Diabetes

Question 1

what is the insulin signalling pathways

Answer 1

signalling pathways allow glucose to enter the cell thru glucose transporters regulated by GLUT4 receptors

Question 2

What is the insulin dependent pathway (GLUT4 pool B)

Answer 2

insuln binds to the A subunit of the insulin membrane receptor (alpha sub unit signals to the beta subunit that activates tyrosine kinase to phosphorylate the receptor substrate (IRS1)

substate forms a complex that stims the translocation of the GLUT 4 transporter to the cell membrane from intracellular vesicles

Question 3

What is the independent insulin pathway (GLUT4 pool A)

Answer 3

• calcium released from the sarcoplasmic reticulum can lead to the activation of signalling intermediates
• causes translocation of the GLUT4 transporter to the cell membrane and glucose to enter the cell

Question 4

how does increased FFA lead to the pathogenesis of diabetes

Answer 4

intracellular FFA pathways may change the activation of IRS1 complexes that allow for glucose to enter the cell

-FFA presented to cells increase the intramyocellular lipids (IMCLs) which promote the phosphorylation of IRS1

Question 5

dx criteria for diabetes (4)

Answer 5

fasting glu >7mmol

A1c >6.5%

Plama glu in oral test >11.1

random plasma glu >11.1

Question 6

What Ac1 is prediabetics

Answer 6

6-6.4

Question 7

What is the dx criteria of metabolic syndrome

Answer 7

> 3 of the following:

• elevated waist circumference
• elevated TG
• reduced HDLc
• elevated BP
• Elevatedd FastingPG

Question 8

what should glucose be preprandial (before eating) and at bedtime in controlled diabetics

Answer 8

preprandial- 4.4-6.7

bedtime- 5.6-7.8

Question 9

what should HbA1c levels be in those w type 1/2

Answer 9

<7%

Question 10

Pharm agents for management of diabetes (3)

Answer 10

1. Suldonylurea (increases insulin resposne to glu, decreases gluconeogenesis, increases insulin sen)
2. Biguanide (metformin)- decreases output of glu, decreases intestinal glu absorb, increases insulin sen
3. Alpha-glucoside inhibitor- delays glu absorption

Question 11

dietary support supported by evidence for diabetes

Answer 11

• med diet
• DASH diet
• High consumption of while grains, low fat dairy products, yogurt, olive oil, chocolate. fibre. magnesium, favinoids

Question 12

What sups are supported for diabetes

Answer 12

Vit D (risk reduction of 30%)
Fibre
Selenium
Zinc

Question 13

how does cinomin help diabetes

Answer 13

Demonstated sig decrease in FPG and HbA1c levels

-it has been reported that it increases the number of insulin receptor B pros and GLUT 4 pros ultimatly increaseing gluc uptake

2g/day

Question 14

fibre intake and diabetes

Answer 14

high fibre intake did not affect postprandial glucose and insulin respinse or 24hr area under the curve