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Biochemistry > Diabetes And Its Effect On Metabolism + Periodontal Disease and Diabetes > Flashcards

Diabetes And Its Effect On Metabolism + Periodontal Disease and Diabetes Flashcards

1
Q

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

A

Diabetes mellitus

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2
Q

Type of diabetes that is insulin-dependent

A

Type 1

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3
Q

Type of diabetes that is not dependent on insulin

A

Type 2

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4
Q

Type of insulin that is usually caused by an autoimmune destruction of insulin producing β-cells in the pancreas.

A

Type 1

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5
Q

Typos of insulin that occurs when cells become resistant to the effects of insulin and the pancreas cannot make enough insulin to overcome the resistance.

A

Type 2

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6
Q

Type 1 diabetes risks factors:

A
  • family history

- age (any age but more likely at younger age)

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7
Q

disorder of the human immune system that makes it difficult for the body to produce insulin:

A

Type 1 diabetes

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8
Q

What happens to the body when it doesn’t have insulin?

A

cannot convert sugar from food into nutrients for cells which causes excess sugars to build up in the blood stream and may eventually cause severe damage to organs and premature death.

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9
Q

which type let of diabetes does not produce insulin?

A

Type 1

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10
Q

Which type of diabetes causes insulin resistance at receptor and post-receptor levels?

A

Type 2

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11
Q

Type 1 diabetes is generally diagnosed in which population?

A

children, teens, young adults

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12
Q

Which factors are involved in the cause of T1D?

A

autoimmune, genetic, environmental

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13
Q

T1D occurs when the body’s immune system attacks and destroys the ___ cells in the ____.

A

beta

pancreas

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14
Q

Since the ____ are the source of insulin, patients with ____ must receive daily injections of insulin in order to stay alive.

A

beta cells

T1D

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15
Q

Prediabetes and T2D risk factors:

A
  • overweight
  • > 45 y/o
  • immediate family member with T2D
  • not physically active
  • had gestational diabetes
  • certain ethnic groups (AA, Hispanic/Latin American, American Indian, Alaskan Native)
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16
Q

The majority of diabetes causes in America are which type of diabetes?

A

T2

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17
Q

There is a correlation of ____ rates and diabetes prevalence in America.

A

obesity

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18
Q

What are the clinical symptoms of uncontrolled diabetes?

A
  • pee often

- very thirsty often

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19
Q

Prolonged high blood glucose will lead to the production of:

A

Advanced Glycation End-products (AGEs)

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20
Q

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

A

AGEs

Hg associated

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21
Q

This product is believed to play a causative role in vascular complications arising with long term diabetes as well as a factor in normal aging and worsening of many degenerative diseases.

A

AGEs

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22
Q

The higher the blood glucose and the longer hyperglycemia, the (lower/higher) the AGEs.

A

higher

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23
Q

glycated form of hemoglobin

A

HbA1c

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24
Q

this form of Hg is used to measure avg blood glucose conc over a longer period of time compared to fasting glucose or glucose tolerance test

A

HbA1c

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25
Q

is glycation reversible or non-reversible?

A

non-reversible

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26
Q

common test used to further diagnose diabetes and/or how well it’s being managed; aka glycated or glycosylated Hg test

A

A1c test

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27
Q

What is a normal A1c level?

A

<5.7%

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28
Q

What is a prediabetic A1c level?

A

5.7% - 6.4%

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29
Q

What is a diabetic A1c level?

A

> 6.5%

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30
Q

Cells sense insulin through:

A

insulin receptors

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31
Q

Insulin binding to its receptor results in the activation of the __________ signaling pathway

A

PI3K/Akt/mTOR

32
Q

Signaling through the PI3K/Akt/mTOR pathway may be blunted by high circulating levels of:

A

free fatty acids

33
Q

In T2D, insulin secretions occur, but its action is blocked by insulin resistance at the tissue/cellular level. Causes of this resistance include:

A

-mutations/defect signaling in GLUT4 which leads to diminished glucose uptake by fat/muscle cells and less transport of glucose out of the blood

34
Q

What are the complications associated with long tern diabetes?

A
  • diabetic retinopathy
  • diabetic nephropathy
  • diabetic neuropathy
  • stroke
  • cardiovascular disease
  • poor wound healing
35
Q

How do periodontal disease and other systemic bacterial and viral infections affect diabetes?

A

increase insulin resistance by increasing systemic inflammation (also worsen glycemic control)

36
Q

Hyperglycemia associated with Diabetes leads to increased production ___.

A

AGEs (or advanced glycation end products)

37
Q

___ can bind to receptors on cells and stimulate inflammatory reaction

A

AGEs

38
Q

Insulin (increases/decreases) lipid storage and (activates/inhibits) lipolysis.

