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PMCOL 344 > Diabetes-2 > Flashcards

Diabetes-2 Flashcards

1
Q

how can you describe insulin release

A

biphasic

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2
Q

what does it mean that insulin release is biphasic (what are the phases)

A

2 phases, first is a spike and it descends a bit then second is more rounded increase then down again

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3
Q

what happens in T2DM with biphasic release

A

the first phase is missing, the second phase is normal

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4
Q

what happens in T1DM with biphasic release

A

both phases absent, its just a straight line of insulin release (being none)

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5
Q

what happens to ions in insulin secreting cells with low plasma glucose

A

K+ exits the cells, making the inside more negative

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6
Q

what happens to ions in insulin secreting cells with high plasma glucose

A

block K+ leaving, Ca++ enters and insulin release

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7
Q

what does adding glucose do to membrane from beta cells

A

increases depolarization, so more insulin secretion

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8
Q

what is the mechanism of action of sulfonylureas

A

inhibit SUR1 , part of the K ATP channels (inhibiting the channel causes insulin release)

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9
Q

what is Kir6.2

A

pore forming subunit to allow K+ to pass through

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10
Q

what does ATP do to Kir6.2

A

inhibits it

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11
Q

what is the mechanism of diazoxide - what does this cause

A

binds to SUR1 to open channel (reduces insulin secretion)

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12
Q

what disease state do you use diazoxide for

A

hypoglycemia

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13
Q

what is a drug we use to inhibit insulin release

A

diazoxide

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14
Q

what do anabolic hormones do

A

uptake and store glucose (as polymer glycogen), amino acids and fats, inhibits catabolism

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15
Q

is insulin anabolic or catabolic

A

anabolic

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16
Q

what does insulin do to the liver

A

inhibits glycogenolysis and gluconeogenesis, stimulates glycogen synthesis, increases lipogenesis —> increases glycogen and triglyceride stores

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17
Q

what does insulin do to the muscle

A

increase glucose uptake by GLUT4 and stimulates glycogen synthesis —> increase glycogen stores

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18
Q

what does insulin do to the adipose tissue

A

increase glucose uptake by GLUT4, stimulates glycerol and fatty acid synthesis (end products of glucose metabolism) —> increase glycogen and triglyceride stores

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19
Q

which tissues get increase TG with insulin

A

liver and adipose

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20
Q

which tissues get increase glycogen with insulin

A

adipose, muscle and liver

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21
Q

which tissues get both increased glycogen and TG stores with insulin

A

adipose and liver

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22
Q

which tissues only get increased glycogen stores with insulin

A

muscle

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23
Q

what kind of receptors does insulin bind to (what mechanism)

A

tyrosine kinase linked receptors

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24
Q

what subunits are in the tyrosine kinase linked receptors that insulin bind to

A

2alpha and 2beta

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25
what happens when insulin binds to its receptors
dimerization and auto phosphorylation on tyrosine residues
26
what happens when there is dimerization and auto phosphorylation on tyrosine residues
phosphorylation of insulin receptor substrate (IRS) proteins
27
what do IRS (insulin receptor substrate) proteins do
interact with -SH2 domain
28
what does insulin do to glycogen fat and protein formation
increase
29
what does insulin do to glucose uptake
increase
30
what does insulin do to glucose utilization
increase
31
what does insulin do to formation of glucose from glycogen fat and protein
decrease
32
what does insulin do to growth
increase
33
what does insulin do to gene expression
increase
34
what does insulin do to blood glucose
decrease
35
what kind of molecule is glucagon
peptide hormone
36
where is glucagon produced
alpha cells and in GI tract
37
is glucagon the fight or flight or rest and digest
fight or flight
38
is insulin the fight or flight or rest and digest
rest and digest
39
what stimulates glucagon secretion (3)
amino acids, low plasma glucose, sympathetic activation (beta adrenoceptors)
40
what inhibits glucagon secretion (2)
somatostatin, high glucose
41
what does glucagon do to plasma glucose
increases
42
what does glucagon do to fat
causes breakdown for more energy
43
what does glucagon do to protein
breakdown for more energy
44
what does glucagon do to glycogenolysis
increase
45
what does glucagon do to gluconeogenesis
increase
46
what does glucagon do to glycogen synthesis
decrease
47
what does glucagon do to glucose oxidation
decrease
48
what does glucagon do to lipolysis
increase
49
what does glucagon do to fatty acid oxidation
increase
50
when do you use glucagon therapeutically
when hypoglycemic and acute heart failure caused by beta blockers
51
what are the mechanisms similar to of glucagon
beta adrenoceptor mediated actions of adrenaline (cAMP)
52
why can glucagon be used in acute heart failure caused by beta blockers
because it has similar actions to beta adrenoceptor mediated actions of adrenaline (cAMP), it can help icnrease cardiac output
53
what is amylin structure
a 37aa peptide
54
when is amylin secreted
co-secreted with insulin
55
is amylin affected in DM
yes, it is absent or reduced
56
what are 3 things that amylin does
inhibits glucagon secretion, delays gastric emptying, acts as satiety agent
57
who may amylin replacement be good for
DM to improve glycemic control
58
what may be bad with amylin replacement therapy
it tends to aggregate and form amyloid fibres, which plays a part in beta cell destruction in T2DM
59
what is a synthetic amylin analogue
pramlintide
60
what is pramlintide
synthetic amylin analogue with improved bioavailability
61
what are incretins
peptides released from gut
62
what are 2 examples of incretins
GLP-1 and GIP
63
what is GIP
glucagon-like insulinotropic peptide
64
what is GLP-1
glucagon-like peptide 1
65
when are incretins released
in response to ingestion of food
66
what stimulates the first peak in insulin release + how
incretins via cAMP production
67
what are 2 main things that incretins cause
stimulate first insulin peak and inhibit glucagon secretion
68
what is DPP-4 / what does it do
terminates the actions of incretins (breaks down GLP-1 and GIP)
69
are incretins affected with T2DM + how
yes, loss of incretin effects
70
what is diabetes mellitus
chronic metabolic disorder characterized by high blood glucose
71
what causes hyperglycemia in DM
uncontrolled hepatic output and reduced uptake of glucose by skeletal muscle with reduced glycogen synthesis
72
why do you drink a lot more in DM
glucose in urine which causes osmotic diuresis, then dehydration
73
what % of people have type1DM that have DM
10%
74
what are 2 main causes of T1DM
immune mediated or idiopathic
75
what happens in T1DM
destruction of beta cells means that pancreas no longer produces insulin, or very little (more than %destruction causes hyperglycemia)
76
what happens in T2DM
body does not produce or respond properly to insulin (insulin resistant)
77
what is gestational diabetes
insufficient insulin secretion and lack of responsiveness during pregnancy, increased chance of both mother and fetus getting DM later
78
what are 2 examples of genetic defects that cause cause types of DM
defects in beta cell function (like K ATP mess up) | defects in insulin action (like receptor defects)
79
what is an example of a disease that can cause DM
pancreatic disease (like CF or pancreatitis)
80
can drugs cause DM
yes
81
can viruses cause DM
yes
82
what is HbA1c + what is the role
glycolated hemoglobin, a measure of average glucose concentrations to which Hb has been exposed over last 3 months
83
what is a good tool to diagnose DM
check HbA1c
84
what is a healthy fasting plasma glucose level in mmol/L
3.89-5.5
85
what is a diabetes fasting plasma glucose level in mmol/L
7+

PMCOL 344 (27 decks)

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