Diabetes Flashcards
Insulin secreted by _______ cells of the pancreas
Beta
Pancreatic alpha cells secrete _____________.
Glucagon
Pancreatic delta cells secrete __________.
Somatostatin ( inh. Insulin, glucagon, GH)
What tissue does insulin act on? (4)
Liver
Muscle
Brain
Adipose
Insulin actions (6)
Cell growth
Gene expression
Protein synthesis
Gluconeogenesis
Glycogen synthesis
Glucose uptake
Glucagon
Acts to stop blood glucose levels from getting too low
Gluconeogenesis
Glycogenolysis
Increase lipolysis in liver/adipose tissues
Decrease fatty acid synthesis
Adrenaline
Inhibits insulin secretion
Gluconeogenesis
Glycogenolysis
Reduce glucose uptake
Cortisol in crosstalk with insulin
Increase gluconeogenesis and decrease glycogen synthesis in liver
Increase lipolysis in adipose tissue
Acts on pancreas to decrease insulin/increase glucagon
Effect of GH in crosstalk with insulin
Leads to hyperglycaemia
Insulin deficiency leads to
Dehydration
Acidosis
Death
Type 1 diabetes
Younger
Normal weight
No family history
Absolute insulin deficiency
Beta cells destroyed by autoimmunity
Diabetic ketone acidosis
Type 2 diabetes
Middle aged
Overweight
Family history usually
Relative insulin deficiency
Insulin resistance
DKA is rare
Diagnosis of diabetes (4)
Symptoms
Random plasma glucose
Fasting plasma glucose
2 hour level in OGTT
New diabetes diagnostic criteria includes:
HbA1c
When can HbA1c not be used for diagnosis?
Children and young people hence not in T1D
T2D with symptoms of less than 2 months
Pregnancy
Cute diabetes complications
Hypoglycaemia
DKA
Hyperosmolar non-ketotic coma (HONK)
Diabetic ketoacidosis (DKA)
No insulin -> no glucose entering muscles -> increased hepatic gluconeogenesis = > fat burning as alternative energy source(lipolysis) => FFAs and ketone bodies => ketones add H+ to the blood
What’s elevates ketone bodies?
Pregnancy
Starvation
And alcohol
Biochemical abnormalities in DKA
Acidosis
Hyperkalaemia
Raised urea
Raised creatinine
Raised beta-hydroxy butyrate
Urine dip stick positive for ketone bodies and positive for glucose
DKA treatment (2)
IV insulin
Antibiotics
HHS
Hyperglycaemic hyperosmolar syndrome
Common in T2D
High plasma osmolality
No ketones in urea
Macrovascular complications of diabetes
Ischemic heart disease
Peripheral vascular disease
Microvascular complications of diabetes
Retinopathy
Neuropathy
Nephropathy
What’s an early sign of kidney damage?
Albumin leakage
