diabetes

Question 1

what are the complications of diabetes

Answer 1

hyperglycaemia
cardiovascular, renal, retinal, neurologic complications

Question 2

where is insulin synthesised

Answer 2

B-cells of the Islets of Langerhans

Question 3

what is the half life insulin and c peptide

Answer 3

Insulin: half-life: 4-10 min
Peptide C half -life: 20-50 min

Question 4

what is the role of insulin in the liver

Answer 4

Insulin stimulates glycogen synthesis (glycogenesis),
inhibits synthesis of new glucose (inhibits gluconeogenesis)
stimulates glycolysis (for the synthesis of fatty acids),

Question 5

what is the role of insulin in the muscle

Answer 5

Stimulates glucose uptake (translocation of GLUT-4)
Stimulates amino acid uptake and protein synthesis
Glucose will be used for glycolysis (20-50%) and synthesis of muscle glycogen

Question 6

what is the role of insulin in adipose tissue

Answer 6

stimulates glucose uptake (translocation of GLUT-4), and metabolism into glycerol-phosphate
promotes triglyceride storage
Inhibits release of fatty acids and stimulates lipogenesis.
Activates adipose tissue lipoprotein lipase

Question 7

what is gluconeogenesis

Answer 7

synthesis of new glucose (induced by adrenaline and glucagon, cortisol)

Question 8

what is glycolysis

Answer 8

degradation of glucose into small products (induced by insulin) for ATP or fatty acid synthesis

Question 9

what is glycogenolysis

Answer 9

degradation of glycogen into glucose (glucagon, adrenaline)

Question 10

what is glycogenesis

Answer 10

synthesis of glycogen from glucose (insulin, cortisol)

Question 11

what is lipolysis

Answer 11

degradation of fatty acid (inhibited by insulin. Promoted by cortisol, adrenaline, GH)

Question 12

what is lipogenesis

Answer 12

synthesis of fatty acid and triglyceride (insulin)

Question 13

what is glucagon

Answer 13

Important role in maintaining normal concentrations of glucose in blood by potently increasing blood glucose levels.

Question 14

what is glucagon inhibited by

Answer 14

Insulin, high levels of glucose

Question 15

what are incretins

Answer 15

gastro-intestinal hormones which regulates insulin secretion (glucagon like peptides)

Question 16

what are effects of glucagon like peptides on stomach cell

Answer 16

slows gastric emptying

Question 17

what are effects of glucagon like peptides on cns cell

Answer 17

promotes satiety

Question 18

what are effects of glucagon like peptides on alpha cells

Answer 18

inhibits glucagon secretion

Question 19

is insulin therapy required in T1D

Answer 19

insulin therapy is essential to prevent ketoacidosis

Question 20

what do sulphonureus do

Answer 20

potentiates insulin secretion (insulin secretagogues)
(tolbutamide, glibenclamide, gliclazide etc)

Question 21

what do biguanides do?

Answer 21

reduces hepatic glucose production (metformin)

Question 22

what do thiazolinediones do

Answer 22

increase peripheral glucose utilisation

Question 23

what do sglt do

Answer 23

inhibit renal reabsorption of glucose)

Question 24

what is the criteria for diabetes

Answer 24

Diabetes symptoms (ie polyuria, polydipsia and unexplained weight loss if type I) plus
a random plasma glucose concentration › 11.1 mmol/l or
or a fasting plasma glucose concentration › 7.0 mmol/l (whole blood › 6.1mmol/l) or glucose tolerance test:
plasma glucose concentration two hours after 75g glucose intake.

Question 25

what are the 5 steps for type two diabetes

Answer 25

1. lifestyly interventions
2. start metformin
3. sulphonylurea
4. add insulin
5. consider glitazone