Pathophysiology of Diabetes Flashcards

Diabetic peripheral neuropathy (DPN) predominantly affects which nerve fiber type first, causing the classic glove and stocking sensory loss pattern?

Answer: Small unmyelinated and thinly myelinated sensory fibers (C and A-delta fibers)

DPN typically begins with dysfunction of small unmyelinated (C) and thinly myelinated (A-delta) fibers responsible for pain, temperature, and autonomic function, causing the length-dependent distal-to-proximal pattern.

Which statement correctly describes the relationship between hyperglycemia and atherosclerosis in diabetes?

Answer: Hyperglycemia accelerates atherosclerosis via endothelial dysfunction, increased LDL oxidation, platelet hyperactivity, and pro-inflammatory pathways

Hyperglycemia accelerates atherosclerosis through multiple mechanisms: endothelial dysfunction, oxidized LDL accumulation, platelet hyperreactivity, increased inflammatory cytokines, and smooth muscle proliferation.

Which mechanism explains how diabetic nephropathy progresses from microalbuminuria to overt proteinuria?

Answer: Hemodynamic and metabolic stress causing glomerular hyperfiltration, basement membrane thickening, and mesangial expansion

Diabetic nephropathy progresses through glomerular hyperfiltration, intraglomerular hypertension, basement membrane thickening, mesangial expansion, and podocyte injury -- leading from microalbuminuria to macroalbuminuria and declining GFR.

Which of the following best explains the phenomenon of the dawn phenomenon in diabetes?

Answer: Early morning hyperglycemia caused by overnight counter-regulatory hormone release (growth hormone, cortisol) that increases insulin resistance

The dawn phenomenon is early morning hyperglycemia caused by physiological surges in growth hormone, cortisol, and catecholamines during the early morning hours that increase hepatic glucose production and insulin resistance.

Which component of the metabolic syndrome most directly drives the development of type 2 diabetes?

Answer: Visceral adiposity with associated insulin resistance

Visceral (central) adiposity is the primary driver of insulin resistance in metabolic syndrome, which is the central mechanism leading to type 2 diabetes.

A CDCES is explaining to a patient why their blood glucose may be higher when they are sick with an infection. Which physiological explanation is correct?

Answer: Infection triggers counter-regulatory hormone release (cortisol, catecholamines) that increases insulin resistance and hepatic glucose production

Illness triggers a stress response involving cortisol and catecholamine release, which increases hepatic glucose output and causes peripheral insulin resistance, raising blood glucose in people with diabetes.