Type 2 Diabetes Overview

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Questions and Answers

What percentage of HbA1c is considered the threshold for diagnosing diabetes?

5.6%

6.4%

6.5% (correct)

Which blood glucose level (mg/dL) corresponds to a HbA1c of 9%?

240 mg/dL

180 mg/dL

270 mg/dL

210 mg/dL (correct)

Which of the following characterizes Type 2 Diabetes (T2D)?

Complete absence of insulin production

Insulin present but with resistance (correct)

Normal GLUT4 expression in peripheral tissues

Insulin independence and hyperglycemia

What primarily causes hyperglycemia in Type 2 Diabetes?

Poor uptake of glucose by peripheral tissues Signup and view all the answers

What is the role of GLUT4 in individuals with Type 2 Diabetes?

Decreased expression in muscle and adipose tissue Signup and view all the answers

What is the role of intestinal lipases in fat digestion?

They degrade triacylglycerols into fatty acids and glycerol. Signup and view all the answers

How do chylomicrons reach the tissues after their formation in the intestinal mucosa?

They move through the lymphatic system to tissues. Signup and view all the answers

What results from an increased concentration of VLDL in the blood?

Hypertriacylglycerolemia. Signup and view all the answers

Which of the following correctly describes the function of lipoprotein lipase?

It converts triacylglycerols to fatty acids and glycerol. Signup and view all the answers

What triggers the uptake of glucose in adipose tissue?

Insulin signaling. Signup and view all the answers

What is the primary use of insulin detemir?

Basal control for type 1 diabetes Signup and view all the answers

How should insulin detemir be administered?

Subcutaneously Signup and view all the answers

What characteristic of insulin detemir contributes to its slow action?

It has a fatty acid side chain Signup and view all the answers

What is the classification of NPH insulin?

Intermediate-acting insulin Signup and view all the answers

Which insulin preparation is NOT suitable for mealtime release?

Insulin glargine Signup and view all the answers

What is the main function of rapid-acting insulin preparations?

Mimic the prandial release of insulin Signup and view all the answers

Insulin preparations are categorized into which of the following groups?

Rapid, short, intermediate, long-acting Signup and view all the answers

Which type of insulin is specifically mentioned for basal control in type 1 diabetes?

NPH insulin Signup and view all the answers

Which statement is true regarding long-acting insulin preparations?

They should only be given subcutaneously Signup and view all the answers

What differentiates intermediate-acting insulin from rapid-acting insulin?

Speed of absorption and action duration Signup and view all the answers

Study Notes

Blood Sugar Comparison

HbA1c Levels: Ranges from 4% (60 mg/dL) to 13% (330 mg/dL) indicating varying levels of blood glucose.
Normal, Prediabetes, and Diabetes: Normal (≤5.6), Prediabetes (5.7-6.4), Diabetes (≥6.5).
Progression of Blood Glucose Levels: Increases in blood glucose (mg/dL) correlate with higher HbA1c percentages.

Type 2 Diabetes (T2D) Characteristics

T2D involves insulin presence but with insulin resistance and inadequate production by beta-cells.
Hyperglycemia results primarily from poor glucose uptake by tissues (muscle/adipose).
Decreased expression of GLUT4 in peripheral tissues contributes to glucose uptake impairment.
GLUT2 in the liver is insulin-insensitive and affects glucose metabolism.

Pathophysiology

Hypertriacylglycerolemia arises from increased VLDL without chylomicron accumulation.
T2D management includes various insulin types to mimic physiological insulin release.

Insulin Preparations

Types of Insulin:
- Rapid/Short-Acting: Controls postprandial glucose.
- Intermediate-Acting: Used for fasting control, often administered subcutaneously.
- Long-Acting: Provides basal control; examples include Insulin Detemir and Insulin Glargine.

Major Contributors to Hyperglycemia

Insulin Resistance: Predominantly in liver, adipose, and muscle tissues.
Increased Gluconeogenesis: Resulting in higher blood glucose levels and decreased insulin secretion from beta-cells.
Conditions leading to hyperglycemia include obesity, age, and impaired glucose tolerance.

Mechanism of Insulin and Diabetes Treatment

Insulin Icodec: Offers continuous blood sugar reduction via strong yet reversible binding to albumin. Approval expected in 2024.
Metformin: A biguanide insulin sensitizer, promotes uptake into cells via OCT1, noted for possible vitamin B12 deficiency with long-term use.

Treatment Strategies

Initial Management: Metformin recommended for patients without comorbidities.
Regular monitoring of B12 levels is advised, especially in patients with risk factors like anemia or peripheral neuropathy.

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Description

This quiz covers key aspects of Type 2 Diabetes (T2D) including HbA1c level classifications, characteristics of insulin resistance, and the pathophysiology of hyperglycemia. It also delves into the management strategies involving insulin preparations. Test your knowledge on these crucial topics related to diabetes.