Diabetes Flashcards
What are the metabolic consequences of T1D
Though blood glucose is high the body thinks it’s low so glucagon levels are raised so the liver remains gluconeogenic and as a result, there is a loss of muscle mass. excess fatty acids get turned into VLDL’s and TAG’s in the liver and enter the bloodstream which increases the risk of CVD
What does prolonged low insulin to glucagon ratio result in
increased mobilisation of fatty acids from adipose tissue
increased amounts of the enzymes required to synthesise and utilise ketone bodies.
Why does increased lipid mobilisation stimulate ketone body production
the increased demand for gluconeogenesis in the liver depleted OAA which increases the level of Acetyl-CoA which is the substrate for ketone bodies.
What effect does hyperglycaemia have on the urine
High glucose levels result in glucose being excreted in the urine with a loss of water due to the osmotic effect, this leads to thirst.
What are short term consequences of T1D
hyperglycaemia, ketoacidosis and hyperosmolar hyperglycaemic state
What are long term consquences of T1D
predisposition to CVD and organ damage, retinopathy (cataracts, glaucoma and blindness)
nephropathy and neuropathy.
How is T1D diagnosed
Fasting blood glucose levels and glucose tolerance test. HBA1c is also used to reflect average blood glucose levels over the lifespan of the blood cells.
How is T1D treated
mimic normal daily insulin secretion, endogenous insulin secretion normally peaks within one hour after a meal.
What is the cause of T2D
A combination of: impaired insulin secretion, increased peripheral insulin resistance and increased hepatic glucose output.
What can cause insulin resistance
Mutations in the insulin receptor gene but most important are defects in the insulin signalling pathway..
