5. Diabetes Basic Science Flashcards
name the 4 catabolic hormones that work against insulin
glucagon , catecholamine, cortisol and growth hormone
Define diabetes mellitus
reduction in action of insulin enough to cause a level of hyperglycaemia
what is non-diabetic hyperglycaemia and what 3 things does it relate to
insulin action is reduced to such that glucose is raised above normal but not enough to cause microvascular damage
NDH - non diabetic hyperglycaemia
IGT- impaired glucose tolerance
IFG- impaired fasting glucose
What percentage of people will diabetes have;
type 1
type 2
10% type 1
90% type 2
why are type 1 diabetes ketosis prone
they produce no insulin at all so fat is burned inappropriately and in an uncontrolled way which generates ketones
why are type 2 diabetics ketosis resistant
you only need a small amount of insulin to stop fat being burned uncontrollably
which cells in the islets of langerhans of the pancreas is responsible for producing
- insulin
- glucagon
insulin by beta cells
glucagon by alpha cells
why does T1 DM occur
the pancreas stop producing insulin
beta-cell destruction possibly by viruses such as coxsackie B virus and enterovirus
organ specific autoimmune
Why does T2 DM occur
repeated exposure to glucose and insulin makes the cells in the body become resistant to the effects of insulin
The beta cells become fatigued and resistant
insulin resistance and reduced insulin sensitivity
What are the non-modifiable risk factors for T2 DM
older age
ethnicity (black, Chinese, South Asian)
note that use lower threshold for diagnosis ini these patients eg BMI
family history
what are the modifiable risk factors for T2 DM
Obesity
Sedentary lifestyle
high carbohydrate diet (particularly refined carbs)
why do people with hyperglycaemia have an increased risk of infections (opportunistic infections)
it weakens their immune system
What is the difference inn mean age of onset in nT1 and T2
T1 less than 30
T2 greater than 30
What other autoimmune diseases are associated with T1 DM
thyroid disease, perniciouus anaemia, Addisons disease, coeliac disease
what is HbA1c and why is it used
glycated haemoglobin
RBC have a lifespan of around 3-4 months so this is a better estimate of glucose levels
