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Molecular Basis of Disease > An overview of diabetes > Flashcards

An overview of diabetes Flashcards

1
Q

What is the greek original word for Diabetes?

A

Siphon

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2
Q

What is the greek original word for Mellitus?

A

Honey

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3
Q

What is diabetes?

A

Group of metabolic disorders characterised by hyperglycemia

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4
Q

What are the symptoms of diabetes?

A

Polyuria

Polydypsia

Unexplained weight loss

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5
Q

Are all patients symptomatic?

A

No

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6
Q

What causes type I diabetes?

A

Immune mediated

Idiopathic

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7
Q

What percentage of the diabetic population has Type II diabetes?

A

85%

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8
Q

What are possible causes of type I diabetes?

A

Viral cause

Genetic predisposition

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9
Q

What is gestational diabetes?

A

Diabetes diagnosed in pregnancy

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10
Q

Does everyone with diabetes present with symptoms?

A

No

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11
Q

What are the diagnostic criteria for patients with diabetes symptoms?

A

A random venous plasma glucose concentration above 11.1 mmol/l

A fasting plasma glucose concentration above 7 mmol/l

A two hour plasma glucose concentration above 11.1 mmol/l two hours after 75g anhydrous glucose in an oral glucose tolerance test

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12
Q

What are the diagnostic criteria for patients without diabetes symptoms?

A

Diagnosis should depend on the outcome of more than one plasma glucose determination test

Test should be taken on separate days

If the fasting values are not diagnostic, the two hour value should be used

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13
Q

How is HbA1c used for diabetes diagnosis?

A

It is used to identify the 3-month average plasma glucose concentration

Provides more than just a snapshot of the blood glucose levels

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14
Q

How is the HbA1c concentration related to the blood glucose?

A

The higher the HbA1c concentration, the higher the blood glucose concentration has been over 3 months

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15
Q

Why does HbA1c reflect the blood glucose levels over a 3 month period?

A

Once a haemoglobin molecule is glycated, it remains that way

A buildup of glycated haemoglobin within the red cell reflect the average level of glucose to which the cell has been exposed to during its life cycle

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16
Q

In which situations is HbA1c not appropriate for diabetes diagnosis?

A

All children and young people

Patients of any age suspected of having type I diabetes

Patients with symptoms of diabetes less than 2 months

Patients at risk who are actually ill

Patients taking medication that may cause rapid glucose rise

Patients with acute pancreatic damage

Pregnancy

Presence of genetic, haematologic and illness-related factors that influence HbA1c and its measurement

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17
Q

Which cells produce insulin?

A

Beta cells of the pancreas

18
Q

What causes insulin to be released?

A

Increased blood glucose

19
Q

What is the major function of insulin?

A

Maintains low blood glucose

20
Q

What are the other functions of insulin?

A

Stimulates lipogenesis

Decreases lipolysis

Increases amino acid and glucose transport into cells

Increases glycogen synthesis

21
Q

Describe the steps of insulin release and delivery to tissues

A
  1. Beta cells are clustered together into islets in the pancreas
  2. When glucose is released from capillaries into the pancreatic tissue, it triggers the release of insulin from beta cells
  3. Insulin travels to other parts of the body, mainly muscle and fat
  4. Here, insulin helps store glucose for energy
  5. The surfaces of muscle and fat are covered in insulin receptors
  6. When insulin binds to the insulin receptor, it brings the extracellular structures of the receptor together and causes the intracellular structures to unwind
  7. The intracellular protein sets off a long signalling cascade
  8. The cascade causes the intracellular receptor glut4 to translocate into the cellular membrane
  9. This allows glucose into the cells.
22
Q

What is lacking in type I diabetes?

A

Insulin

Beta cells get destroyed

23
Q

What is lacking in type II diabetes?

A

Insulin receptor sensitivity

24
Q

What is the main risk factor for type II diabetes?

A

Obesity

25
Q

How many people in the UK have been diagnosed with diabetes?

A

3.7 million

26
Q

The diabetic population in the UK has doubled in the last 20 years

TRUE or FALSE

A

TRUE

27
Q

What percentage of people with diabetes are overweight?

A

80%

28
Q

What is the underlying pathogenic mechanism behind type II diabetes?

A

Insulin resistance

B-cell dysfunction

29
Q

What happens early on the disease progression in type II diabetes?

A

Pancreatic b-cells compensate for the insulin resistance by producing increased amounts of insulin

When insulin resistance increases past a threshold level, the body can no longer compensate

This results in hyperglycemia

30
Q

What are non-modifiable risk factors of diabetes?

A

Age

Family history

Ethnicity

History of gestational diabetes

Polycystic ovarian syndrome 1

31
Q

What are modifiable risk factors of diabetes?

A

Overweight and obesity

Physical inactivity

Disturbances in intraurine development

Metabolic syndrome

Dietary factors

Depression

Low socio-economic status

32
Q

Which pathways link obesity to insulin resistance?

A

Endocrine, inflammatory and neuronal pathways

33
Q

Which physiological changes in obesity inhibit insulin signaling?

A

Obesity-associated inflammatory factors

Endocrine and inflammatory mediators converging on kinases

Increasing fatty acid concentration

34
Q

How have GWAS been helpful in Type 2 diabetes?

A

Helped to associate SNPs with Type II diabetes

35
Q

In which process were the SNPs associated with type II diabetes involved with?

A

Pancreatic beta-cell function

36
Q

Do patients with molecular disorders similar to those that happen in diabetes necessarily express the condition?

A

No

37
Q

What type of disorder is type I diabetes considered as?

A

Autoimmune disorder

38
Q

Which risk factors have been associated with type I diabetes?

A

Variants in HLA genes

Accounts for 40% of the genetic risk factor for the condition

39
Q

What are other types of diabetes?

A

Maturity onset diabetes

Gestational diabetes

40
Q

What percentage of the NHS budget is allocated towards diabetes control?

A

10%

Molecular Basis of Disease (28 decks)

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