38 Flashcards
Sympt oms of Diabetes
• fatigue
• weight loss
• intense thirst
• frequent urination
• hyperglycaemia
• glucosuria
• ketones
Insulin diabetes vs non insulin dependent
Learn the left one
Maintenance of Blood Glucose During the Day
- diabetic vs not
What happens if blood glucose goes low? Very low?
Signal to eat; – may get the “shakes”
If very low < 1 mmol L -1:
Sweating
Heartbeat increases
Sympathetic nervous system may induce vomiting
Cognitive impairment because there is no glucose to provide energy for the brain; can cause aggressive moods, convulsions and coma
What happens if blood glucose goes high?
Non-enzymatic glycation of protein; esp. at Lys residues
Can target crucial structural proteins
Key examples include:
- Collagen in basement membranes of capillaries
- Crystalline protein of the eye, making the lens go opaque
Also, constriction of blood vessels leads to gangrene and limb amputations
Long-term complications of high glucose
Type one and type 2 diabetes
- build up TAGs in blood
- may lose your sight
- nerves and blood flow is restricted due to basement membrane problems
What kind of hormone is insulin
Peptide
what is insulin synthesised by? What in?
pancreas by b cells
What is insulin secreted in response to?
secreted in response to high
glucose (after a meal)
What does insulin act on?
• acts on liver, muscle and adipose
tissue
6 kDa
Actions of insulin
- actively starts things and actively stops thing
- uptake and storage of fuels - anabolic
- anti catabolic
How do u measure how well insulin is working?
… do a glucose tolerance test
Metabolic consequences of lack of insulin
- very similar to what happens in starvation
Diagram of what’s happening when insulin doesn’t work
- no fed signal if insulin not present
- build up of TAGs
- increased risk of atherosclerosis
Mimic starvation
(Glycosuria is glucose in the blood)
Why are the ketone production bad?
Acetone is the bad smell found on diabitics before they die
Lowers ph
Treatment of Diabetes Type 1
• injections of human insulin (recombinant human insulin)
• aim to mimic normal rise in insulin caused by meals
• hypoglycaemia caused by too much insulin
• coma when glucose < 1.0 mmol.L-1
Treatment of Diabetes Type 2
Tissues resistant to insulin
∴ aim to increase sensitivity of tissues to insulin by:
weight loss
increased exercise hypoglycaemic drugs:
sulphonylureas
glitazones
(insulin injection, if necessary)
Western countries at epidemic level
High costs to health care from side effects such as blindness and cardiovascular disease
Can mimic normal situations
Long term complications of type 1 and 2 diabetes
