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Metabolism II > Diabetes Mellitus > Flashcards

Diabetes Mellitus Flashcards

1
Q

Describe Diabetes Mellitus

A

Diabetes Mellitus is a group of metabolic disorders characterised by chronic hyperglycaemia due to insulin deficiency, insulin resistance or both.

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2
Q

Why type of Diabetes Mellitus is more prevalent in young people?

A

Type I

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3
Q

How can viral infections contribute to the development of Type I Diabetes?

A

It is thought a viral infection stimulates lymphocytes, macrophages and antibodies which destroy Beta cells

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4
Q

What is the Triad of symptoms related to Type I Diabetes?

A

Polydipsia
Polyurea
Weight loss

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5
Q

What is Polydipsia?

A

Excessive thirst and drinking

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6
Q

What is Polyurea?

A

Excess urine production

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7
Q

Why do Type I Diabetics experience Polyurea?

A

There is excess Glucose in the blood and this is filtered in the kidneys.
The extra Glucose in the kidney increases the osmotic load so less water is reabsorbed to maintain osmotic pressures.

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8
Q

How can Type I Diabetes be diagnosed?

A

Increased levels of Glucose in the blood because of a lack of Insulin

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9
Q

What does lack of Insulin cause?

A

Decreased uptake of Glucose into adipose tissue and skeletal muscle
Decreased storage of Glucose as Glycogen in the liver and muscles
Increased Gluconeogenesis in the liver

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10
Q

What is Glycosuria?

A

Glucose in the urine

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11
Q

What happens to the level of Beta cells in Type II Diabetics?

A

They gradually decrease until none are left - develop disorders of Insulin secretion or Insulin resistance

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12
Q

What is the progression of Type I Diabetes?

A

Found with HLA markers and auto-antibodies
Develop impaired Glucose intolerance
Develop Diabetes
Become Insulin dependent

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13
Q

What is the progression of Type II Diabetes?

A

Insulin resistance
Insulin production falls
Impaired Glucose tolerance
Diabetes developed - controlled by lifestyle, then drugs, then Insulin

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14
Q

What is the random venous plasma glucose concentration for a Diabetes diagnosis?

A

11.1 mm/L or more

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15
Q

What is the fasting plasma glucose concentration for a Diabetes diagnosis?

A

7.0 mm/L or more

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16
Q

What is the Plasma glucose concentration (after an oral Glucose tolerance test) for a Diabetes diagnosis?

A

11.1 mm/L or more 2 hours after 75g anhydrous glucose

17
Q

Why are high concentrations of ketone bodies produced in Diabetics?

A

High rates of Beta oxidation of fats occurs in the liver

Low insulin/anti Insulin ratio

18
Q

How does Ketoacidosis occur in Diabetics?

A

The H+ associated with ketone bodies leads to metabolic acidosis

19
Q

How can you test the control of Diabetes?

A

Ketones in the urine

20
Q

What are the symptoms of Ketoacidosis?

A 
Nausea
Vomiting
Abdominal pain
Hyperventilation
Dehydration
21
Q

What is the plasma glucose concentration in Hypoglycaemia?

A

Below 3 mmol/L

22
Q

How can a Diabetic patient become Hypoglycaemic?

A

Insulin/Sulphonylurea treatment with increased activity, missed meals or overdoses

23
Q

What is the fatal plasma Glucose concentration and why?

A

Below 2 mmol/L because the CNS and brain cannot function without Glucose

24
Q

What are the symptoms of Hypoglycaemia?

A 
Sweating
Anxiety
Tremors
Palpatations
Seizures
Coma
25
Q

What is the plasma glucose concentration in Hyperglycaemia?

A

Blood glucose above 10 mmol/L

26
Q

What are the symptoms of Hyperglycaemia?

A 
Tiredness
Blurred vision
Polyurea
Polydipsia
Weight loss
27
Q

What drugs can be used to treat Type II diabetes?

A

Sulphonylureas - they increase insulin release from beta cells and reduce insulin resistance

28
Q

How can persistent Hyperglycaemia result in depleted NADPH?

A

There is abnormal metabolism of Glucose due to its accumulation in tissues. Sorbitol is produced which damages tissues.

29
Q

How does non enzymatic glycosylation of plasma proteins occur?

A

There is high levels of Glucose in the blood and glucose reacts with free amino acid groups to form stable covalent bonds

30
Q

How does glycosylation of a protein change its function?

A

It changes the NET charge and 3D structure so function changes

31
Q

How can glycosylated haemoglobin be used to measure the control of a patient’s condition?

A

The higher the levels of glycosylated haemoglobin, the worse the control has been over the preceding 2-3 months. A valve above 10% is considered poor.

32
Q

What are the macrovascular complications of Diabetes?

A

Increased risk of stroke
Increased risk of MI
Poor circulation to periphery

33
Q

What are the microvascular complications of Diabetes?

A

Diabetic eye disease (due to osmotic effects of glucose)
Nephropathy (damage in the Glomerulus)
Diabetic neuropathy (damage to peripheral nerves)
Diabetic feet (gangrene from reduce blood supply)

Metabolism II (16 decks)

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