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Applied Biochemistry > Diabetes and its Effect on Metabolism > Flashcards

Diabetes and its Effect on Metabolism Flashcards

1
Q

diabetes mellitus

A

a group of diseases is which the body does not properly control the amount of sugar (glucose) in the blood

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2
Q

type 1 diabetes

A

destroys beta cells of the pancreas

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3
Q

type 2 diabetes

A

causes insulin resistance at receptor and post receptor levels

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4
Q

which type is insulin dependent diabetes?

A

type 1

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5
Q

type 1 diabetes is usually caused by

A

an autoimmune destruction of insulin producing beta-cells in the pancreas

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6
Q

type 2 diabetes occurs when cells become

A

resistant to the effects of insulin and the pancreas cannot make enough insulin to overcome the resistance

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7
Q

type 2 diabetes is not

A

insulin dependent

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8
Q

risk factors of type 2 diabetes (2)

A

family history

age (can get type 1 at any age, but more likely to develop at younger ages)

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9
Q

type 1 diabetes is a disease which can strike children and adults suddenly and requires supplemental insulin along with

A

carefully regimented diet and exercise to manage properly

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10
Q

who is generally diagnosed with type 1 diabetes?

A

children, teenagers, young adults

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11
Q

what causes type 1 diabetes?

A

it is unknown, but it is believed that autoimmune, genetic, and environmental factors are involved

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12
Q

since the beta cells are the source of insulin, patients with type 1 diabetes must

A

receive daily insulin injections via a pump to stay alive

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13
Q

prediabetes and type 2 diabetes risk factors (6)

A

overweight
>45 years of age
immediate family member with type 2 diabetes
not physically active
has gestational diabetes (given birth to a baby over 9 lbs)
certain ethnic groups

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14
Q

how many Americans have diabetes? how many are type 1?

A
  1. 3 million

1. 25 million

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15
Q

the percentage of those >65 with diabetes is

A

25%

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16
Q

how many people over age 18 have prediabetes?

A

84.1 million

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17
Q

what is the estimated cost of diabetes in the US in 2017

A

327 billion

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18
Q

common symptoms of diabetes (8)

A 
urinating often
feeling very thirsty 
feeling very hungry 
extreme fatigue 
blurry vision
cuts/bruises that are slow to heal 
weight loss even though you are eating more (type 1)
tingling, pain, or numbness in the hands/feet (type 2)
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19
Q

fasting blood glucose levels
normal
prediabetes
diabetes

A

normal: <100 mg/dl
prediabetes: 100-125 mg/dl
diabetes: >126 mg/dl

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20
Q

oral glucose tolerance test
normal
prediabetes
diabetes

A

normal: <140 mg/dl
prediabetes: 140/199 mg/dl
diabetes: >200 mg/dl

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21
Q

prolonged high blood glucose levels will lead to the production of

A

advanced glycation end-products (AGEs)

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22
Q

AGEs result from

A

a chain of chemical reactions following an initial non-enzymatic glycation reaction (chemical reaction of glucose with a body protein or lipid)

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23
Q

AGEs are believed to play a causative role in

A

vascular complications airing with long term diabetes as well as a factor in normal aging and worsening of many degenerative diseases

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24
Q

the higher the blood glucose concentration and the longer the hyperglycemia, the

A

higher AGEs

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25
Q

HbA1c

A

glycated form of hemoglobin

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26
Q

HbA1c corresponding to

A

3 month average plasma glucose level

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27
Q

HbA1c is used to measure

A

the average blood glucose concentration over a longer period of time compared to a fasting glucose or glucose tolerance test

28
Q

glycation is — and is only removed upon degradation or turnover

A

non-reversible

29
Q

HbA1c test

A

glaciated or glycosylated hemoglobin set

a common test used to further diagnose diabetes and/or how well it is being managed

30
Q

HbA1c
normal
prediabetes
diabetes

A

normal: <5.7
prediabetes: 5.7-6.4
diabetes: >6.5

31
Q

cells sense insulin through

A

insulin receptors

32
Q

insulin binding to its receptor results in the activation of the

A

PI3K/Akt/mTOR signaling pathway

33
Q

signaling through this pathway may be blunted by high circulating levels of

A

free fatty acids

34
Q

consequences of diabetes on organ systems (8)

A 
cardiovascular disease 
neuropathy (nerve damage)
nephropathy (kidney damage)
retinopathy 
poor wound healing (especially lesions on feet)
skin conditions
hearing impairment 
Alzheimers disease
35
Q

which autoinflammatory responses are increased in diabetes? (2)

A

TNF-alpha

IL-1

36
Q

why might glycemic control may be important in this response>

A

since the crevicular fluid IL-1 were almost 2 fold higher in patients with HbA1c levels greater than 8% compared with patients whose HbA1c levels were less than 8%

37
Q

another factor in enhanced inflammation is the accumulation of AGEs which

A

bind to receptors on inflammatory cells and further increase production of proinflammatory cytokines like IL-1 and TNF-alpha

38
Q

how can periodontal disease affect diabetes?

