Diabetes Flashcards
What is the process of glycogenesis and which hormones regulate this process?
The conversion of glucose to glycogen due to an increase in insulin and a decrease in glucagon.
What is the process of glycogenolysis and which hormones regulate this process?
The conversion of glycogen to glucose due to a decrease in insulin and an increase in glucagon.
What is the process of gluconeogenesis and which hormones regulate this process?
The conversion of lactic acid and/or amino acids to glucose due to a decrease in insulin and an increase in glucagon.
What is the process of ketogenesis and which hormones regulate this process?
The conversion of fatty acids to ketones due to a decrease in insulin and an increase in glucagon.
What is the process of lipolysis and which hormones regulate this process?
The conversion of triglycerides to glycerol and fatty acids due to a decrease in insulin and an increase in glucagon.
What is the process of lipogenesis and which hormones regulate this process?
The conversion of glucose and/or amino acids to lipids due to an increase in insulin and a decrease in glucagon
Which cells produce insulin and where are they found?
Beta cells located in the islets of Langerhans in the pancreas.
Which cells produce glucagon and where are they found?
Alpha cells located in the islets of Langerhans in the pancreas.
What proteins does insulin activate and what does this do?
Insulin causes the translocation of transporter proteins such as GLUT4 to move to the surface of the cell membrane - these facilitate the influx of glucose into the cell.
Define diabetes.
Abnormal glucose metabolism resulting from defects in insulin release and/or action,
What percentage of diabetes cases are type 1 and type 2?
Type 1 accounts for 5-10% of diabetes cases.
Type 2 accounts for 90-95% of diabetes cases.
What are the causes of type 1 diabetes and who does the disease mainly affect?
The cellular-mediated autoimmune destruction of the pancreatic beta cells meaning that no insulin production can occur.
This can occur abruptly in anyone, but it is often a juvenile onset (under 35). There may be a family history.
It can occur in thin/normal weight individuals
What are the treatments for someone with type 1 diabetes?
Insulin will be required to be injected.
Diet and exercise adjustments can be beneficial in the regulation of blood sugar levels too.
What are the causes of type 2 diabetes and who does the disease mainly affect?
The progressive loss of insulin secretion in line with an increase in insulin resistance.
Insulin resistance occurs most likely due to a high level of fat deposition.
A family history of the disease may be a contributing factor.
It is most likely to occur in those over 40, although there is an increase in juvenile cases as obesity rates rise.
The onset is gradual and can go unseen for up to 10 years.
What are the treatments for someone with type 2 diabetes?
It requires weight loss, diet change and exercise.
It can require oral hyperglycemic drugs and in some cases insulin.
What are the modifiable risk factors of type 2 diabetes?
Weight, Inactivity, A previously identified glucose intolerance, metabolic syndrome, diet and smoking.
What are the non-modifiable risk factors of diabetes?
Ethnicity, family history, age, gender, a history of gestational diabetes and inflammation.
What is a normal blood sugar level? (In HbAC1, fasting levels and 2hr plasma glucose terms)
HbAC1 = <5.7%
Fasting glucose levels = <5.6 mmol/L
2hr Plasma glucose levels = <7.8 mmol/L
What is a prediabetes diagnosis blood sugar level? (In HbAC1, fasting levels and 2hr plasma glucose terms)
HbAC1 = <5.7-6.4%
Fasting glucose levels = 5.6-6.9 mmol/L
2hr Plasma glucose levels = 7.8-11 mmol/L
What is a diabetes diagnosis blood sugar level? (In HbAC1, fasting levels and 2hr plasma glucose terms)
HbAC1 = >6.5%
Fasting glucose levels = >7 mmol/L
2hr Plasma glucose levels = > 11.1 mmol/L
Describe the onset of type 2 diabetes.
Resistance to insulin starts to occur as influencing factors such as fat deposition increases.
The body adapts by increasing insulin production thus maintaining homeostasis.
However, as resistance continues more and more insulin is needed - the pancreas becomes overloaded and insulin production can fall thus a rise in blood glucose levels.
What is hyperglycemia and what are the symptoms?
Too much glucose in the blood.
The symptoms are increased urine output, headache, fatigue and weakness.
What is Hyperosmolar Nonketonic Syndrome?
Dehydration caused by high blood sugar levels - it can lead to decreased mentation and even coma.
What is Diabetic Ketoacidosis and what are the symptoms?
When insulin is very low or absent fat metabolism increases and ketone production in the liver rises.
This can cause abdominal pain, nausea, vomiting, rapid or deep breathing, sweet/fruity smelling breath and can lead to coma or even death.
What is hypoglycemia?
Too little glucose in the blood - it can also be termed ‘insulin shock’.
What symptoms does hypoglycemia lead to and why?
Shakiness, weakness, sweatiness, nervousness, anxiety and tingling mouth and fingers occurs due to an increase in stress hormones (adrenaline and cortisol)
Headaches, visual disturbances, confusion, amnesia, seizures and comas can occur due to a decreased availability of glucose to the brain (Neuroglycopenia).
What glucose level is considered hypoglycemic?
When blood glucose drops to 3.3-3.89 mmol/L
What can cause hypoglycemia?
Too much insulin or antidiabetic agent
Too little CHO intake or missed meals
Too much/excessive exercise
What causes Macrovascular disease and what is the risk of this condition?
Insulin resistance and consequent hyperglycemia and hyperinsulinemia contribute to vascular injury and the progression of atherosclerosis.
It leads to an increased risk of CAD, stroke and peripheral artery disease.
What is retionopathy?
Damage to the small blood vessels that supply the retina at the back of the eyes.