Diabetes Mellitus

Question 1

3 characteristics of diabetes?

Answer 1

Hyperglycaemia, relative insulin deficiency or resistance, usually irreversible

Question 2

What is the pathogenesis of T1D?

Answer 2

Autoimmune. T cell mediated destruction of pancreatic beta cells

Question 3

What is T2D?

Answer 3

Chronic progressive disease characterised by abnormal insulin action and secretion

Question 4

Genes associated with T2D?

Answer 4

GKRP, PPARG

Question 5

Intrinsic stress of obesity?

Answer 5

Mitochondrial dysfunction, oxidative stress

Question 6

Extrinsic damage of obesity?

Answer 6

Accumulation of lipids and FFAs-> chronic inflammation

Question 7

T2D common alterations to insulin?

Answer 7

Decrease in number and catalytic activity of receptors, increased activity of tyrosine phosphatases, decreased function of GLUT4

Question 8

Effect of diabetes on glucagon?

Answer 8

Excessive circulating amounts in both.

Question 9

What is MODY?

Answer 9

Autosomal dominant inherited form. Beta cell dysfunction.

Question 10

What is HbA1c?

Answer 10

Measure of glycated Hb

Question 11

HbA1c cut off?

Answer 11

48mmol/mol

Question 12

What do thiazolidinodicines do?

Answer 12

Act on transcription factors

Question 13

What does metformin do?

Answer 13

Increased glucose transport, sensitivity, blocks gluconeogenesis, stimulates GLP1

Question 14

What do biguanides do?

Answer 14

Inhibit gluconeogenesis

Question 15

What do sulfonylureas and meglintinides do?

Answer 15

Stimulate insulin secretion

Question 16

Characteristics of dyslipidaemia?

Answer 16

Ectopic fat deposition in skeletal muscle and liver, macrovascular complications

Question 17

Where is the excess glucose diverted?

Answer 17

Hyperactivation of protein kinase C. Inc permeability and inflammation, occlusion, reactive oxygen species

Question 18

What is the effect of glycation on proteins?

Answer 18

Structural modifications and interactions with AGE receptors

Question 19

What is non proliferative diabetic retinopathy?

Answer 19

Dilation of retina veins and microanaeurysms lead to internal haemorrhaging and oedema

Question 20

What is proliferative diabetic retinopathy?

Answer 20

Fragile new blood vessels form near optic disk and grow in the retina. Bleed and reduce vision

Question 21

What is diabetic nephropathy?

Answer 21

Damage to glomerular blood vessels, proteinuria, glomerular hypertrophy, decreased filtration, renal fibrosis

Question 22

What are the macrovascular complications of diabetes?

Answer 22

Atherosclerotic plaque, stroke, MI, peripheral vascular disease