8 Diabetes type 1/2 and metabolic syndrome Flashcards by Cordelia Kuti

what are the triad of symptoms in Diabetes?

polyuria
polydipsia (thirst)
weight loss

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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

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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

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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

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examples of drug medications for diabetes

metformin
DPP4 inhibitors
SGLT2 inhibitors
sulphonyureas
thiazolidinediones

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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%

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microvascular long term issues?

retinopathy
nephropathy
neuropathy

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macrovascular long term issues?

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

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hormone that stimulates appetite?

Ghrelin

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hormone that satisfies?

Leptin

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definition of metabolic syndrome?

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

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what are some risk factors for metabolic syndromes?

diabetes
pre-diabetes
obesity
high cholesterol
high BP

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what is an epigenetic trait?

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

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High levels of insulin result in what

Hypoglycaemia

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How do cannabinioids increase appetite

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

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Insulin resistance results in what

Hyperglycaemia and hyperinsulinaemia

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Liver and muscle convert glucose to what

Glycogen

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Low levels of insulin result in what

Hyperglycaemia

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rapid postnatal growth is associated with what

risk of obesity

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What 2 processes do epigenetics affect

histones modification
DNA methylation

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What 2 processes do epigenetics affect

histones modification
DNA methylation

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What are features of ketoacidosis

Prostration
Hyperventilation
Nausea
Vomiting
Dehydration

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what are some examples of epigenetic factors(4)

drugs
aging
diet
enviromental chemicals

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

Thyroid hormones
Cortisol
Growth Hormone

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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