Diabetes

Question 1

Insulin secreted by _______ cells of the pancreas

Answer 1

Beta

Question 2

Pancreatic alpha cells secrete _____________.

Answer 2

Glucagon

Question 3

Pancreatic delta cells secrete __________.

Answer 3

Somatostatin ( inh. Insulin, glucagon, GH)

Question 4

What tissue does insulin act on? (4)

Answer 4

Liver
Muscle
Brain
Adipose

Question 5

Insulin actions (6)

Answer 5

Cell growth
Gene expression
Protein synthesis
Gluconeogenesis
Glycogen synthesis
Glucose uptake

Question 6

Glucagon

Answer 6

Acts to stop blood glucose levels from getting too low
Gluconeogenesis
Glycogenolysis
Increase lipolysis in liver/adipose tissues
Decrease fatty acid synthesis

Question 7

Adrenaline

Answer 7

Inhibits insulin secretion
Gluconeogenesis
Glycogenolysis
Reduce glucose uptake

Question 8

Cortisol in crosstalk with insulin

Answer 8

Increase gluconeogenesis and decrease glycogen synthesis in liver
Increase lipolysis in adipose tissue
Acts on pancreas to decrease insulin/increase glucagon

Question 9

Effect of GH in crosstalk with insulin

Answer 9

Leads to hyperglycaemia

Question 10

Insulin deficiency leads to

Answer 10

Dehydration
Acidosis
Death

Question 11

Type 1 diabetes

Answer 11

Younger
Normal weight
No family history
Absolute insulin deficiency
Beta cells destroyed by autoimmunity
Diabetic ketone acidosis

Question 12

Type 2 diabetes

Answer 12

Middle aged
Overweight
Family history usually
Relative insulin deficiency
Insulin resistance
DKA is rare

Question 13

Diagnosis of diabetes (4)

Answer 13

Symptoms
Random plasma glucose
Fasting plasma glucose
2 hour level in OGTT

Question 14

New diabetes diagnostic criteria includes:

Answer 14

HbA1c

Question 15

When can HbA1c not be used for diagnosis?

Answer 15

Children and young people hence not in T1D
T2D with symptoms of less than 2 months
Pregnancy

Question 16

Cute diabetes complications

Answer 16

Hypoglycaemia
DKA
Hyperosmolar non-ketotic coma (HONK)

Question 17

Diabetic ketoacidosis (DKA)

Answer 17

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

Question 18

What’s elevates ketone bodies?

Answer 18

Pregnancy
Starvation
And alcohol

Question 19

Biochemical abnormalities in DKA

Answer 19

Acidosis
Hyperkalaemia
Raised urea
Raised creatinine
Raised beta-hydroxy butyrate
Urine dip stick positive for ketone bodies and positive for glucose

Question 20

DKA treatment (2)

Answer 20

IV insulin
Antibiotics

Question 21

HHS

Answer 21

Hyperglycaemic hyperosmolar syndrome
Common in T2D
High plasma osmolality
No ketones in urea

Question 22

Macrovascular complications of diabetes

Answer 22

Ischemic heart disease
Peripheral vascular disease

Question 23

Microvascular complications of diabetes

Answer 23

Retinopathy
Neuropathy
Nephropathy

Question 24

What’s an early sign of kidney damage?

Answer 24

Albumin leakage