Podcast
Questions and Answers
What characterizes Type 1a diabetes?
What characterizes Type 1a diabetes?
What is a common consequence of absolute insulin deficiency in Type 1 diabetes?
What is a common consequence of absolute insulin deficiency in Type 1 diabetes?
Which of the following antibodies are often present in patients with Type 1a diabetes?
Which of the following antibodies are often present in patients with Type 1a diabetes?
What describes Type II diabetes?
What describes Type II diabetes?
Signup and view all the answers
What typically occurs in the absence of insulin for patients with Type 1 diabetes?
What typically occurs in the absence of insulin for patients with Type 1 diabetes?
Signup and view all the answers
How does hyperglycemia develop in Type II diabetes?
How does hyperglycemia develop in Type II diabetes?
Signup and view all the answers
What might happen to patients with progressive beta cell failure in Type II diabetes?
What might happen to patients with progressive beta cell failure in Type II diabetes?
Signup and view all the answers
What is the primary cause of Type 2 diabetes?
What is the primary cause of Type 2 diabetes?
Signup and view all the answers
Which hormones are released from the gut to stimulate insulin release?
Which hormones are released from the gut to stimulate insulin release?
Signup and view all the answers
What is an incorrect statement about diabetic ketoacidosis?
What is an incorrect statement about diabetic ketoacidosis?
Signup and view all the answers
What significant factors contribute to the rise in Type 2 diabetes prevalence?
What significant factors contribute to the rise in Type 2 diabetes prevalence?
Signup and view all the answers
How does an increase in blood glucose affect insulin release from β-cells?
How does an increase in blood glucose affect insulin release from β-cells?
Signup and view all the answers
What is the role of KATP channels in insulin secretion?
What is the role of KATP channels in insulin secretion?
Signup and view all the answers
What is the estimated number of adults living with diabetes as of 2024?
What is the estimated number of adults living with diabetes as of 2024?
Signup and view all the answers
What type of diabetes is often referred to as juvenile diabetes?
What type of diabetes is often referred to as juvenile diabetes?
Signup and view all the answers
What is the prevalence of end stage chronic kidney disease in type 1 diabetes patients?
What is the prevalence of end stage chronic kidney disease in type 1 diabetes patients?
Signup and view all the answers
What effect does dipeptidyl peptidase (DPP-4) have on incretins?
What effect does dipeptidyl peptidase (DPP-4) have on incretins?
Signup and view all the answers
Which complication is most likely to cause death in patients with type 1 diabetes?
Which complication is most likely to cause death in patients with type 1 diabetes?
Signup and view all the answers
Which statement about type 2 diabetes and macrovascular diseases is accurate?
Which statement about type 2 diabetes and macrovascular diseases is accurate?
Signup and view all the answers
What health risk is significantly increased by tobacco use in diabetic patients?
What health risk is significantly increased by tobacco use in diabetic patients?
Signup and view all the answers
Which factor is most likely contributing to the 66-year-old man's poor diabetes management in the case study?
Which factor is most likely contributing to the 66-year-old man's poor diabetes management in the case study?
Signup and view all the answers
What is the most common complication of insulin therapy?
What is the most common complication of insulin therapy?
Signup and view all the answers
What should be added if the combination of non-insulin agents fails to control glucose levels?
What should be added if the combination of non-insulin agents fails to control glucose levels?
Signup and view all the answers
Which potential side effect is associated with the use of pioglitazone alongside insulin?
Which potential side effect is associated with the use of pioglitazone alongside insulin?
Signup and view all the answers
In patients experiencing frequent hypoglycemic episodes, what happens to their autonomic warning signals?
In patients experiencing frequent hypoglycemic episodes, what happens to their autonomic warning signals?
Signup and view all the answers
Which class of medication has been shown to possibly increase the risk of developing diabetes in patients with hypertension?
Which class of medication has been shown to possibly increase the risk of developing diabetes in patients with hypertension?
Signup and view all the answers
What is a common effect of beta blocker therapy in diabetic patients?
What is a common effect of beta blocker therapy in diabetic patients?
Signup and view all the answers
What type of insulin is recommended for improving fasting glucose levels when added to a medication regimen?
What type of insulin is recommended for improving fasting glucose levels when added to a medication regimen?
Signup and view all the answers
What defines gestational diabetes mellitus (GDM)?
What defines gestational diabetes mellitus (GDM)?
Signup and view all the answers
When instituting a more intensive insulin regimen, what is the primary type of insulin that is combined with rapid-acting analog before meals?
When instituting a more intensive insulin regimen, what is the primary type of insulin that is combined with rapid-acting analog before meals?
Signup and view all the answers
Which laboratory finding is diagnostic of diabetes mellitus?
Which laboratory finding is diagnostic of diabetes mellitus?
Signup and view all the answers
During which trimester of pregnancy is insulin resistance most pronounced?
During which trimester of pregnancy is insulin resistance most pronounced?
Signup and view all the answers
What does an HbA1c level below 6.5% indicate?
What does an HbA1c level below 6.5% indicate?
Signup and view all the answers
What is the significance of the plasma glucose level of 100–125 mg/dL?
What is the significance of the plasma glucose level of 100–125 mg/dL?
Signup and view all the answers
What mechanism does insulin ICODEC use to prolong its action?
What mechanism does insulin ICODEC use to prolong its action?
Signup and view all the answers
What does the lifespan of red blood cells (RBCs) reflect in terms of HbA1c measurements?
