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Alimentary (MEDI302) > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What is the main characteristic of diabetes?

A

The body can’t control blood glucose levels

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2
Q

What is the role of the pancreas?

A

To secrete hormones in response to blood glucose levels

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3
Q

Outline insulin release

A
  1. Glucose is transported into the beta cell by GLUT2.
  2. Glucose is converted to glucose-6-phosphate (glycolysis).
  3. ATP produced.
  4. K+ channels in cell membrane close.
  5. Increase in K+ produces +ve charge inside membrane (a depolarisation)
  6. Voltage-gated Ca++ channels open, Ca++ enters cell
  7. Increase in intracellular Ca++ concentration triggers secretion of insulin via exocytosis.
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4
Q

Outline the insulin receptor and glucose transport process

A
  1. Insulin binds to the alpha subunits on the insulin receptor.
  2. Conformational change induced, transmitted to the beta subunits.
  3. Beta subunits phosphorylate > cascade of phosphorylation and dephosphorylation reactions.
  4. Translocation of GLUT4 to cell membrane
  5. Glucose uptake increases
  6. GLUT4 repackaged into vesicles when glucose levels fall and insulin goes away.
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5
Q

When is glucagon secreted?

A

When blood glucose levels are low

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6
Q

What does glucagon do?

A

Triggers the breakdown of glycogen and promotes gluconeogenesis

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7
Q

What does glucagon activate?

A

Adipose lipase

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8
Q

What does insulin do in the muscles?

A

Promote: gycolysis, glycogenesis and amino acid uptake
Inhibit: glycogenolysis, protein degradation and amino acid release

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9
Q

What does insulin do in adipose tissue?

A

Promote formation of glycerol

Inhibit lipolysis

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10
Q

What does insulin do in the liver?

A

Promote: glycolysis, glycogenesis and fatty acid synthesis
Inhibit: glycogenolysis, gluconeogenesis and ketogenesis

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11
Q

What does glucagon do in the muscles?

A

Promote: glycogenolysis, protein degradation and amino acid release
Inhibit: gycolysis, glycogenesis and amino acid uptake

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12
Q

What does glucagon do in the adipose tissue?

A

Promote lipolysis

Inhibit formation of glycerol

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13
Q

What does glucagon do in the liver?

A

Promote: glycogenolysis, gluconeogenesis and ketogenesis
Inhibit: glycolysis, glycogenesis and fatty acid synthesis

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14
Q

What does insulin do, in general?

A

Promote the use of carbohydrates for fuel and inhibits the use of fats and proteins

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15
Q

What does glycogen do, in general?

A

Promote the breakdown of glycogen, fats and proteins for fuel to raise blood glucose levels

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16
Q

What is diabetes mellitus (diabetes type 1)?

A

The deficiency or absence of insulin

17
Q

Pathogenesis of diabetes mellitus (type 1 diabetes)

A

Autoimmune: immune system damages beta cells

Risk factors: genetic and environmental triggers

18
Q

What percentage of all diabetes cases is diabetes mellitus (type 1)?

A

10%

19
Q

How is diabetes mellitus (type 1 diabetes) managed?

A

Regular insulin injections and maintenance of normal blood glucose levels

20
Q

What are the symptoms of type 1 diabetes (mellitus)?

A 
Excessive urination
Headaches
Blurred vision
Slow healing
Constant hunger
Mood swings
Leg cramps
Weakness and fatigue
Unexplained weight loss
Excessive thirst
21
Q

How is diabetes mellitus (type 1 diabetes) diagnosed?

A

Detection of glucose in the urine
Glucose tolerance test
Blood insulin levels

22
Q

How is type 1 and type 2 diabetes differentiated?

A

C-peptide test

23
Q

What is diabetic ketoacidosis?

A

A condition of untreated diabetes, in which there is a build-up of acetoacetate and beta-hydroxybutyric acid.
Treated by insulin and fluids

24
Q

What are the signs and symptoms of diabetic ketoacidosis?

A

Reduced consciousness, fruity smelling breath, nausea, vomiting, coma, death

25
Q

How is diabetic ketoacidosis diagnosed?

A

Detection of ketone bodies in blood and urine

26
Q

What are the major consequences of untreated diabetes (hyperglycaemia)?

A

Diabetic nephropathy
Diabetic retinopathy, cataracts and glaucoma
Diabetic neuropathy

27
Q

Complications of diabetic retinopathy?

A

Micro-aneurysms -> spots
Swelling and distortion of blood vessels -> reduced blood flow to retina&raquo_space; new blood vessels
Scar tissue > retinal detachment

28
Q

How does diabetes cause glaucoma?

A

Osmotic swelling damages optic nerve fibres

29
Q

How does diabetes cause cataracts?

A

Excess sorbitol > swollen lense&raquo_space; apoptosis in lens epithelial cells

30
Q

Outline the pathophysiology of diabetic neuropathy

A

Hyperglycaemia damages nerve blood vessels > nerve damage.
Lose ability to feel sensations OR feel sensations that aren’t stimulated by the environment.
Complications: ulcers, infections, amputation

31
Q

What is polyol?

A

Increased glucose levels > converted to sorbitol, then to fructose. Increased oxidative stress

32
Q

What are the symptoms of hypoglycaemia?

A

Pale, shakiness, excessive sweating, palpitations, loss of consciousness, seizures

33
Q

What metabolic pathways are activated in untreated type 1 diabetes?

A

beta-oxidation
Gluconeogenesis
Ketogenesis

34
Q

What is type 2 diabetes caused by?

A

Insufficient insulin production or resistance

35
Q

What are the risk factors for type 2 diabetes?

A

Family history
Overweight
Ethnicity

36
Q

What is gestational diabetes?

A

Abnormal glucose tolerance during pregnancy.

Goes back to normal once baby is born

37
Q

What is MODY?

A

Maturity Onset Diabetes in the Young:

Monogenic diabetes caused by autosomal dominant mutations, non-insulin dependent

38
Q

Why does type 2 diabetes develop?

A

In high sugar diets, the pancreas has to constantly secrete insulin to control blood glucose > beta cells work to death.
> cells stop responding to insulin

Alimentary (MEDI302) (7 decks)

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