CDE Pathophysiology 2

Question 1

Which mechanism primarily drives beta-cell dysfunction in long-standing type 2 diabetes?

Accepted Answer

Glucotoxicity and lipotoxicity causing oxidative stress

Answer

Chronic hyperglycemia (glucotoxicity) and elevated free fatty acids (lipotoxicity) generate oxidative stress that progressively impairs and destroys beta cells in type 2 diabetes.

Question 2

In type 1 diabetes, the primary immunological mediators of beta-cell destruction are:

Accepted Answer

Autoreactive CD4+ and CD8+ T lymphocytes

Answer

Autoreactive CD4+ helper and CD8+ cytotoxic T lymphocytes are the principal mediators of beta-cell destruction in type 1 diabetes through a cell-mediated autoimmune process.

Question 3

The incretin effect is significantly reduced in type 2 diabetes primarily because:

Accepted Answer

Beta-cell responsiveness to GIP is diminished

Answer

In type 2 diabetes, GLP-1 secretion may be near-normal but beta-cell responsiveness to glucose-dependent insulinotropic polypeptide (GIP) is markedly reduced, diminishing the incretin effect.

Question 4

Hepatic insulin resistance in type 2 diabetes primarily leads to:

Accepted Answer

Decreased glycogen synthesis and increased gluconeogenesis

Answer

Hepatic insulin resistance impairs insulin's ability to suppress gluconeogenesis and promote glycogen synthesis, resulting in inappropriately elevated fasting hepatic glucose output.

Question 5

Latent autoimmune diabetes in adults (LADA) is best distinguished from type 2 diabetes by:

Accepted Answer

Presence of islet autoantibodies such as GAD65

Answer

LADA is characterized by the presence of islet autoantibodies (most commonly anti-GAD65) in adults who initially appear to have type 2 diabetes but have underlying autoimmune beta-cell destruction.

Certified Diabetes Educator Test Practice Test

Certified Diabetes Educator Test Practice Test

CDE Pathophysiology 2