diabetes Flashcards
what does insulin act on
hepatocytes, myocytes and adipocytes to alter plasma glucose levels
what happens after a meal
rising plasma glucose acts as a signal to the pancreas to release insulin
what is diabetes
disorder of carb metabolism characterised by high blood sugar levels and presence of sugar in urine
effects of hyperglycaemia
glycation of tissue
leads to organ damage
how does hyperglycaemia develop
when insulin production or insulin is inadequate
type 1
insulin dependant
pancreatic beta cells destroyed
daily injection of insulin
type 2
non-insulin dependant
occurs gradually in adulthood
impaired insulin action
obesity
beta cells less responsive to increased glucose
what happens with greater fat availability
decreased glucose oxidation
principle of hyperinsulinaemic euglycaemic clamp
infusion of insulin decreases to high physiological levels
plasma glucose falls as glucose taken up
glucose infused decreases to maintain euglycaemia
what is hyperinsulinaemia
0 hepatic glucose
how does exercise affect transporters
increased conc of transporters
glut4 measures in membrane and microvesicle fractions of muscles
ALCAR increased glut4 translocation
how can exercise improve uptake of glucose in muscle
increased perfusion of active muscle
translocation of glut4 to the cell membrane
increased expression of glut4
increased glycogen synthase activity
alter glycaemic control by
delivery of glucose and insulin into muscle
insulin signalling
amount of glut4
glycogen synthase activity
benefit of muscle hypertrophy
increase in target tissue
benefits of muscle capillary density
increased exposure to target tissue
effects of glycaemic control
less inhibition of insulin induced capillary perfusion
increased insulin signalling - due to reduced adiposity and changes in circulation adipocytokines
increased mrna of glut4
the increased enzyme of glucose storage and oxidationn
insulin resistance leads to
obesity
more dense LDL
decreased HDL-C
hypertension
increased TAG
what switches off grehlin
increases in insulin
attenuated by people with insulin resistance
how to improve sensitivity
reducing fat in the liver and muscle and increasing adiponectin
