Diabetes Flashcards
Prevalence diabetes
1/10 or 463 million
Proportion of diabetes patients that has type 2 diabetes
Around 90%
Diabetes increases the risk of
Cardiovascular disease, kidney failure and blindness
Effects of insulin
Stimulate uptake of glucose by skeletal muscle, liver and adipose tissue.
Inhibit synthesis (gluconeogenesis) and secretion of glucose by the liver.
-> Lower blood glucose levels.
Types of diabetes
Type 1 diabetes, type 2 diabetes, gestational diabetes and rare types of diabetes.
Common characteristic of all diabetes types
Hyperglycaemia (= high blood glucose levels)
Characteristics pre-diabetes
- Impaired fasting glucose (IFG)
= Increased fasting blood glucose levels - Impaired glucose tolerance (IGT)
= Increased glucose levels after a meal
Characteristics type 2 diabetes
- Insulin resistance
= Cells respond less well to insulin - Beta-cell failure
= Beta-cells do not produce enough insulin.
Prevalence of diabetes will increase due to
Increase in population size, increase in life-expectancy and increase in obesity prevalence.
‘Categories’ of diabetes complications
Acute metabolic disturbance, macrovascular complications, microvascular complications
Microvascular complications
Affect capillaries and arterioles, particularly in the eye (retinopathy), kidneys (nephropathy) and nervous system (neuropathy)
Structure insulin
51 amino acids, two peptide chains (A & B), contains disulphide bonds
Insulin is produced by
Beta-cells of the Islets of Langerhans (pancreas)
Normal blood glucose levels
3.5-8.0 mmol/L
Counter-regulatory hormone of insulin
Glucagon (produced by pancreatic alpha-cells).
Type 1 diabetes
Autoimmune disease (destruction of beta-cells leads to insulin deficiency), presents at younger age, genetic predisposition (specific HLA types).
Type 2 diabetes
Often in people with poor nutrition and reduced physical activity (obesity), characterized by insulin resistance, presents at older age.
Gestational diabetes
Diabetes appearing (for the first time) in pregnancy. Often dissapears after pregnancy but increases risk of developing diabetes again later in life.
Pathophysiology type 2 diabetes
Nutrient excess > insulin resistance > insulin hypersecretion (compensation) > beta-cell loss > insulin hyposecretion.
Acute presentation of diabetes
Polyuria (excessive urine), thirst, polydipsia (excessive fluid intake), weight loss
Subacute presentation of diabetes
Lack of energy, visual blurring (retinopathy), skin infections, polyneuropathy (tingling/ numbness in feet), arterial disease.
Diagnosis diabetes (+ cut off values)
Fasting plasma glucose (FPG) > 7.0 mmol/L
75-g oral glucose tolerance test (OGTT) > 11.1 mmol/L (after 2 hours)
Glycosylated haemoglobin (HbA1c) > 48 mmol/L
Hypoglycaemia
Low blood glucose (< 3 mmol/L)
Common side-effect of insulin therapy; inject more insulin than needed.
Diabetic ketoacidosis
Accumulation of ketones in the blood due to insulin deficiency.
