Diabetes and its effect on metabolism Flashcards
what is type 1 diabetes caused by
caused by an autoimmune destruction of beta cells in the pancreas
what happens in type 2 diabetes
occurs when cells become resistant to the effects of insulin and the pancreas cannot make enough insulin to overcome the resistance
what are the risk factors for type 1 diabetes
family history and age
when are you likely to develop type 1 diabetes
at young ages
which type of diabetes is insulin dependent
type 1
what are the risk factors for type 2 diabetes and prediabetes
- overweight
-over 45 years of age - immediate family member with type 2
- not physically active
-had gestational diabetes - certain ethnic groups
which form of diabetes is more common in americans
type 2
what are common symptoms of diabetes
-urinating often
- thirsty
- feeling hungry even though you are eating
- extreme fatigue
- blurry vision
-cuts/ bruises are slow to heal
- weight loss even though you are eating (type 1)
- tingling, pain , numbness in hands and feet (type 2)
what is the normal, prediabetic, and diabetic fasting plasma glucose levels
normal: under 100
pre: 100-125
diabetic: over 125
what is the normal, prediabetic, and diabetic concentration for oral glucose tolerance test
normal: less than 140
pre: 140-199
diabetes; greater than 200
what do prolonged high blood glucose levels lead to
production of advanced glycation end products (AGEs)
what is HbA1c
glycated form of hemoglobin
how often do we take HbA1c and why
every 3 months because that is the time of RBC turnover
what does HbA1c measure
blood glucose over a long period of time
what happens in the insulin binding pathway when the insulin receptor doesn’t recognize insulin or cant bind it
glut4 transporters are not moved to the membrane to transport glucose into the cell so circulating levels of glucose remain high
what pathway is blocked when insulin cant bind to its receptor
PI3K/Akt/mTOR
what effect does diabetes have on other organ systems
- cardivascualr disease
- neuropathy
-nephropathy - retinopathy
- poor wound healing
-skin conditions
-hearing impairment - alzheimer’s disease
what inflammatory response is increased in diabetic patients
TNF-alpha and IL-1 levels are increased
what causes the inflammatory response in diabetic patients
- glycemic control
- AGE’s
-periodontal disease
what happens to fatty acid production if you don’t produce enough insulin or receptor does not recognize insulin
FA production increases
what substance causes vasodilation
eNOS
what substance causes vasoconstriction
angiotensin 2
what are the 2 forms of diabetic retinopathy
dry and wet
what are the 2 phases in diabetic retinopathy
- nonproliferative retinopathy
- proliferative retinopathy
what happens in the nonproliferative retinopathy stage
forms cotton wool spots that obstructs the retina and creates blurred vision
what happens in proliferative retinopathy
abnormal growth of blood vessels in the eye that are irreversible
what form of retinopathy is more common
dry
what are the various forms of insulin available for type 1 diabetes
rapid acting, short acting, long acting
how can type 2 diabetes be controlled
diet, exercise, maintain healthy weight, medications
how does insulin medication work
lowers blood glucose by stimulating cellular uptake and glycogen synthesi
how does metformin work
works on the liver to reduce the release of glucose in type 2 diabetes
how do sulphoylureas work
increase insulin release by pancrease
how do GLP-1 receptor agonists work
incretin receptor agonists
how do DPP-4 inhibitors work
increase incretin levels
how do thiazolinediones work
reduces fatty acid oxidation and thereby increases use of glucose as fuel
what other pathways does insulin increase the rate of
glycogen synthesis and lipogensis
what do angiotensin and renin do
peptide hormones that cause vasoconstriction and subsequent rise in blood pressure
what is the mechanism of action of the angiotensin/renin pathway
renin cleaves angiotensin into angiotensin 1 which is then used to form angiotensin 2 from ACE
what does NO do
powerful vasodilator with a short half life