A

increases

inhibits

39
Q

Insulin binding to the insulin receptor activates ___ which facilitates activation of _____ which leads to generation of PI(3,4,5)P3, second messenger. PI(3,4,5)P3 then activates ___ and ___ which then phosphorylate/activate a number of key targets important for function.

A

IRS1
PI 3-kinase
PDK and AKT

40
Q

The insulin receptor is a _____ ______ receptor.

A

tyrosine kinase

41
Q

major storage form of energy

A

glycogen

42
Q

What are the 2 primary organs that store glycogen?

A

liver and muscle

43
Q

How are T2D screened for pre-diabetes/diabetes?

A

fasting plasms glucose (after 8 hour fast) every 3 years

44
Q

What are ex. of rapid acting insulin for T1D?

A

Humalog and Novorapid

45
Q

What are ex. of short acting insulin for T1D?

A

Humalin and Novolin

46
Q

What are ex. of long acting insulin for T1D?

A

Lantus, Levemir, Tresiba

47
Q

Control for T1D?

A

insulin via injection or pumps

48
Q

control for T2D?

A

diet
exercise
maintain healthy weight
medications

49
Q

inhibitor that block reabsorption of glucose by the kidney

A

SGLT2

50
Q

Body doesn’t produce insulin

A

Type 1

51
Q

Body produces insulin but it doesn’t do what’s it’s supposed to do by it’s insulin resistant at receptor or post receptor level

A

Type 2

52
Q

Which immunoinflammatory responses are increased in diabetes?

A

TVF-alpha and IL1

53
Q

IL1 is present is:

A

Gingival crevicular fluid

54
Q

Patients with uncontrolled diabetes are going into have (increased/decreased) IL1 which causes an increase in gingival disease.

A

Increased

55
Q

Another consequence of diabetes where there is an accumulation of AGEs which bind to receptor on ______ cells and increase production of _______ ______ like IL1 and TNF-alpha.

A

Inflammatory

Pro inflammatory cytokines

56
Q

When blood sugar is high we want to (lower/increase) FA levels.

A

Lower

57
Q

Nitric oxide is a (vasodilator/constrictor).

A

Vasodilator

58
Q

Are implants a solution for perio disease?

A

No

59
Q

What initiates periodontal disease progresses on?

A

Plaque

60
Q

Plaque is an overgrowth of Gram __ bacteria that leads to gingival inflammation in susceptible individuals.

A

Positive

61
Q

Inflammation confined in the gingival unit

A

Gingivitis

62
Q

Does gingivitis involve supporting bone loss and attachment loss?

A

No

63
Q

Supporting bone loss and attachment loss

A

Periodontitis

64
Q

Leading reason of adult tooth loss

A

Periodontal disease

65
Q

Periodontal disease can lead to:

A
  • adverse pregnancy outcomes
  • respiratory diseases
  • cardiovascular disease
  • stroke
  • diabetes*
66
Q

Disorder of glucose metabolism

A

Diabetes mellitus

67
Q

Normal fasting blood sugar test results

A

<100 mg/dL

68
Q

Diabetes fasting blood sugar test results

A

> 126

69
Q

Is diabetes a risk factor for periodontal disease?

A

Yes

  • Increased prevalence and severity of attachment loss
  • periodontal abscess
  • impaired wound healing
70
Q

Diabetes-Periodontal Disease Relationship mechanism

A
  1. Oral microbial flora
  2. altered host defense
  3. Vascular changes
  4. Collagen breakdown
71
Q

Which bacteria is found in the oral microbial flora of T1D

A

Capnocytophaga sp.

72
Q

Which bacteria is found in the oral microbial flora of T2D?

A

Porphyromonas gingivalis

Similar to non-diabetic patients

73
Q

What are the 2 altered host mechanisms inDM?

A
  • Decreased PMN function (decreased phagocytosis and chemotaxis)
  • increased glucose in GCF promotes increased AGE
74
Q

What are the vascular changes in the diabetes-periodontal relationship?

A
  • Increased thickness of basement membrane & vessel walls (due to AGEs accumulation)
  • leading to decreased O2 diffusion and elimination of wastes
75
Q

What is the effect of collagen breakdown in diabetes-periodontal disease relationship?

A

-altered collagen metabolism (stimulation of collagenase activity)
-limited production of growth factors
-impaired wound healing and increased severity of periodontitis
(Bone and tooth loss)

76
Q

Serve periodontics affect which levels in diabetes?

A

HbA1C

77
Q

How does hyperglycemia impact bone metabolism?

A
  • reduce bone mineral density and mechanical properties
  • increase risk of fracture
  • impair endi Honduran bone formation and intramembranous bone formation and quality

Biochemistry (9 decks)

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