8 Diabetes type 1/2 and metabolic syndrome Flashcards
what are the triad of symptoms in Diabetes?
polyuria
polydipsia (thirst)
weight loss
difference b/w type 1 and type 2
type 1-
common in young age
progressive loss of all or most of beta cells in pancreas (autoimmune);
genetic predisposition seen in markers HLA DR3 and HLA DR4
fatal if not treated
treat w/ insulin
type 2-
common in older age
may have genetic component
may be present for long before diagnosis
treat w/ lifestyle change and eventually insulin
what is diabetic ketoacidosis?
high rate of beta oxidation of fats in liver w/ low insulin/anti-insulin ratio leads to large amounts of ketones (acetone, acetoacetate, beta hudroxybutyrates)
dehydration, fruity breath, tired
3 diagnostic tests of diabetes?
1) random venous plasma glucose >or= 11.1mmol/L
2) fasted plasma glucose >or= 7.0mmol/L
3) plasma glucose >or= 11.1mmol/L 2 hours after oral glucose tolerance
examples of drug medications for diabetes
metformin
DPP4 inhibitors
SGLT2 inhibitors
sulphonyureas
thiazolidinediones
what is glycated haemoglobin?
% of Hb glycated to Hb (sticky blood), indicates effective blood glucose control
HbA1C test - avg of glucose concentration over 2-3 months
healthy 4-6%; diabetes >10%
microvascular long term issues?
retinopathy
nephropathy
neuropathy
macrovascular long term issues?
risk of stroke
risk of MI (myocardial infarction)
poor circulation to peripheries
hormone that stimulates appetite?
Ghrelin
hormone that satisfies?
Leptin
definition of metabolic syndrome?
group of symptoms ie) insulin resistance, glucose intolerance, hypertension associated w/ central adiposity and dyslipidaemia
what are some risk factors for metabolic syndromes?
diabetes
pre-diabetes
obesity
high cholesterol
high BP
what is an epigenetic trait?
a stable inherited phenotype causes changes in chromosomes w/o changing DNA sequence
High levels of insulin result in what
Hypoglycaemia
How do cannabinioids increase appetite
Bind to cannabinoid receptor type 1
Increase eating pleasure
Increase ghrelin and decrease PYY
stimulate secondary neurone without primary
Insulin resistance results in what
Hyperglycaemia and hyperinsulinaemia
Liver and muscle convert glucose to what
Glycogen
Low levels of insulin result in what
Hyperglycaemia
rapid postnatal growth is associated with what
risk of obesity
What 2 processes do epigenetics affect
histones modification
DNA methylation
What 2 processes do epigenetics affect
histones modification
DNA methylation
What are features of ketoacidosis
Prostration
Hyperventilation
Nausea
Vomiting
Dehydration
what are some examples of epigenetic factors(4)
drugs
aging
diet
enviromental chemicals
what are some examples of hormones that cause uncoupling leading to ATP turnover
Thyroid hormones
Cortisol
Growth Hormone
what are some hedonic regulatory system hormones
Opioids
GABA
glucose
Cannabinoids
What are some macro vascular complication as a a result of diabetes
Stroke
Heart attack
Intermittent claudication
Gangrene
What are the 2 broad long term effects of hyperglycaemia
Glycation of proteins
Formation of reactive oxygen species
what are the 2 types of neurones that the arcuate nucleus has
primary
secondary
what are the 2 types of primary neurones of the arcuate nucleus
stimulatory
inhibitory
What are the 3 reasons why type 1 diabetes may occur
Pancreatic failure
Autoimmune
Genetic
what are the genetic components associated with birth weight
inheritance
epigenetics
What are the osmotic effects of diabetes
Polyuria
Polydipsia
Glycosuria
what are the receptors on the secondary neurone for a-MSH
MC4 receptors
what are the symptoms associated with metabolic syndrome
insulin resistance
hypertension
abdominal obesity
dyslipidemia
what bariatric procedure would have the most effect on ghrelin levels
gastric sleeve due to most of stomach being removed and ghrelin released from stomach
what bariatric surgery involves removing most of stomach
gastric sleeve
What dietary components is DNA methylation and histone modification dependant on
folic acid
vitamin B12
What do DPP4 (diabetic meds) inhibitors do
Prevent the breakdown of incretins allowing them to work for longer
What Do SGLT2 inhibitors do
Inhibit SGLT2 hence prevent glucose reabsorption from proximal tube leading to glucose secretion
What do sulphonylureas do
Increase insulin release from the beta cells
what does amylin do to appetite
suppress appetite
What does HBA1c measure
Cumulative exposure to plasma glucose concentration
What does HBA1c measure
Cumulative exposure to plasma glucose concentration
what does insulin do to appetite
suppress appetite
what does leptin do to appetite
supress
what does PYY stand for
peptide tyrosine tyrosine
What enviromental factors effect birth weight
nutrition
alcohol
foetal hypoxia
What factors lead to diabetes increasing
Obesity
Longevity-people living longer
Poor diets
Sedentary lifestyle
what genetic factors affect birth weight
maternal pre-pregnancy weight
maternal birth weight
maternal weight gain during pregnancies
what health factors affect birth weight
intrauterine infections
anaemia
gestational diabetes
what is a syndrome
A group or recognisable pattern of symptom or abnormalities that indicate a particular trait or disease
what is amylin secreted by
beta cells in pancreas
What is diabetic ketoacidosis
Body produces high levels of ketone relating to diabetes
What is diabetic ketoacidosis
Body produces high levels of ketone relating to diabetes
what is DNA methylation
methyl group added to DNA and can activate or inactivate a gene
what is foetal programming
environment surrounding foetus during development has a role in determining disease risk later in life
What is glycosuria
Excess glucose in urine
What is hyperglycaemia
High levels of glucose in blood
What is used to treat type 1 diabetes
Insulin injections
What microvascular damage occurs as a result of hypergylcaemia
Neuropathy
Retinopathy
Nephropathy
Hypertension
what neurotransmitters involved in inhibitory primary neurone of the arcuate nucleus
α-MSH
β-endorphin
CART
what neurotransmitters involved in stimulatory primary neurone of arcuate nucleus
Neuropeptide Y (NPY)
Agouti-related peptide (AgRP)
When glycogen storage is full what happens to glucose
Glucose to TG
Carried to adipose by VLDL
when is ghrelin released
when stomach wall empty
when is the satiety centre located
hypothalamus
Where is glucose located in hyperglycaemia
In blood because it cannot be taken up by cells
where is PYY released from
Ileum and colon
Why can’t body produce insulin in type 1 diabetes
Beta cell destruction in the pancreas
