Beetus 2

Question 1

What is DM?

Answer 1

chronic disorder caused by either deficient insulin or defective insulin action

Question 2

DM is characterized by (hypo/hyper)glycemia

Answer 2

Hyperglycemia

Question 3

DM is the leading cause of:

Answer 3

• ESRD
• blindness
• non-traumatic amputation of LE

Question 4

What are the 3 main roles of insulin?

Answer 4

• helps muscle, fat, and liver cells absorb glucose from the blood
• stimulates the liver and (to a lesser extent) muscle tissue store excess glucose in the form of glycogen
• lowers blood glucose by reducing glucose production in the liver

Question 5

Type 1 DM and insulin

Answer 5

Little or no insulin produced

Question 6

Type II DM

Answer 6

Defective insulin and/or impaired cell receptor binding of insulin

Question 7

How does activity impact glucose uptake by muscle?

Answer 7

• increased membrane permeability to glucose

- during mod to heavy exercise

Question 8

How does carbohydrate consumption impact insulin/muscle

Answer 8

insulin can increase rate of glucose transport into resting muscle cell by 15x

Question 9

How does the brain use glucose?

Answer 9

• brain has GLUT1 transporters to allow glucose uptake

- NOT directly insulin dependent

Question 10

What is critical blood glucose level for normal brain function?

Answer 10

Over 20-50 mg/dl

Question 11

What happens below blood glucose of 20-50?

Answer 11

hypoglycemic shock with

• fainting
• seizures
• potentially coma

Question 12

What brain-related effects happen with hyperglycemia that are similar to hypoglycemia?

Answer 12

• progressive loss of consciousness

- leads to coma

Question 13

3 major insulin effects that lead to fat storage in adipose tissue

Answer 13

1. Increased utilization of glucose will decrease utilization of fat, functioning as a fat sparer
2. Promotion of fatty acid synthesis
3. Increased uptake of glucose by fat cells and conversion to fatty acids

Question 14

What does insulin deficiency promote?

Answer 14

• increased plasma cholesterol
• increased phospholipid synthesis from fatty acids in the liver
• ketoacidosis

Question 15

High lipid concentration, especially cholesterol, promotes the development of:

Answer 15

Atherosclerosis in people with deficient insulin action

Question 16

When insulin isn’t available, what is used for metabolism?

Answer 16

Fat

Question 17

Byproduct of ketone bodies produces:

Answer 17

• decreased pH

- results in ketoacidosis

Question 18

s/s of DKA

Answer 18

• strong, fruity breath odor
• drowsiness, confusion, difficulty waking up
• blurred vision
• hot, dry, flushed skin
• thirst and excessive urination

Question 19

Lack of insulin: how does this affect protein metabolism?

Answer 19

• can lead to protein wasting

- results in weakness and diminished organ function

Question 20

Insulin does what for protein metabolism?

Answer 20

Increases protein synthesis and storage

Question 21

Insulin is secreted by beta cells in response to

Answer 21

High blood sugar

Question 22

After a meal, what happens to blood glucose and insulin?

Answer 22

• BG increases

- insulin increases

Question 23

In response to insulin increase, what do cells do?

Answer 23

• take in glucose from the blood for nutrition

- blood glucose and insulin levels go back to resting range

Question 24

What happens when blood glucose decreases between meals and during exercise?

Answer 24

• glucagon is activated to cause the liver to release stored glucose
• in order to maintain homeostasis

Question 25

What factors and conditions increase insulin secretion?

Answer 25

- insulin resistance | - obesity

Question 26

How does insulin resistance increase insulin secretion

Answer 26

- cell receptors damaged - glucose can't be absorbed from blood - insulin increased to overcome resistance

Question 27

How does obesity increase insulin secretion?

Answer 27

Belly fat hormones - metabolic syndrome causing insulin resistance - increased BP - Increased lipids - increased cardio disease

Question 28

Normal fasting BG range (without DM)

Answer 28

70-99 mg/dL

Question 29

BG concentration: fasting with diabetes

Answer 29

80-130 mg/dL

Question 30

BG: 2 hours after meals Normal without diabetes

Answer 30

Less than 140 mg/dL

Question 31

BG: 2 hours after meals Someone with diabetes

Answer 31

Less than 180 mg/dL

Question 32

How does the liver act for blood glucose?

Answer 32

Acts as a buffer system

Question 33

How might a pt with liver disease have issues related to blood glucose?

Answer 33

Pts with severe liver disease have problems maintaining narrow range of BG concentrations

Question 34

This is the primary controller in feedback control systems for maintaining normal blood glucose

Answer 34

Insulin

Question 35

Normal blood glucose restoration following meals

Answer 35

- increased glucose - insulin secretion to drive glucose into cells - restores normal BG

Question 36

Decrease in BG leads to decrease in

Answer 36

Insulin

Question 37

What are the critical reasons blood glucose should not rise too high?

Answer 37

1. Glucose can exert large amt of osmotic pressure in extracellular fluid 2. Excessively high level of BG causes "spill" of glucose into urine 3. Glucose in urine can deplete body of fluid and electrolytes 4. Longer term increase in BG may damage many tissues, especially cardiovascular