Insulin Physiology | Type 1 | Type 2 | Complications | Treatment |
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What is GLUT-4?
This transport protein is stored in vesicles of insulin-target cells, especially muscle cells and adipocytes.
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What is a Type IV HSR?
T1DM is mediated by this type of hypersensitivity reaction, resulting in the destruction of pancreatic beta cells.
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What is insulin resistance?
This phenomenon describes the failure of target tissues to normally respond to insulin.
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What is glucagon?
In DKA, epinephrine release blocks the secretion of insulin, while stimulating the secretion of this hormone.
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What is a monomer?
The forms of insulin consisting of this molecular unit diffuse readily into the blood and have a fast onset of action.
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What is epinephrine?
The production of insulin in the pancreas is inhibited by this hormone during the fight or flight response.
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What are HLA-DR3 & DR4?
The genetic susceptibility of T1DM is associated with these 2 HLA haplotypes.
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What is central obesity?
This pattern of obesity results in adipocytes that carry out more lipolysis than adipocytes of subcutaneous fat, resulting in increased free fatty acids.
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What is sorbitol?
The accumulation of this substance causes the osmotic damage that mediates cataracts and diabetic neuropathy.
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What is regular insulin?
This type of insulin is administered IV to treat DKA and HHS.
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What are amino acids?
Though glucagon typically acts as a counter-regulatory hormone, both insulin and glucagon increase cellular uptake of these molecules.
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What is viral infection?
This environmental factor is hypothesized to have epidemiological association with the development of T1DM due to phenomena such as the "bystander effect" or "molecular mimicry".
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What is acanthosis nigricans?
This skin finding of hyperpigmented plaques in the folds of the neck and axillae is commonly associated with insulin resistance.
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What is type IV collagen?
Advanced glycosylation end products (AGEs) cause the cross-linking of this protein, leading to hyaline arteriolosclerosis.
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What is Detemir?
In addition to glargine, this type of insulin also controls basal levels of glucose and is known as "peakless".
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What is hormone sensitive lipase?
Insulin stimulates fatty acid uptake in peripheral tisues by stimulating capillary lipoprotein lipase synthesis; it also decreases the plasma fatty acid level by inhibiting this hepatic enzyme.
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What is the thymus?
The fundamental immune abnormality in T1DM is the result of defective negative selection that takes place in this organ.
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What is Hyperglycemic Hyperosmolar Syndrome (HHS)?
This complication of T2DM manifests as mental status changes in elderly patients who can't mainain adequate fluid intake.
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What are cotton wool spots?
This finding on fundoscopic exam represents optic nerve infarction due to retinal ischemia.
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What are secretagogues? (sulfonylureas/meglitinides)
This class of drugs cannot be used in T1DM because they bind to the beta cells of the pancreas to stimulate insulin release and thus require functional islets.
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What is the PI3K pathway?
The intrinsic tyrosine kinase activity of the insulin receptor activates this downstream sequence via IRS proteins, leading to the metabolic effects of insulin on glucose transport.
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What is glutamic acid decarboxylase?
This beta-cell enzyme important for neurotransmitter synthesis is a proposed target of auto-antibody attack in T1DM.
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What is amylin?
This peptide packaged and secreted in beta cells with insulin can form fibrils that stain Congo Red.
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What is acetyl-CoA?
In DKA, beta oxidation of fatty acids results in the excess production of this intermediate at a rate faster than it can enter the TCA cycle, resulting in the formation of ketones.
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What are alpha glucosidase inhibitors?
This class of drugs known for causing side effects mimicking lactose intolerance is the only diabetes drug that inhibits glucose absorption in the small intestine.
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