Diabetes Types and Mechanisms Quiz

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Questions and Answers

What primarily differentiates Type 1 diabetes mellitus (T1D) from Type 2 diabetes (T2D)?

Type 1 occurs more frequently in older adults.

Type 1 is characterized by insulin resistance.

Type 1 is an autoimmune condition that leads to insulin deficiency. (correct)

Type 1 is mainly caused by lifestyle choices.

Which of the following factors is most commonly associated with insulin resistance in Type 2 diabetes?

Age-related decrease in beta-cell function.

Obesity and adipose tissue remodeling. (correct)

High physical activity levels.

Genetic mutations affecting insulin production.

Which process is primarily affected by insulin deficiency in Type 1 diabetes?

Glycolysis.

Hepatic gluconeogenesis. (correct)

Lipolysis.

Glycogenolysis.

What is the role of GLUT4 in insulin signaling?

It facilitates the translocation of glucose into adipose tissue and muscle. Signup and view all the answers

What is a primary goal of diabetes treatment?

Normalize blood glucose levels to prevent complications. Signup and view all the answers

What primarily leads to the release of insulin from beta cells during glucose metabolism?

Increased blood glucose concentration Signup and view all the answers

Which type of diabetes is primarily characterized by autoimmune destruction of beta cells?

Type 1 diabetes Signup and view all the answers

What is the role of GLUT2 in glucose metabolism?

Allows glucose to enter the bloodstream from beta cells Signup and view all the answers

What is a common feature of both type 1 and type 2 diabetes mellitus?

Inadequate insulin secretion Signup and view all the answers

In type 2 diabetes, what typically contributes to the development of insulin resistance?

Elevated levels of circulating insulin Signup and view all the answers

How do fatty acids influence glucose metabolism in diabetes?

They can impair insulin signaling pathways Signup and view all the answers

Which hormonal response is triggered by low blood glucose levels?

Increased glucagon secretion Signup and view all the answers

What is the primary function of insulin in glucose metabolism?

Facilitate glucose uptake by tissues Signup and view all the answers

What condition indicates a random blood glucose level of 200 mg/dL or higher?

Diabetes Signup and view all the answers

What HbA1c level is considered diagnostic for diabetes?

6.5% Signup and view all the answers

During the glucose tolerance test, what blood glucose level indicates diabetes at the 2-hour mark?

200 mg/dL Signup and view all the answers

What is the range for normal fasting blood sugar levels?

< 100 mg/dL Signup and view all the answers

What HbA1c level range suggests prediabetes?

5.7% - 6.4% Signup and view all the answers

What condition is indicated by a fasting blood sugar level of 126 mg/dL or higher?

Diabetes Signup and view all the answers

What is a common procedure in the glucose tolerance test?

Monitoring blood glucose levels for 2 hours post glucose ingestion Signup and view all the answers

What blood glucose level at the 2-hour mark suggests prediabetes?

140-199 mg/dL Signup and view all the answers

What type of receptor is involved in insulin signaling in the liver?

Tyrosine kinase receptor Signup and view all the answers

Which primary pathway is activated by glucagon signaling?

cAMP/PKA pathway Signup and view all the answers

What effect does insulin have on gluconeogenesis?

Inhibits gluconeogenesis Signup and view all the answers

What condition is primarily associated with excessive glucagon action in Type 2 diabetes?

Hyperglycemia Signup and view all the answers

What type of damage is caused by the accumulation of Advanced Glycation End Products (AGEs)?

Oxidative stress and inflammation Signup and view all the answers

Which of the following complications is NOT associated with AGEs and their receptor RAGE?

Osteoporosis Signup and view all the answers

Which of the following statements regarding glucose and protein interaction is true?

AGEs can form when glucose binds to proteins/lipids. Signup and view all the answers

What is the overall effect of insulin on blood glucose levels?

Decreases blood glucose levels Signup and view all the answers

What does the presence of glucose in the urine indicate?

Blood glucose levels exceeding renal threshold Signup and view all the answers

Which test is used to measure levels of β-Hydroxybutyrate (BHB) to indicate fat metabolism?

Ketone test Signup and view all the answers

What is the significance of C-peptide levels in blood testing?

Helps differentiate between type 1 and type 2 diabetes Signup and view all the answers

Which treatment regimen typically involves 2-3 daily injections?

Standard Treatment for T1D Signup and view all the answers

What is the most common complication of insulin therapy?

Hypoglycemia Signup and view all the answers

Which individuals should avoid tight control in diabetes management?

Elderly individuals Signup and view all the answers

What lifestyle changes are recommended for initial management of T2D?

Weight reduction and regular exercise Signup and view all the answers

What type of oral antihyperglycemic agent decreases hepatic gluconeogenesis?

Biguanides Signup and view all the answers

In intensive treatment for T1D, what is the typical HbA1c level target?

Around 7% Signup and view all the answers

Which of the following indicates a higher risk of hypoglycemia?

Intensive treatment regimen Signup and view all the answers

What primarily leads to the misidentification of β cells in Type 1 diabetes?

Variations in HDL genes Signup and view all the answers

What metabolic change is characterized by increased hepatic glucose production and reduced peripheral utilization?

Hyperglycemia Signup and view all the answers

Which of the following symptoms is associated with Diabetic Ketoacidosis (DKA)?

Metabolic acidosis Signup and view all the answers

What is the relationship between Type 2 diabetes (T2D) and insulin resistance?

Insulin resistance is accompanied by impaired β-cell function Signup and view all the answers

In Type 1 diabetes, what does the mobilization of fatty acids lead to?

Ketoacidosis Signup and view all the answers

Which hormonal imbalance is primarily caused by defects in β-cell function?

