2 - insulin and diabetes

Question 1

difference between type 1 and type 2 diabetes?

Answer 1

type 1 - inability to produce insulin
type 2 - insulin resistance in muscle so muscle is unable to use glucose

• they both lead to increased blood glucose

Question 2

what does insulin stimulate?

Answer 2

the uptake, use and storage of glucose

• glucose ->glycogen (glycogenesis)
• triglyceride synthesis (lipogenesis)
• protein synthesis

Question 3

what does insulin inhibit?

Answer 3

• glycogen breakdown (glycogenolysis)
• glucose production (gluconeogenesis)
• fat breakdown
• protein breakdown

Question 4

what is diabetes?

Answer 4

its a disease where the body’s ability to produce or respond to the hormone insulin, leading to hyperglycemia

Question 5

type 1 diabetes explained

Answer 5

• decreased insulin from pancreas is delivered to blood vessels
• increased glucose due to low insulin
• muscle unable to use glucose due to low insulin
• glycogen and protein breakdown causes keto-acidosis

Question 6

type 2 diabetes explained

Answer 6

• sufficient insulin from pancreas is delivered to blood stream
• increased glucose in blood stream
• muscle unable to use glucose due to insulin resistance
• obesity, inheritance and other factors leading to insulin resistance

Question 7

what are the 3 P’s?

Answer 7

polyuria - the need to urinate frequently
polydipsia - increased thirst and fluid intake
polyphagia - increased appetite

Question 8

what are the changes in adipose tissue with increasing adiposity?

Answer 8

• lean with normal metabolic function
• obese with mild metabolic function
• obese with full metabolic disfunction

key points: increased inflammation and loss of metabolic control

Question 9

what is intermediate hyperglycaemia “prediabetes”

Answer 9

• biochemical state where a person has impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT)

Question 10

what is metabolic syndrome?

Answer 10

a cluster of interrelated metabolic abnormalities that ca increase the risk of diabetes and other conditions

Question 11

How does polyuria come about?

Answer 11

BGL levels are elevated causing the filtration rate to exceed the amount that the kidneys can absorb

Question 12

How does polydipsia come about?

Answer 12

Results from intracellular dehydration because BGL rise

Question 13

How does polyphagia come about?

Answer 13

Results from cellular starvation and the depletion of carbs, fats and proteins

Question 14

What does “osmotic diuresis” mean?

Answer 14

Glucose polar molecule > gets in urine and takes H2o with it

Question 15

What would the HbA1c and FBG tests results show for someone with intermediate hyperglycemia?

Answer 15

HbA1c = 41-49mmol/L

FBG: 6.1-6.9 mmol/L

Question 16

What level of HbA1c and FBG results in the diagnoses of diabetes?

Answer 16

HbA1c = 50mmol/L or greater 
FBG = >7mmol/L

Question 17

What are the risk factors in getting T1DM?

Answer 17

genes

pre/post viral infection

Question 18

What is the pathogenesis of T1DM?

Answer 18

activates the immune system
infiltration of beta cells in pancreas
leading to destruction

Question 19

what are some diagnostic tests that can be used for T1DM?

Answer 19

• HbA1c
• fasting blood glucose (FBG)
• glucose tolerance test
• measure antibodies

Question 20

Signs and symptoms of T1DM

Answer 20

3 P’s
weight loss
fatigue

Question 21

management of T1DM

Answer 21

• try to match insulin dose with food intake

- exercise

Question 22

What are acute complications of T1DM

Answer 22

• hypoglycemia (brain not getting enough glucose DKA)

Question 23

what are chronic complications of both type 1 and type 2 diabetes?

Answer 23

• retinopathy,
• amputations,
• neucopathy (nerve damage)
• nephronpathy (kidney damage)
• infections
• poor wound healing

Question 24

what are the risk factors of T2DM

Answer 24

• genes
• age
• ethnicity
• envrionment factors
• low physical activity
• increased BP
• metabolic syndrome

Question 25

what is the pathogenesis of T2DM

Answer 25

insulin resistance - insulin is not being recognised by cells, causing an increase in insulin secretion, beta cell failure, causing a rise in blood glucose resulting in diabetes

Question 26

what are some diagnostic tests for T2DM

Answer 26

HbA1c x 2 (repeated to confirm diagnosis)

Question 27

signs and symptoms of T2DM

Answer 27

• non specific
• less clear
• blurred vision
• poor wound healing
• 3 p’s but not as obvious

Question 28

management of T2DM

Answer 28

• weight loss
• healthy diet
• decrease in saturated fats

Question 29

acute complications of T2DM

Answer 29

• hypoglycemia

- coma

Question 30

define insulin resistance

Answer 30

an impaired response of the body to insulin, resulting in increased levels of glucose in the blood

Question 31

why is it important to identify people with intermediate hyperglycemia?

Answer 31

they have a 70% chance of developing diabetes

Question 32

what is ketoacidosis?

Answer 32

• The body starts breaking down fat to use as energy because it cant use glucose as its energy source
• the process of breaking down fat for energy releases a by product called ketones resulting in ketoacidosis

Question 33

metabolic syndrome is a cluster of interrelated metabolic abnormalities diagnosed by co-occurance of 3 out of 5 issues. what are the 5 abnormalities?

Answer 33

• abdominial obesity
• increased fasting glucose
• hypertension
• high serum tryglycerides
  low high-density cholesterol (HDL-C) levels (good cholesterol)