Diabetes Flashcards
Pancreas cells
Alpha cells secrete glucagon
Beta cells secrete insulin
Delta cells secrete somatostatin
Glucagon
Facilitates glucose release into the body
Stimulus- decreased blood glucose
Target- liver, adipose tissue, glucose synthesis, glycogen breakdown, elevate blood glucose concentration
Controlled by somatostatin, which inhibits production of glucagon and insulin
Insulin
Stimulus- increase blood glucose level, increased blood amino acids
Targets most cells of the body - facilitating glucose uptake storage of fat and glycogen
Interaction with tyrosine kinase
Controlled by somatostatin, which inhibits production of glucagon and insulin
Metabolism
Sum of all chemical reactions in the body
Anabolism
Synthesis of large biomolecules from smaller ones
Requires input of energy
Fed State
Catabolism
Breakdown of large biomolecules into smaller ones
Releases energy
Fasting state
Carbohydrates in Fed state
Used immediately for energy through aerobic pathways
Use for Lipoproteins synthesis in liver
Stored as glycogen in liver and muscle glycogenesis
Excess converted to fat and stored in adipose tissue
Carbohydrates in fasted state metabolism
Glycogen polymers broken down, glycogenolysis, to glucose in liver and kidney or to glucose six phosphate for use in glycolysis
Carbohydrates, absorbed as
Glucose primarily
Fructose
Galactose
Proteins, absorbed as
Amino acids primarily
Small peptides
Proteins in fed state metabolism
Most amino acids go to tissues for proteins synthesis in liver to intermediates for aerobic metabolism, deamination
Excess converted to fat and started adipose tissue lipogenesis
Proteins in fasted state metabolism
Proteins, broken down into amino acids
Amino acids deaminated in liver for ATP production, or used to make glucose gluconeogenesis
Fats absorbed as
Fatty acids
Triglycerides
Cholesterol
Fats fed states metabolism
Stored as triglycerides, primarily in the liver and Adipose tissue lipogenesis
Cholesterol use for steroid synthesis or as a membrane components
Fatty acids used for Lipoproteins and eicosanoid synthesis
Fats fasted, state metabolism
Triglycerides, broken down into fatty acids and glycerol lipolysis
Fatty acids used for ATP production through aerobic pathways beta oxidation
Fed state
Insulin dominate
Decreases plasma glucose
Fasting state
Glucagon dominates
Helps maintain adequate plasma glucose by promoting
Glycogenolysis
Gluconeogenesis
Ketogenesis
Diabetes mellitus
Abnormally elevated plasma glucose concentration, or hyperglycemia
Complications of diabetes
Eyes
Blood vessels accelerated atherosclerosis
Kidneys, nephron damage
Nervous system polyneuropathy
Diabetic cardiomyopathy
Chronic systemic disorder
Hyperglycemia
Carbohydrate, protein, and fat, metabolism affected
If there is an impaired glucose uptake, the body will do what?
The body will secrete more insulin, hyperinsulinemia, in an effort to bring the blood glucose level down
The pancreas eventually cannot produce insulin
Diabetes type one versus type two
Type one diabetes mellitus- 90% insulin deficiency from auto immune destruction of beta cells
Type two diabetes mellitus -insulin resistant diabetes
Gestational diabetes mellitus
4% of pregnancies
Baby over 9 pounds six weeks after pregnancy normal or reclassify the diabetes mellitus
Testing for diabetes
Hemoglobin A1C
Fasting plasma glucose
Oral glucose tolerance test
Hemoglobin A1C
Reflects glucose level over the past 8 to 12 weeks
Normal A1c level is below 5.7% equivalent to 97 mg/dL of glucose
Fasting plasma glucose
Test- eight hours of fasting blood drawn in the morning
Normal value is less than 100 mg/dL
Oral glucose tolerance test
Fasted for eight hours
Two hours after drinking a liquid containing 75 g of glucose
Normal less than 140 mg /dL
Prediabetes
Hemoglobin A1C 5.7-6.4%
Fasting glucose 100-125 mg/dL
Two hour random plasma 140-199 mg/dL glucose
Diabetes mellitus testing numbers
Hemoglobin A1C > 6.5%
Fasting glucose > 126 mg/dL
Two hour- 200 mg/dL glucose
Type 1 diabetes
Genetic predisposition sometime, preceded by a viral infection, often in childhood juvenile on set
Without insulin sells, go into fasted state metabolism
protein metabolism
Fat metabolism
Glucose metabolism, hyperglycemia
Brain metabolism, excessive eating
Osmotic, diuresis and polyuria
Dehydration
Metabolic acidosis
Breakdown of fat so ketones can be used for energy but ketones are also acids and lead to ketoacidosis fruity breath
Type two diabetes treatment
First therapy- exercise and weight loss
Drugs
Stimulate beta cells, secretion of insulin
Slow digestion, or absorption of carbohydrates
Inhibit, hepatic glucose output
Make target tissues, more responsive to insulin
Promote glucose excretion in urine
Mimic endogenous hormones- amylin, and cretin mimetics
