Diabetes

Question 1

Type 1 diabetes

Answer 1

• juvenile diabetes
• genetic/ environmental component
• underlying mech involves autoimmune desruction of insulin prod beta cells
• 5-10% of diabetes

Question 2

Type 2 diabetes

Answer 2

Adult onset (50% are obese)

• insulin resistant skeletal muscle
• 90-95% of diabetes

Question 3

complications T2DM

Answer 3

• CVD
• lower limb amputation
• kidney failure
• cognitive dysfunction

Question 4

symptoms of T2DM

Answer 4

• fatigue (not braking down energy sources)
• extreme thirst (to dialate glucose)
• extreme hunger
• lean body loss

Question 5

flow or how muscle atrophy+ decreased insulin signaling happens due to T2DM

Answer 5

metabolic acidosis
increase FFA
Inflammation (IL6, TNfa)
increase glucose

all lead to decreased insulin signaling

Question 6

normal insulin signaling

Answer 6

• when insulin binds to receptors phosphate sites open + autophosphorylation occurs
• IRS gets phosphorylates and activates P13K which converts PIP2 to PIP3
• PIP3 phosphorylates PDK1 which goes to AKT
• AKT travels to AS160 which dissociates from GLUT4

Question 7

Non normal insulin signaling

Answer 7

-FFA will come into cell and block IRS1 and increase ROS which blocks P13K
-both cause PIP2 not to become PIP3
TNFa allso activates IKK which blocks IRS1

Question 8

Ischemia affects

Answer 8

increase ROS, Ca, Calpain, H+, decrease ATP, inhibition of oxidative phosphorylation

Question 9

reprofusion affects

Answer 9

increase ROS, Ca, Calpain, Caspase-3, opens MPTP which leads to cell death

Question 10

both ischemia and reprofusion lead to

Answer 10

mitochondrial injury and cardiac cell death due to necrosis and apoptosis

Question 11

exercise effects on CVD

Answer 11

• increase parasympathetic regulation protecting against ischemia-reprofusion injury
• promotes muscle derived myokines
• can improve myocardial regeneration capacity
• can reverse loss of muscle mass/strength
• angiogenesis (coronary collaterization)

Question 12

Mediators for cardioprotection

Answer 12

• NO increases vasodialation (less likely for obstruction)
  -HSP- increase immediatly following ex, protects pro from ROS
  -ER stress pro- protects from calcium overload
  cystolic antioxidants- fight against free rads in mitochondria
  SODI1/2- found in matrix of mito, converts reactibe O2 rto H2O2

Question 13

Endurance training effect against I-R injury

Answer 13

increases SOD2 which alters mito turnover and phenotype which provides cardio protection

Question 14

Heart failure + symptoms

Answer 14

when heart is unable to pump sufficiently to maintain bf to the body
-shortness of breath, fatigue, swelling in legs, rapid/irregular heart beat

Question 15

2 types of heart failure

Answer 15

HF w/ preserved ejection fraction
- stiff and thick chambers, maladaptive

HF w/ reduced ejection fraction
-stretched and thin chambers, can fill heart just not strong enough to pump blood out

Question 16

cardiovascular improvement w endurance/Hiit

Answer 16

• increase Vo2 max
• decrease resting HR
• Increase LV size
• improved systolic and diastolic lv function