carbohydrate metabolism disorder Flashcards
what are the glucose metabolism
glycolysis
kerb cycle
oxidative phosphorylation
what is glycolysis and what does it produce?
Break down glucose and produce pyruvate
Produces 2 ATP and 2NADH
what is the primary regulatory hormone in glucoregulation?
insulin
action of the insulin
binds to extracellular alpha-subunits
which cause a conformational change
role of insulin on glucose
insulin facilitates the translocation of GLUT-4 from vesicles to the cell membrane
What does GLUT-4 do?
Forms a pore that allows glucose to diffuse into the cells
where is glucose stored?
liver in the form of glycogen
does insulin have any relation with rate of glycogen synthesis?
yes
insulin increases the rate of glycogen synthesis by activating glycogen synthase
insulin decrease the rate of glycogen breakdown
what other function does insulin have other than glucose synthesis?
increase lipogenesis
promotes protein synthesis
counter-regulatory hormones
what does hyperglycaemia mean?
high blood sugar level
What is diabetes mellitus
most prevalent cause of hyperglycaemia
lack of / insensitivity to insulin
type 1 DM
absolute lack of insulin
cause by autoimmune destruction of pancreatic beta cells
what are pathogenesis of type 1 DM?
lymphocytes infiltrate into pancreatic islets and destroy B-cells
symptoms of type 1 DM
- thirst
- polyuria / nocturia
- dehydration
- fatigue
- diabetic ketoacidosis
what’s so special about diabetic ketoacidosis?
occurs in type 1 DM only
insulin deficiency that can cause:
- gluconeogenesis
- glycogenesis
- decreased peripheral utilization of glucose
increased metabolism of fatty acids and ketones as energy substrates
what is shock
insufficient blood circulating into the tissues
what are the types of shock
Hypovolemic
Cardiogenic
Obstructive
Distributive
what is obstructive shock
anatomical blockage of the great vessels of the heart
which leads to decreased venous return, increased afterload, and decreased cardiac output
what is cardiogenetic shock
a life-threatening condition in which your heart suddenly can’t pump enough blood to meet your body’s needs
What is hypovolemic shock
an emergency condition in which severe blood or other fluid loss, then makes the heart unable to pump enough blood to the body
cause organs to stop working
what is distributive shock
a medical condition in which abnormal distribution of blood flow in the smallest blood vessels results in an inadequate supply of blood to the body’s tissues and organs.
how can we manage type 1 DM
exogenous insulin
pancreas transplant
islet cell transplant
artificial pancreas
what are the treatment of DKA
- insulin
- fluid replacement
- potassium (ONLY if the patient is hypokalaemic)
- bicarbonate
what is hypokalaemia
low potassium level in your blood stream
causes of cerebral oedema
inflammation
fluid overload
coagulopathy
what is diabetes mellitus type 2
insulin resistance - decreased biological response to normal insulin levels
mechanism unclear - defect in intracellular signalling pathway for insulin receptor to be active
what is diabetic nephropathy
progressive kidney disease
caused by damage to the capillaries in the kidney glomeruli
lead to end stage i.e. renal failure
define chronic complications
long-term problems that can developm gradually
define acute complications
short-term problem that can happen anytime
types of chronic complication of diabetes
retinopathy Nephropathy Neuropathy ischaemic heart disease cerebrovascular disease peripheral vascular disease
where will Diabetic nephropathy first affects?
glomerular basement membrane (GBM)
how will DN cause a problem?
Increase glycoprotein in glomeruli
change in permeability and increase in hydrostatic pressure
treatment for diabetic nephropathy
improved glycaemic control
treatment with anglotensin converting enzyme inhibitor (ACE)
what is diabetic retinopathy
caused by microvascular complication
how does diabetic retinopathy affects us
microanuerysms burtst causing occlusion of sight
why do complications hppen
hyperglycaemia promotes non-enzymatic attachment of glucose to protein molecules
schiff base <== glucose + non-enzymatic
v
changes physical / biochemical structure
v
reduces its solubility and result in cataract formation
What are the macrovascular disease (give example)
big vessel disease
i.e. heart disease
cerebrovascular disease
prevention of macrovascular disease
stop smoking reduce cholesterol level arterial surgery angioplasty stents
What is hypoglycaemia
where plasma glucose is < 2.2mmol/L
symptoms of hypoglycaemia during sleep
crying out or having nightmares
sweating enough to make your pj / sheets damp
feeling tired, irritable to confused after waking up
What causes hypoglycaemia
error of metabolism
- galactosaemia
- hereditary fructose intolerance
- glucogen storage disease
what is galactosaemia
galactokinase deficiency
metabolic disorder
how many types in galactosaemia
3
why is hypoglycaemia so significance
lactose is broken down into glucose and galactose
toxin level buid up
galactose-1-phosphate ==> galactitol
causes of hypoglycaemia
liver disease
endocrine disease
adrenal failure
stress
