Type 2 Diabetes Mellitus – Hyperglycemia

by Carlo Raj, MD

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    Let’s talk about type II. The type II diabetes, the basic characteristics, epidemiology: usually later in life, greater than 30. These patients will be obese as far as you’re concerned and a major, major genetic family history component. In fact, if your mother and father have diabetes, you have close to 100 percent penetrance of you yourself developing diabetes. So, therefore, with that type of history, which you as a clinician would be maybe perhaps interviewing me, would then want to always check for pre-diabetes, right, impaired glucose tolerance, so on and so forth. Here, the patho-physio that you want to know for sure, priority would be the fact that the insulin receptors are resistant. Do you remember those insulin receptors with two beta sub-units, with autophosphorylation in tyrosine kinase? Somewhere in that apparatus of the membrane, the insulin receptor isn’t working. Where’s my glucose? Decreased peripheral glucose uptake resulting in hyperglycemia. The beta cell dysfunction is quite interesting, we’ll walk you through this. So, initially, the patient becomes obese. Okay, gradually; you don’t become obese overnight. As it goes on to become obese, the insulin receptors are working less and less and less which means that now the patient is increasing their glucose step by step by step overtime. In type II diabetes, it’s still possible that you have insulin in your pancreas, correct? Yes, therefore, with that hyperglycemia early on, do you think that your patient with type II diabetes might have hyperinsulinemia? Yeah, lot of research mind you with this because that hyperinsulinemia can actually wreak havoc up and down the body. For example, take a look at the armpits of a patient with type II diabetes or the back of the neck of type II diabetes and you’ll notice there’s darkening of the skin. Nigra means...

    About the Lecture

    The lecture Type 2 Diabetes Mellitus – Hyperglycemia by Carlo Raj, MD is from the course Pancreatic Disease & Diabetes.

    Included Quiz Questions

    1. Most diagnoses are made when patients present with DKA
    2. Disease process most often occurs later in life
    3. A stronger genetic predisposition than with Type 1 DM
    4. Patients are usually obese
    5. Presence of prediabetes is strong indicator of development of disease
    1. β cell dysfunction and impaired insulin secretion
    2. DKA
    3. Hypoglycemia
    4. Decreased response to exogenous insulin
    5. Increased release of glucagon
    1. Amyloid
    2. Hyaline
    3. Lymphocytes
    4. Phospholipase A
    5. Mutated glucagon
    1. Glucagon
    2. Glucokinase
    3. GLUT-4
    4. Insulin receptor
    5. Insulin molecule

    Author of lecture Type 2 Diabetes Mellitus – Hyperglycemia

     Carlo Raj, MD

    Carlo Raj, MD

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