What does the lifespan of red blood cells (RBCs) reflect in terms of HbA1c measurements?
Signup and view all the answers
What are the amino acid substitutions present in insulin ICODEC?
What are the amino acid substitutions present in insulin ICODEC?
Signup and view all the answers
Study Notes
Diabetes
- Chronic metabolic disease characterized by elevated blood glucose levels.
- Can lead to serious damage to heart, blood vessels, eyes, kidneys, and nerves over time.
Type 1 Diabetes
- Juvenile diabetes or insulin-dependent diabetes.
- Body produces little or no insulin.
- Most common type is immune-mediated.
- Often diagnosed before the age of 30, but can occur at any age.
Type 2 Diabetes
- Adult-onset diabetes
- Body becomes resistant to insulin or doesn't produce enough.
Diabetes Statistics
- 537 million adults are living with diabetes.
- Projected to rise to 643 million by 2030 and 783 million by 2045.
- 3 in 4 adults with diabetes live in low- and middle-income countries.
- Over 90% of adults with diabetes have type 2.
The Pancreas
- Contains Islets of Langerhans cells.
- Produces hormones:
- Insulin: Storage and anabolic hormone.
- Glucagon: Hyperglycemic factor that raises blood glucose.
Insulin
- Secreted by beta-cells of Islets of Langerhans.
- Stimuli for release: Sugars, amino acids, GLP-1, GIP, glucagon, cholecystokinin, high concentrations of fatty acids, and beta-adrenergic sympathetic activity.
- Incretins (GIP and GLP-1) are hormones released from the gut in response to food, they increase insulin release.
- Dipeptidyl peptidase (DPP-4) terminates their action.
Insulin Release
- Continuous basal secretion with surges at feeding times.
- Beta-cells possess K+ channels regulated by intracellular ATP (KATP channels).
- Increase in blood glucose leads to increased ATP in beta-cells.
- ATP closes KATP channels.
- Depolarization of beta-cell initiates Ca2+ influx.
- Ca2+ influx triggers insulin release.
Type 1 Diabetes
- Severe or absolute insulin deficiency.
- Results in decreased glucose uptake by insulin-sensitive tissues.
- Leads to lipolysis and muscle proteolysis, causing weight loss and weakness.
- Increased levels of free fatty acids and glycerol.
- Acetyl-CoA is converted to ketone bodies, causing acidosis (ketoacidosis).
Type 2 Diabetes
- Tissue resistance to insulin and relative deficiency in insulin secretion.
- Initially, patients can be controlled with diet, exercise, and non-insulin glucose-lowering drugs.
- Some patients develop progressive beta cell failure and require insulin therapy.
Gestational Diabetes
- Abnormal glucose levels during pregnancy.
- Placenta and placental hormones create insulin resistance.
Other Specific Types of Diabetes
- Pancreatectomy, pancreatitis, non-pancreatic diseases, drug therapy, etc.
Laboratory Findings
- Plasma or serum glucose: ≥126 mg/dL (7 mmol/L) on more than one occasion after at least 8 hours of fasting is diagnostic.
- HbA1c measurements: Reflect glucose levels over the preceding 8-12 weeks.
- Normal range: 4-6%
- Elevated in people with diabetes.
- Oral Glucose Tolerance Test (OGTT)
Drugs Used in the Treatment of Diabetes
- Insulin:
- Human Insulin: Rapid, short, intermediate, long-acting.
- Insulin Analogs: Rapid (lispro, aspart, glulisine), short (regular), intermediate (NPH), long (glargine, detemir, degludec).
- Sulfonylureas:
- Glipizide, glyburide, glimepiride.
- Meglitinides:
- Repaglinide, nateglinide.
- Thiazolidinediones:
- Pioglitazone, rosiglitazone.
- Alpha-glucosidase inhibitors:
- Acarbose, miglitol.
- GLP-1 receptor agonists:
- Exenatide, liraglutide, semaglutide, dulaglutide.
- DPP-4 inhibitors:
- Sitagliptin, saxagliptin, linagliptin.
- Sodium-glucose co-transporter 2 (SGLT2) inhibitors:
- Canagliflozin, dapagliflozin, empagliflozin.
- Other drugs:
- Metformin, D-phenylalanine analogs.
Drug Interactions
- Beta-blockers:
- Can worsen diabetes and dyslipidemia.
- May increase the risk of hypoglycemia by blunting the symptoms.
- Increase the risk of developing diabetes in patients with hypertension (except for diuretics).
Acute Complications of Diabetes
- Hypoglycemia:
- Most common complication of insulin therapy and oral agents that stimulate insulin secretion.
- Occurs more frequently with long-acting sulfonylureas.
- Symptoms: Autonomic hyperactivity (sympathetic and parasympathetic), convulsions, coma.
Chronic Complications of Diabetes
- Microvascular complications:
- Retinopathy, nephropathy, neuropathy.
- Macrovascular complications:
- Myocardial infarction, stroke.
- End-stage chronic kidney disease:
- Higher prevalence in patients with type 1 diabetes.
Tobacco Use
- Increases the risk of both microvascular and macrovascular complications in patients with diabetes.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz explores the chronic metabolic disease known as diabetes, including its types, statistics, and the role of the pancreas. Test your knowledge about Type 1 and Type 2 diabetes, their effects on health, and the hormonal functions involved. Ideal for students and healthcare professionals alike.
