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Biology > Diabetes 💘 > Flashcards

Diabetes 💘 Flashcards

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AP® Biology flashcards Biology 101 flashcards
1
Q

LADA

A

Late autoimmune disease in adults
Mixture of type one and two
Up to 25% of cases

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2
Q

Gestational

A

Diabetes when pregnant

Hormone changes causes insulin resistance and resolves on birth of baby

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3
Q

MODY

A

Maturity onset off diabetes in young
Very rare
Linked to mutation in one gene

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4
Q

Type 1 diabetes

A

An auto immune condition while the immune system targets the insulin secreting beta cells in the islets of Langerhans in the pancreas for destruction

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5
Q

Phase 1 of type 1 diabetes

A

Beta cells death, might be natural or infection induced.
Usually in pancreatic remodeling beta cells die via apoptosis and removed by macrophages.
In this case excess B cell apoptosis so macrophages can’t remove quickly enough

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6
Q

Phase 2 t1

A

Priming of alter reactive b cells and T cells.

Dendritic cells pick up the antigen and take it to the pancreatic lymph nodes/islet of Langerhans, known as insulitis.

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7
Q

Phase 3 t1

A

Back in the pancreas destruction of beta cells.
Period of regulation after initial influx of activated immune cells . Lots of regulation activities as well as cytokines cd 8+ T cells increase CTL potential and Kill b cells by apoptosis.
Innate natural killer cells and macrophages potentiate this destruction

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8
Q

HLA

A

People who express HLA II molecule DQ8 and HLA I molecule A2 have a higher risk of developing t1 diabetes

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9
Q

Genetics-signal strength

A

Signal strength between the tissue restricted antigen presented by MHC & TCR governs fate of new T cells.
If weak T cells live as it’s non-auto reactive if strong T cells die as it’s auto reactive.
This is called negative selection and it’s believed that diabetes is inadequate at this and causes weak bonds and auto reactive resulting in release

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10
Q

Allelic variants

A

Altered based in genes encoding immunoregulatory proteins
Can occur in cytotoxic T cells associated antigen CTLA for involved in switching off T cells.
PTPN 22 is involved in regulation of signals for both the TCR and BCR

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11
Q

Variable number of tandem repeats

A

This encodes insulin transcription in the thymus. Less than 50 VNTR leads to low insulin so weaker bonds and a higher risk of type one diabetes.

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12
Q

Environmental factors of t1 diabetes

A

Type one diabetes is more prevalent in the northern hemisphere and can be linked to vitamin D levels as it makes immune response more affective but autoimmune less effective

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13
Q

Incretin effect

A

Amounts of insulin produced in blood should be high when given oral glucose and lower amounts when given isoglycaemic intravenous glucose
in type two it’s low insulin produced for both

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14
Q

Type 2 diabetes

A

Insulin resistance/Insentivity linked yo impaired trafficking of glut 4 to cell membrane which allows glucose to enter cell
High fat diet causes this because the fat kinases inhibit the glucose kinases
Also increase in ros reducing mitochondria activity

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15
Q

Macrophage difference in type two

A

Normally m2 anti inflammatory macrophages on adipose with mediators IL4 IL13
In insulin resistance there’s m1 pro inflammatory macrophage and release of its cytokines and ssip oki Ed causing increased gluconeogenesis in liver and skeletal muscle as arteriosclerosis and hyaline arteriosclerosis occurs reducing blood flow and gas exchange in vessels

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16
Q

Diabetic kidney disease

A

Raised glucose layers chemical composition of kidney leading to malfunction and leakage of protein into urine
Proteins can cross link causing fibrosis/scarring replacing normal tissue resulting in kidney failure

17
Q

Diabetic neuropathy

A

Family of nerve disorders
Can be symptomless tingling or loss if feeling
Large fibres affect ability to sense vibrations
Small fibres u can’t feel pain temp or body function
Proximal motor affects butt hops and thigh one sided
Entrapment is chronic compression of nerves -pain

18
Q

Diabetic foot syndrome

A

Due to nerve and artery damage if you get a cut u won’t feel it and it will get infected and cause ulcers
Increased risk of amputation

19
Q

Diabetic neuropathy

A

Leasing cause of blindness
Background retinopathy-tiny bulges in vessel but no damage
Pre proliferative- more severe damage to vessels leading to leakage of blood into eye
Proliferative-scar tissue formation and weaker new vessels causing extensive leakage of blood into eye

20
Q

Metformin

A

Biguanide which improves insulin resistance through a camp mediated mechanism
Reduced glucose production in liver glucose uptake in muscle and glucose absorption in gut

21
Q

Advantages of metformin

A

Hba1c reduction of 11mmol/mol
Weight neutral
Improves cardiovascular mortality

22
Q

Disadvantages of metformin

A

GI upset
Reduced vitamin b12 absorption
Should be avoided in people with kidney problems

23
Q

Sulfonylureas

A

Increases first and second phase insulin secretion in response to a rise in plasma glucose

24
Q

Advantages of sulfonylureas

A

Rapidly absorbed orally

Hba1c reduction of 11-15 mmol/mol

25
Q

Disadvantages of sulfonylureas

A

Hi disturbance
Hypoglycaemia
Weight gain
Hypersensitivity reactions

26
Q

Thiazolidine

A

Modulates transcription of insulin sensitising genes in liver skeletal muscle and adipose tissue

27
Q

Tjiazolidine advantages and disadvantages

A

Reduce hb1ac by 11
No hypoglycaemia risk
GI issues headache swelling weight gain liver dysfunction and increased of fractures and bladder cancer

28
Q

GLP drugs

A

Glucagon like peptide 1 derived from inestinal l cells
GIP derived from k cells
Incretin hormones which activate b cells and suppress a cells
These drugs are agonists for these

29
Q

Advantages and disadvantages of GLP drugs

A

Reduce weight

Gi issues decreased appetite headache gastritis reflux disease and possible pancreatitis

30
Q

DPP 4 inhibitors

A

Aka gliptins

Make glp 1 stay in blood longer

31
Q

DPP 4 advantages and disadvantages

A

Weight neutral
Oral preparation
Mild gi symptoms
Increase in respiratory infections possible pancreatitis and exfoliative dermatitis

32
Q

Types of Insulin

A 
Shot acting 
Intermediate acting 
Premixed (mix of short and intermediate)
Long acting 
Pens injection pump
33
Q

Side effects of insulin

A

Hypoglycaemia
Allergic reactions/lipoatropy of subcutaneous fat
Injection site problems

34
Q

Familial renal glucosuria

A

Rare disease causing glucose loss in urine at normal glucose levels (4-7)
Two types a and b
A has lower threshold so less glucose reavsorption
SGLT2 receptors absorb glucose in kidneys and it’s defective in this disease

35
Q

Treatment for familial renal glucosuria

A

SGLT2 inhibitors tablets
Promotes weight loss
No hypoglycaemia risk
But increased genitourinary infections

Biology (39 decks)

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