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Metabolism > 8 Diabetes type 1/2 and metabolic syndrome > Flashcards

8 Diabetes type 1/2 and metabolic syndrome Flashcards

1
Q

what are the triad of symptoms in Diabetes?

A

polyuria
polydipsia (thirst)
weight loss

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2
Q

difference b/w type 1 and type 2

A

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

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3
Q

what is diabetic ketoacidosis?

A

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

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4
Q

3 diagnostic tests of diabetes?

A

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

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5
Q

examples of drug medications for diabetes

A

metformin
DPP4 inhibitors
SGLT2 inhibitors
sulphonyureas
thiazolidinediones

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6
Q

what is glycated haemoglobin?

A

% 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%

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7
Q

microvascular long term issues?

A

retinopathy
nephropathy
neuropathy

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8
Q

macrovascular long term issues?

A

risk of stroke
risk of MI (myocardial infarction)
poor circulation to peripheries

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9
Q

hormone that stimulates appetite?

A

Ghrelin

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10
Q

hormone that satisfies?

A

Leptin

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11
Q

definition of metabolic syndrome?

A

group of symptoms ie) insulin resistance, glucose intolerance, hypertension associated w/ central adiposity and dyslipidaemia

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12
Q

what are some risk factors for metabolic syndromes?

A

diabetes
pre-diabetes
obesity
high cholesterol
high BP

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13
Q

what is an epigenetic trait?

A

a stable inherited phenotype causes changes in chromosomes w/o changing DNA sequence

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14
Q

High levels of insulin result in what

A

Hypoglycaemia

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15
Q

How do cannabinioids increase appetite

A

Bind to cannabinoid receptor type 1
Increase eating pleasure
Increase ghrelin and decrease PYY
stimulate secondary neurone without primary

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16
Q

Insulin resistance results in what

A

Hyperglycaemia and hyperinsulinaemia

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17
Q

Liver and muscle convert glucose to what

A

Glycogen

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18
Q

Low levels of insulin result in what

A

Hyperglycaemia

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19
Q

rapid postnatal growth is associated with what

A

risk of obesity

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20
Q

What 2 processes do epigenetics affect

A

histones modification
DNA methylation

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21
Q

What 2 processes do epigenetics affect

A

histones modification
DNA methylation

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22
Q

What are features of ketoacidosis

A

Prostration
Hyperventilation
Nausea
Vomiting
Dehydration

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23
Q

what are some examples of epigenetic factors(4)

A

drugs
aging
diet
enviromental chemicals

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24
Q

what are some examples of hormones that cause uncoupling leading to ATP turnover

A

Thyroid hormones
Cortisol
Growth Hormone

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25
Q

what are some hedonic regulatory system hormones

A

Opioids
GABA
glucose
Cannabinoids

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26
Q

What are some macro vascular complication as a a result of diabetes

A

Stroke
Heart attack
Intermittent claudication
Gangrene

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27
Q

What are the 2 broad long term effects of hyperglycaemia

A

Glycation of proteins
Formation of reactive oxygen species

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28
Q

what are the 2 types of neurones that the arcuate nucleus has

A

primary
secondary

29
Q

what are the 2 types of primary neurones of the arcuate nucleus

A

stimulatory
inhibitory

30
Q

What are the 3 reasons why type 1 diabetes may occur

A

Pancreatic failure
Autoimmune
Genetic

31
Q

what are the genetic components associated with birth weight

A

inheritance
epigenetics

32
Q

What are the osmotic effects of diabetes

A

Polyuria
Polydipsia
Glycosuria

33
Q

what are the receptors on the secondary neurone for a-MSH

A

MC4 receptors

34
Q

what are the symptoms associated with metabolic syndrome

A

insulin resistance
hypertension
abdominal obesity
dyslipidemia

35
Q

what bariatric procedure would have the most effect on ghrelin levels

A

gastric sleeve due to most of stomach being removed and ghrelin released from stomach

36
Q

what bariatric surgery involves removing most of stomach

A

gastric sleeve

37
Q

What dietary components is DNA methylation and histone modification dependant on

A

folic acid
vitamin B12

38
Q

What do DPP4 (diabetic meds) inhibitors do

A

Prevent the breakdown of incretins allowing them to work for longer

39
Q

What Do SGLT2 inhibitors do

A

Inhibit SGLT2 hence prevent glucose reabsorption from proximal tube leading to glucose secretion

40
Q

What do sulphonylureas do

A

Increase insulin release from the beta cells

41
Q

what does amylin do to appetite

A

suppress appetite

42
Q

What does HBA1c measure

A

Cumulative exposure to plasma glucose concentration

43
Q

What does HBA1c measure

A

Cumulative exposure to plasma glucose concentration

44
Q

what does insulin do to appetite

A

suppress appetite

45
Q

what does leptin do to appetite

A

supress

46
Q

what does PYY stand for

A

peptide tyrosine tyrosine

47
Q

What enviromental factors effect birth weight

A

nutrition
alcohol
foetal hypoxia

48
Q

What factors lead to diabetes increasing

A

Obesity
Longevity-people living longer
Poor diets
Sedentary lifestyle

49
Q

what genetic factors affect birth weight

A

maternal pre-pregnancy weight
maternal birth weight
maternal weight gain during pregnancies

50
Q

what health factors affect birth weight

A

intrauterine infections
anaemia
gestational diabetes

51
Q

what is a syndrome

A

A group or recognisable pattern of symptom or abnormalities that indicate a particular trait or disease

52
Q

what is amylin secreted by

A

beta cells in pancreas

53
Q

What is diabetic ketoacidosis

A

Body produces high levels of ketone relating to diabetes

54
Q

What is diabetic ketoacidosis

A

Body produces high levels of ketone relating to diabetes

55
Q

what is DNA methylation

A

methyl group added to DNA and can activate or inactivate a gene

56
Q

what is foetal programming

A

environment surrounding foetus during development has a role in determining disease risk later in life

57
Q

What is glycosuria

A

Excess glucose in urine

58
Q

What is hyperglycaemia

A

High levels of glucose in blood

59
Q

What is used to treat type 1 diabetes

A

Insulin injections

60
Q

What microvascular damage occurs as a result of hypergylcaemia

A

Neuropathy
Retinopathy
Nephropathy
Hypertension

61
Q

what neurotransmitters involved in inhibitory primary neurone of the arcuate nucleus

A

α-MSH
β-endorphin
CART

62
Q

what neurotransmitters involved in stimulatory primary neurone of arcuate nucleus

A

Neuropeptide Y (NPY)
Agouti-related peptide (AgRP)

63
Q

When glycogen storage is full what happens to glucose

A

Glucose to TG
Carried to adipose by VLDL

64
Q

when is ghrelin released

A

when stomach wall empty

64
Q

when is the satiety centre located

A

hypothalamus

65
Q

Where is glucose located in hyperglycaemia

A

In blood because it cannot be taken up by cells

66
Q

where is PYY released from

A

Ileum and colon

67
Q

Why can’t body produce insulin in type 1 diabetes

A

Beta cell destruction in the pancreas

Metabolism (9 decks)

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