Diabetes Flashcards
how is glucose stored in the body
liver as glycogen
adipose tissue as fat
stored in muscles as glycogen
what by definition is diabetes
high levels of blood glucose ie hyperglycaemia
what is the normal range for blood glucose, high and low
around 5 mmol/L
low is less than 4 and high is more than 11
what is the role of alpha and beta cells, delta and gamma cells in the pancreas
alpha - produce glucagon
beta cells produce insulin (75% of cells)
delta - produce somatostatin
gamma - pancreatic polypeptide
what is also released when insulin is made
c peptide
what type of disease is diabetes, what are the signs and symptoms
syndorme
symptoms - thirst, polyuria, weightless and tiredness
signs - dry mouth, weight loss, hyperglycaemia
what is the diagnosis of diabetes
fasting glucose higher than 7 mmol/L
75g oral glucose tolerence test
HbA1c criteria - more than 48mmol/L
what is the difference between type 1 and type 2 diabetes
type 1 - autoimmune destruction of islet beta cells usually young people
type 2 - insulin resistance due to genetics or obesity - mainly older people
what is the pathophysiology of type 1 diabetes
HLA2 and environmental trigger
T1DM autoantibodies, rapid onset, weight loss, diabetic ketoacidosis
insulinitis - inflammation of islets of langerhams due to infiltrating macrophages and T/b cells
what are the symptoms and management of type 2 diabetes
minimal weight loss, vision or foot ulcers, fungal infection
exercise and diet
oral metformin
what is gestational diabetes, risk factors, consequences and management
during pregnancy
high OGTT after fasting
high BMI, can cause pre-eclampsia, still birth develop T2DM in mother
manage wit diet and metformin but also insulin
when would you not use HbA1c for diabetes testing
for pregnant women
what are three types of genetically inherited diabetes
MODY - maturity onset diabetes in young - autosomal dominant inheritance
maternal inherited diabetes and deafness
Wolfram syndrome (DI, DM, optic atrophy and deafness)
what type of disease of the pancreas lead to secondary diabetes
chronic / calcific pancreatitis
cystic fibrosis fuses pancreatic duct
haemochromatosis - iron overload
what types of drugs can induce diabetes
diuretics
steroids
antipsychotics / psychiatric
retroviral in HIV
how does acromegaly cause diabetes
high growth hormone levels can increase in blood glucose and cause diabetes
how can cushings cause diabetes
excess cortisol independent of ACTH secretion - causes high glucose
how does a pheochromocytoma cause diabetes
tumour of chromatin cells that secrets high amounts of catecholamines - increases blood glucose
what hormones oppose the action of insulin and increases blood sugar
glucagon, adrenaline/ NA, glucocorticoids such as cortisol
what are stimulants of insulin release
glucose, fattt acids and ketones, vagal nerve stimulation, drugs prostaglandins
what causes the inhibition of insulin release
sympathetic stimulation, alpha adrenergic agents (dopamine, serotonin etc)
what is the role of glucagon, what stimulates and inhibits it
increase secretion of insulin and growth hormone by negative feedback
increase glucose levels
induce - glycogenolysis, glujconeogeneis and lipolysis
simuli - amino acids, beta aderergic stim, exercise
inhibition - glucose, free fatty acids, ketones
what organ aids monitoring of blood glucose
hypothalamus
what happens during hyperglycaemia via hypoglycaemia
hyper - insulin - lower levels
hypoglycaemia - glucagon, pituitary - ACTH to adrenal cortex - cortisol
pituitary - GH - increase levels
Pituitary - adrenal medulla - adrenaline and catecholamines increase blood glucose