A

systemic bacterial and viral infections such as the common cold or influenza result in increased systemic inflammation which increases insulin resistance. in the same way, chronic periodontal infections can exacerbate insulin resistance and worsen glycemic control

39
Q

hormone sensitive lipase triggers the

A

release of FFA from stored triglycerides

40
Q

diabetic retinopathy

A

poor vascular tone leads to micro hemorrhage, obscure the retina, leads to blindness

41
Q

what type of receptor is the insulin receptor?

A

tyrosine kinase receptor

when insulin binds to the insulin receptor, the tyrosine kinase autophosphorylates, leading to downstream signaling

42
Q

glucose monomers are strung together into long polymers linked by

A

a-1,4 linear bonds

a-1,6 branching bonds

43
Q

ways in which people are born with genetic risk for type 2 diabetes (2)

A
  • a genetic inability of the tissues to respond to insulin (or insulin resistance)
  • a genetic instability of the insulin producing cells to secrete enough insulin to overcome the insulin resistance
44
Q

can you genetically test for type 2 diabetes?

A

no, there is no single genetic test to identify type 2 diabetes or individuals at risk for type 2 diabetes

45
Q

type 1 rapid acting insulin (2)

A

humalog

novorapid

46
Q

type 1 short acting insulin (2)

A

humalin R

novolin R

47
Q

type 1 long acting insulin (3)

A

Lantus
Levemir
tresiba

48
Q

insulin formulations come from (3)

A

animals
human (bioengineered)
analogs (sub group of human insulins)

49
Q

how to control type 2 diabetes (4)

A

diet
exercise
maintaining healthy weight
medications

50
Q

IRS1

A

insulin receptor substrate-1, substrate of the insulin receptor tyrosine kinase and a participant in insulin signaling

51
Q

IRS 2

A

insulin receptor substrate-2, substrate of the insulin receptor tyrosine kinase and a participant in insulin signaling

52
Q

PPARG

A

peroxisome proliferator activated receptor gamma. Act by controlling networks of target genes. Act as lipid sensors (fatty acids ) and regulate energy metabolism and adipocyte differentiation.

53
Q

PAX4

A

expressed in beta cells of pancreas and functions to increase survival

54
Q

AKT2

A

an isoform of phosphoinositide dependent protein kinase AKT which is implicated in insulin dependent signaling

55
Q

GCK

A

glucose kinase. The phosphorylation of glucose at the sixth carbon position is the first step in glycolysis. Glucokinase is expressed only in mammalian liver and pancreatic islet beta cells. Because of its unique functional characteristics, the enzyme plays an important regulatory role in glucose metabolism, e.g., the rate of glucose metabolism in liver and pancreas is a function of the activity of the enzyme.

56
Q

GCGR

A

glucagon receptor that mediates signaling by coupling via GTP-binding proteins to adenylate cyclase. Mutation in GCGR leads to reduced glucagon affinity and late-onset non-insulin dependent diabetes mellitus.

57
Q

RETN

A

resistin. Linked to obesity and down-regulated in adipocytes treated with thiazolidinediones, antidiabetic drugs that interact with PPARgamma receptor.

58
Q

GLUT4 (SLC2A4)

A

Mutation in Glut4 glucose transporter: Non-insulin dependent diabetes

59
Q

insulin hormone lowers blood glucose by stimulating

A

cellular uptake and glycogen synthesis. (ex: Humalin R)

60
Q

metformin works on the liver to

A

reduce release of glucose in type 2 diabetes

61
Q

acarbose

A

by inhibition of intestinal alpha glucosides, it delays carbohydrate digestion prolongs overall carbohydrate digestion, reducing the rate of glucose absorption

62
Q

sulphonylureas increase

A

insulin release by pancreas

63
Q

GLP1 receptor agonists

A

incretin receptor agonists

-bind to incretin receptor to stimulate insulin release

64
Q

DPP4 inhibitors

A

increase incretin levels

65
Q

thiazolidinediones

A

reduces fatty acid oxidation and thereby increases use of glucose as a fuel

66
Q

SGLT2 inhibitors

A

sodium glucose contrasporter inhibitor, blocks reabsorption of glucose to the kidney

Applied Biochemistry (52 decks)

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