Insulin deficiency Signup and view all the answers

What complication can occur in 25-40% of newly diagnosed Type 1 diabetes cases?

Diabetic Ketoacidosis Signup and view all the answers

How does Type 1 diabetes affect metabolic processes in tissues?

Impairs liver and white adipose tissue metabolism Signup and view all the answers

Study Notes

Diabetes Mellitus Overview

Diabetes mellitus (DM) is a chronic metabolic disease caused by elevated blood glucose levels.
DM leads to serious damage to the heart, blood vessels, eyes, kidneys, and nerves over time.
Three main types of DM: type 1, type 2, and gestational diabetes.

Type 1 Diabetes (T1D)

Pathophysiology: Autoimmune attack on pancreatic islet beta cells, leading to insulin deficiency.
Symptoms: Develop rapidly (weeks), including polyuria, polydipsia, polyphagia, fatigue, and blurred vision.
Beta-cell loss: Gradual destruction over years, symptoms appear after 80-90% loss.
Trigger factors: Environmental stimuli (e.g., viral infections) and genetic predisposition.
Metabolic changes: Increased hepatic glucose production, ketone production, and potential diabetic ketoacidosis (DKA).
Intertissue relationships: Reduced glucose uptake in muscle and adipose tissue, increased ketone body production, and potentially abnormal lipid metabolism in visceral adipose tissues.
Diagnosis & tests: Elevated blood glucose levels, HbA1c, and glucose tolerance tests.
Treatment: Insulin injections/pump therapy. Tight control is goal to minimize long-term complications.

Type 2 Diabetes (T2D)

Pathophysiology: Insulin resistance combined with impaired beta-cell function.
Symptoms: Develop slowly (several years), including increased thirst, frequent urination, and blurred vision.
Beta-cell dysfunction: Initially compensatory with increased insulin levels for a duration before inadequate insulin secretion.
Metabolic differences: Milder metabolic alterations compared to Type 1.
Insulin resistance: Reduced ability of target tissues (muscle/adipose tissue) to respond to insulin. Increased hepatic glucose production, adipose lipolysis increase free fatty acids.
Diagnosis & tests: Elevated blood glucose levels, HbA1c, and glucose tolerance tests.
Treatment: Lifestyle modifications (nutrition, weight loss, exercise), medical nutrition therapy, and potential for oral medications and insulin if needed.

Insulin Receptor Signaling

Insulin binds to insulin receptors on target cells, triggering phosphorylation (activation)
Leads to GLUT4 translocation, increasing glucose uptake into cells.
Type 1 Diabetes: Lack of insulin severely disrupts signaling.
Type 2 Diabetes: Insulin resistance impedes GLUT4 translocation, leading to decreased glucose uptake and hyperglycemia.

Diabetic Complications (T1D & T2D)

Hyperglycemia & AGEs: Elevated blood glucose leads to advanced glycation end products (AGEs) causing oxidative stress, inflammation, and vascular damage. They can promote inflammatory pathways, causing tissue damage
RAGE Receptor: A receptor on endothelial cells, neurons, and immune cells, triggers inflammation and oxidative stress upon AGE binding.
Diabetic complications: retinal problems, nephropathy (kidney failure), neuropathy (nerve damage), and vascular damage, leading to cardiovascular issues.
Chronic inflammation: Exacerbates tissue damage.

Diabetes Diagnosis & Tests

Hyperglycemia: Elevated blood glucose levels, diagnosed via random, fasting, or oral glucose tolerance tests.
Glycated hemoglobin (HbA1c): Measures average blood glucose levels over 2-3 months, used for diabetes diagnosis and monitoring.
Oral glucose tolerance test (OGTT): Assesses how the body processes glucose. A 2-hr glucose level > 200mg/dl confirms diabetes. Fasting glucose level > 126 mg/dL or higher may indicate diabetes .
Glycosuria: Glucose in urine, indicates high blood glucose levels.
Ketones: Measured in blood or urine, indicating potential diabetic ketoacidosis (DKA).
C-peptide levels: Indicates how much insulin the pancreas is producing. High levels suggest type 2 diabetes; low levels may suggest type 1 diabetes.

Diabetes Treatment

T1D: Involves insulin therapy (injections or pump therapy) aiming for tight control.
T2D: Lifestyle changes are initial approaches: Weight reduction, regular exercise, and dietary modifications (low carbohydrate diet). Oral medications and insulin may be needed.
Intensive Therapy: Aggressive treatment aiming for tight glucose control to prevent long-term complications, may not be suitable for all patients (e.g. children, elderly)

Adipose Tissue & Insulin Resistance

Visceral white adipose tissue (WAT) is highly metabolically active, and excess WAT is linked to insulin resistance. Chronic weight gain and high fat intake are risks.
The adipose tissue influence the immune system and may potentially influence the metabolism and overall inflammation in the body.
Adipokines, released by adipose tissue, play roles in metabolism and inflammation; altered adipokine secretion can contribute to insulin resistance, chronic inflammation, and other complications.
Changes in adipose tissue structure and function can influence signaling and metabolism to increase the risk of Type 2 Diabetes.

Hepatic Gluconeogenesis

Lack of insulin leads to unregulated gluconeogenesis (production of glucose in the liver).
Unopposed glucagon stimulates gluconeogenesis further, resulting in hyperglycemia.
Different mechanisms are involved in gluconeogenesis/glycogenolysis in T1D vs T2D. Mechanisms influencing the signaling will have different results in each type of diabetes.

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Description

Test your knowledge on the key differences between Type 1 and Type 2 diabetes mellitus. This quiz covers various aspects including insulin resistance, the role of glucose transporters, and the metabolic processes affected by insulin. Determine your understanding of diabetes treatment goals and hormonal responses.