24 Questions
What is the primary cause of hyperglycemia in diabetes mellitus?
Both defective insulin action and inadequate insulin secretion
What is the typical age range for the peak presentation of type 1 diabetes mellitus?
11-13 years
What is the result of osmotic diuresis caused by the presence of glucose in urine in the kidneys?
Polyuria
What is the consequence of accelerated breakdown of fat and muscle in type 1 diabetes mellitus?
Weight loss
What arises from a state of total insulin deficiency?
Diabetic ketoacidosis
What is the autoimmune response that leads to the destruction of pancreatic beta cells?
Activation of immune cells and autoantibodies
What is the classical triad of symptoms of insulin deficiency?
Polyuria, polydipsia, and weight loss
What is the disease that is induced by an environmental event, or events, in a genetically susceptible person?
Type 1 diabetes mellitus
What is the primary method for diagnosing gestational diabetes?
Oral glucose tolerance test in the 2nd trimester
What is a risk factor for gestational diabetes mellitus?
BMI > 30 kg/m2
What is the primary treatment goal for hypoglycemia?
Quickly getting blood sugar back to within the standard range
What is a common cause of hypoglycemia in people with diabetes?
Too much insulin or other diabetes medications
What is a symptom of worsening hypoglycemia?
Loss of coordination
What is a lifestyle modification that can help prevent hypoglycemia?
Eating regular meals
What is a potential complication of severe hypoglycemia?
Seizures
What is a common sign of hypoglycemia?
Sweating
What happens when blood glucose level is too low?
Glucagon is secreted from alpha cells of the pancreatic islets
What is the result of glucagon acting on hepatocytes?
Glucose is released from the liver into the blood more rapidly
What inhibits the release of glucagon?
High blood glucose level
What is the effect of insulin on glucose in cells?
Glucose is phosphorylated and cannot diffuse back through the cell membrane
What is the result of insulin lack in the liver?
Increased production of acetoacetic acid and ketosis
What is the effect of insulin on glycogenolysis?
Insulin slows the conversion of glycogen into glucose
What is the result of insulin secretion from beta cells of the pancreatic islets?
Blood glucose level falls
What is the effect of insulin on protein synthesis?
Insulin increases protein synthesis
Study Notes
Insulin Related Disorders
- Hyperglycemia: High blood sugar (glucose) level
- Hypoglycemia: Low blood sugar (glucose) level
Hyperglycemia
- Main cause of hyperglycemia: Diabetes mellitus due to metabolic disorders, inadequate insulin secretion, defective insulin action, or both
- Two major forms of diabetes: Type 1 and Type 2
- Complications of diabetes: Retinopathy leading to blindness, nephropathy leading to renal failure, neuropathy (nerve damage), and atherosclerosis (stroke, gangrene, or coronary artery disease)
Type 1 Diabetes Mellitus
- Results from insulin deficiency or absence due to destruction of pancreatic beta cells
- Chronic, organ-specific autoimmune disease induced by environmental events or genetic susceptibility
- Peak age of presentation: 11-13 years (more common in children)
- Symptoms: Polyuria, polydipsia, weight loss, diabetic ketoacidosis, hyperphagia, blurred vision
Gestational Diabetes
- Most patients are asymptomatic, diagnosed after screening with an oral glucose tolerance test in the 2nd trimester
- Risk factors: BMI > 30 kg/m2, previous macrosomic baby, previous gestational diabetes, first-degree relative with type 2 diabetes, ethnic origin with high prevalence of diabetes mellitus
Hypoglycemia
- Condition in which blood sugar (glucose) level is lower than the standard range
- Symptoms: Pale, shakiness, sweating, headache, hunger, fast heartbeat, fatigue, dizziness, numbness of lips, tongue, or cheek
- Severe symptoms: Confusion, unusual behavior, loss of coordination, slurred speech, blurry vision, nightmares, unresponsiveness, seizures
- Causes: Side effect of diabetes medications, excessive insulin, excessive alcohol drinking, critical illnesses, taking someone else's oral diabetes medication
Control of Secretion of Glucagon and Insulin
- Low blood glucose level (hypoglycemia) stimulates secretion of glucagon from alpha cells of the pancreatic islets
- Glucagon promotes glycogenolysis and gluconeogenesis, increasing blood glucose level
- High blood glucose level (hyperglycemia) inhibits release of glucagon and stimulates secretion of insulin
- Insulin acts on various cells to accelerate glucose uptake, glycogenesis, and protein synthesis, and slow glycogenolysis and gluconeogenesis
Learn about insulin related disorders, including hyperglycemia and hypoglycemia, and their causes, symptoms, and complications, with a focus on diabetes mellitus.
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