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Questions and Answers
What is the primary characteristic of Type 1 diabetes (IDDM)?
What is the primary characteristic of Type 1 diabetes (IDDM)?
- Adult onset and non-insulin dependent
- Insulin resistance with excess glucagon
- Seldom associated with hyperosmolar states
- Insulin dependence with ketosis tendency (correct)
Which of the following is a significant contributing factor for the development of Type 2 diabetes (NIDDM)?
Which of the following is a significant contributing factor for the development of Type 2 diabetes (NIDDM)?
- Autoimmune destruction of pancreatic cells
- Genetic predisposition at a young age
- Obesity and lack of exercise (correct)
- Diet rich in carbohydrates
What percentage of all diabetes cases does Type 2 diabetes account for?
What percentage of all diabetes cases does Type 2 diabetes account for?
- 90% (correct)
- 5-10%
- 50%
- 75%
Which symptom is common to both Type 1 and Type 2 diabetes?
Which symptom is common to both Type 1 and Type 2 diabetes?
What is the fasting plasma glucose level that indicates diabetes?
What is the fasting plasma glucose level that indicates diabetes?
What is a typical laboratory finding in both types of diabetes?
What is a typical laboratory finding in both types of diabetes?
Which factor is least likely to contribute to the onset of Type 1 diabetes?
Which factor is least likely to contribute to the onset of Type 1 diabetes?
Which statement about Type 2 diabetes is correct?
Which statement about Type 2 diabetes is correct?
What is the primary function of insulin in glucose metabolism?
What is the primary function of insulin in glucose metabolism?
Where is glucagon synthesized?
Where is glucagon synthesized?
During times of physical and emotional stress, which hormone is released to increase blood glucose levels?
During times of physical and emotional stress, which hormone is released to increase blood glucose levels?
What effect does cortisol have on glucose metabolism?
What effect does cortisol have on glucose metabolism?
Which hormone decreases glucose entry into cells while increasing plasma glucose?
Which hormone decreases glucose entry into cells while increasing plasma glucose?
Thyroxine is primarily responsible for which of the following?
Thyroxine is primarily responsible for which of the following?
What is somatostatin's role in glucose metabolism?
What is somatostatin's role in glucose metabolism?
What characterizes Type 1 Diabetes Mellitus?
What characterizes Type 1 Diabetes Mellitus?
What type of carbohydrates cannot be hydrolyzed to a simpler form?
What type of carbohydrates cannot be hydrolyzed to a simpler form?
Which of the following is made up of two monosaccharides?
Which of the following is made up of two monosaccharides?
What is the primary function of glycogenesis?
What is the primary function of glycogenesis?
Gluconeogenesis primarily involves the conversion of which substances into glucose?
Gluconeogenesis primarily involves the conversion of which substances into glucose?
Which metabolic pathway is activated during fasting to increase blood glucose levels?
Which metabolic pathway is activated during fasting to increase blood glucose levels?
During glycolysis, what is the end product formed if glucose is fully metabolized?
During glycolysis, what is the end product formed if glucose is fully metabolized?
Which carbohydrate is NOT classified as a polysaccharide?
Which carbohydrate is NOT classified as a polysaccharide?
Lipogenesis is primarily associated with which process?
Lipogenesis is primarily associated with which process?
What are the key elements found in carbohydrates?
What are the key elements found in carbohydrates?
Which of the following is a common feature of polysaccharides?
Which of the following is a common feature of polysaccharides?
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Study Notes
Diabetes Mellitus
- Metabolic disease characterized by elevated blood glucose due to defects in insulin secretion, insulin action, or both.
Diabetes Mellitus Classification
- Type 1 (IDDM): 5-10% of all diabetes cases
- Occurs in childhood and adolescence
- Abrupt onset
- Insulin dependence
- Tendency towards ketosis
- Absence of insulin with excess glucagon
- β-Cell destruction leading to absolute insulin deficiency
- Autoantibodies
- Type 2 (NIDDM): 90% of all diabetes cases
- Adult onset
- Insulin resistance with secretory defect
- Relative insulin deficiency (hyperinsulinemia)
- Increased with age, obesity, and lack of exercise
- Glucagon secretion is attenuated
- Non-insulin dependent
- Ketosis tendency is rare
- Higher tendency to develop hyperosmolar states
Diabetes Mellitus Symptoms
- Polydipsia (increased thirst)
- Polyuria (increased urination)
- Polyphagia (increased hunger)
Diabetes Mellitus Laboratory Findings
- Increased glucose in plasma and urine
- Increased urine specific gravity
- Increased serum and urine osmolality
- Ketones in serum and urine (ketonemia and ketonuria)
- Decreased blood pH and urine pH (acidosis)
- Electrolyte imbalance (decreased Na, increased K)
Diabetes Mellitus Diagnostic Criteria
- Random plasma glucose ≥200 mg/dL with symptoms of diabetes
- Fasting plasma glucose ≥126 mg/dL
- 2-hour plasma glucose ≥200 mg/dL during an oral glucose tolerance test (OGTT)
Categories of Fasting Plasma Glucose (FPG)
- Provisional diabetes diagnosis: FPG ≤126 mg/dL
- Impaired fasting glucose: FBG 100-125 mg/dL
- Normal fasting glucose: FBG ≤99 mg/dL
Regulation of Glucose Metabolism
- Insulin (hypoglycemic agent)
- Primary hormone for decreasing blood glucose
- Synthesized by β cells in the islets of Langerhans (pancreas)
- Increases glycogenesis, glycolysis, and lipogenesis; decreases glycogenolysis
- Glucagon (hyperglycemic agent)
- Primary hormone responsible for increasing blood glucose
- Synthesized by α cells in the islets of Langerhans (pancreas)
- Increases glycogenolysis and gluconeogenesis
- Epinephrine
- Produced by the adrenal medulla; increases blood glucose
- Released during stress
- Inhibits insulin secretion; increases glycogenolysis and lipolysis
- Cortisol (glucocorticoids)
- Produced by the adrenal cortex; increases plasma glucose
- Decreases intestinal glucose entry into cells; increases gluconeogenesis, glycogenolysis, and lipolysis
- Growth hormone
- Produced by the anterior pituitary gland; increases plasma glucose
- Decreases glucose entry into cells; increases glycolysis
- Thyroxine
- Produced by the thyroid gland; increases plasma glucose
- Increases glycogenolysis, gluconeogenesis, and glucose intestinal absorption
- Somatostatin
- Produced by the delta cells of the islets of Langerhans in the pancreas and hypothalamus.
- Increases plasma glucose by inhibiting insulin, glucagon, growth hormone, etc.
Hyperglycemia
- Increase in plasma glucose leads to insulin secretion by β cells in the pancreatic islets.
Glucose Metabolism
- Glycolysis (Embden-Meyerhof Pathway): Glucose is converted into ATP, lactate, and pyruvate; insulin-dependent
- Gluconeogenesis: Formation of glucose-6-phosphate from non-carbohydrate sources (like fats and proteins); yields glucose and ketone bodies.
- Glycogenolysis: Breakdown of glycogen into glucose for energy; glucagon-dependent
- Glycogenesis: Conversion of glucose into glycogen for storage; insulin-dependent
- Lipogenesis: Conversion of carbohydrates into fatty acids
- Lipolysis: Decomposition of fat
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