Diabetes Flashcards
Type 1 diabetes
- juvenile diabetes
- genetic/ environmental component
- underlying mech involves autoimmune desruction of insulin prod beta cells
- 5-10% of diabetes
Type 2 diabetes
Adult onset (50% are obese)
- insulin resistant skeletal muscle
- 90-95% of diabetes
complications T2DM
- CVD
- lower limb amputation
- kidney failure
- cognitive dysfunction
symptoms of T2DM
- fatigue (not braking down energy sources)
- extreme thirst (to dialate glucose)
- extreme hunger
- lean body loss
flow or how muscle atrophy+ decreased insulin signaling happens due to T2DM
metabolic acidosis
increase FFA
Inflammation (IL6, TNfa)
increase glucose
all lead to decreased insulin signaling
normal insulin signaling
- 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
Non normal insulin signaling
-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
Ischemia affects
increase ROS, Ca, Calpain, H+, decrease ATP, inhibition of oxidative phosphorylation
reprofusion affects
increase ROS, Ca, Calpain, Caspase-3, opens MPTP which leads to cell death
both ischemia and reprofusion lead to
mitochondrial injury and cardiac cell death due to necrosis and apoptosis
exercise effects on CVD
- 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)
Mediators for cardioprotection
- 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
Endurance training effect against I-R injury
increases SOD2 which alters mito turnover and phenotype which provides cardio protection
Heart failure + symptoms
when heart is unable to pump sufficiently to maintain bf to the body
-shortness of breath, fatigue, swelling in legs, rapid/irregular heart beat
2 types of heart failure
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
cardiovascular improvement w endurance/Hiit
- increase Vo2 max
- decrease resting HR
- Increase LV size
- improved systolic and diastolic lv function
