diabetes?

    <p>The genetic component. (D)</p> Signup and view all the answers

    Flashcards

    Diabetes Mellitus (DM)

    A chronic disease characterized by hyperglycemia due to insulin issues.

    Hyperglycemia

    Elevated blood glucose levels due to insufficient insulin.

    Type 1 DM

    An autoimmune condition where the body fails to produce insulin.

    Type 2 DM

    A condition characterized by insulin resistance, often associated with obesity.

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    Insulin

    A hormone produced by the pancreas that regulates blood glucose levels.

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    Islets of Langerhans

    Clusters of cells in the pancreas that produce insulin.

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    Glycogen

    The stored form of glucose, primarily in the liver and muscles.

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    Anabolic Hormone

    A hormone, like insulin, that promotes the building up of tissues.

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    Prediabetes

    A state where blood glucose levels are higher than normal but not high enough for DM.

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    Insulin-dependent tissues

    Tissues such as muscle and fat that require insulin for glucose uptake.

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    Counterregulatory Hormones

    Hormones that oppose the effects of insulin to raise blood sugar levels.

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    Type 1 Diabetes

    An autoimmune disorder where the body destroys insulin-producing cells.

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    Symptoms of Type 1 DM

    Classic symptoms include polydipsia, polyuria, and polyphagia.

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    Ketoacidosis

    A life-threatening condition due to lack of insulin and high glucose levels.

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    Honeymoon Period

    Temporary phase where newly diagnosed Type 1 DM patients need less insulin.

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    Type 2 Diabetes

    A condition characterized by insulin resistance and inadequate insulin secretion.

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    Insulin Resistance

    When body tissues don't respond properly to insulin, preventing glucose entry.

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    Endogenous Insulin

    Insulin produced naturally by the body.

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    Genetic Link in Diabetes

    Certain genes contribute to susceptibility to Type 1 and Type 2 DM.

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    Failure of β cells

    Inability of pancreatic β cells to adapt, possibly due to chronic hyperglycemia or free fatty acids.

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    Increased glucagon

    Excessive production of glucagon by α cells of the pancreas, affecting glucose regulation.

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    Inappropriate glucose production

    Liver releases glucose erratically rather than in response to blood needs.

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    Adipokines

    Hormones produced by adipose tissue, involved in glucose and fat metabolism.

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    Adiponectin

    An adipokine that enhances insulin sensitivity and regulates glucose levels.

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    Leptin

    An adipokine that regulates energy balance by inhibiting hunger.

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    Chronic inflammation

    Long-lasting inflammation linked to insulin resistance and type 2 DM.

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    Metabolic syndrome

    A collection of five risk factors increasing type 2 DM likelihood.

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    Components of metabolic syndrome

    Includes high glucose, abdominal obesity, high BP, high triglycerides, low HDL.

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    Delayed type 2 DM diagnosis

    Type 2 DM often diagnosed years after onset due to undetected hyperglycemia.

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    Study Notes

    Diabetes Mellitus (DM)

    • Chronic multisystem disease characterized by high blood sugar (hyperglycemia) from abnormal insulin production or use.
    • A significant global health problem, affecting approximately 34.2 million people (10.5% of the population) in the US. An estimated 7.3 million people remain undiagnosed.
    • The 7th leading cause of death in the US.
    • Prediabetes affects 88 million US adults.

    Etiology and Pathophysiology

    • Causes of DM are often a combination of genetic, autoimmune, and environmental factors (e.g., viruses, weight).
    • Primarily involves abnormal glucose metabolism due to insufficient or absent insulin, or impaired insulin use.
    • Four main types of DM: Type 1, Type 2, Maturity-onset diabetes of the young (MODY), Gestational DM, and other specific types.

    Normal Glucose and Insulin Metabolism

    • Insulin, a hormone produced by the pancreas's beta cells, regulates glucose levels.
    • Insulin is released continuously, and its release increases after eating.
    • Normal blood glucose levels range from 74-106 mg/dL (4.1-5.9 mmol/L).
    • Daily insulin production in an adult is typically 40-50 units (or 0.6 units/kg body weight).
    • Insulin facilitates glucose transport into cells for energy production.
    • Excess glucose is stored as glycogen in the liver and muscles.
    • Insulin's role as an anabolic (storage) hormone is crucial. During fasting, counterregulatory hormones (like glucagon and cortisol) help maintain glucose in circulation.
    • Some tissues (brain, liver, blood cells) don't directly rely on insulin.
    • Insulin signaling depends on presence of receptors for many cells

    Type 1 Diabetes

    • Accounts for 5-10% of diabetes cases.
    • Primarily affects people under 40, although it can affect people of any age.
    • An autoimmune disorder where the body attacks insulin-producing beta cells in the pancreas.
    • Genetic predisposition and viral exposure may contribute.
    • Development of symptoms is often rapid, leading to severe hyperglycemia or diabetic ketoacidosis (DKA).
    • Characterized by classic symptoms: excessive thirst, frequent urination, and extreme hunger.
    • Requires exogenous (external) insulin for survival.
    • "Honeymoon period" is possible for newly diagnosed patients with temporary remission.
    • Eventually requires lifelong insulin treatment as beta cells are destroyed

    Type 2 Diabetes

    • Accounts for 90-95% of diabetes cases.
    • Associated with a variety of risk factors, including: family history, obesity, and advancing age (increasing incidence in children as well).
    • Ethnic background is increasingly a factor.
    • Characterized by both impaired insulin secretion and insulin resistance.
    • Patients usually produce some insulin.
    • Develops gradually, often without obvious symptoms for years. Many are diagnosed during routine tests or unrelated medical care.
    • Often diagnosed after significant beta cell loss (~50% to 80% lost). People usually have had the condition for six and a half years before diagnosis.
    • Type 1 DM genetic predisposition linked to human leukocyte antigens (HLAs).
    • Specific HLA types (DR3 and DR4) increase type 1 diabetes risk.
    • Idiopathic diabetes (a type 1 sub-type) is strongly inherited without autoimmunity.
    • Latent autoimmune diabetes in adults (LADA) is a slower, autoimmune form of type 1 diabetes

    Type 2 Pathophysiology

    • Several metabolic factors contribute to type 2.
      • Reduced insulin sensitivity (resistance): Insulin receptors are ineffective, insufficient, or both, causing high blood sugar.
      • Decrease in insulin production by the pancreatic beta cells (compensatory): The cells overproduce insulin initially to compensate for resistance but eventually fatigue or lose beta cell mass.
      • Unregulated glucose production by the liver
      • Adipokines (hormones released by fat tissue) may play a role in insulin resistance and chronic inflammation.
        • Adiponectin and leptin are two adipokines of importance.
      • The role of the brain, kidneys, and gut are currently under study regarding how they contribute.
    • Individuals with metabolic syndrome (high blood sugar, abdominal obesity, high blood pressure, high triglycerides, and low HDL levels) are at higher risk.

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    Description

    This quiz covers essential aspects of Diabetes Mellitus, including its definition, prevalence, and causes. Explore the etiology and pathophysiology of the disease, as well as the role of insulin in glucose metabolism. Test your knowledge on the different types of diabetes and their impact on health.

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