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Biochem > diabetes mellitus > Flashcards

diabetes mellitus Flashcards

1
Q

fed/absorptive state

A

increased blood glucose -> secretion of insulin (which brings blood glucose back down)

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2
Q

fasted state

A

secretion of glucagon -> gluconeogenesis

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3
Q

insulin binding sites

A

adipose tissue, skeletal muscle, and liver

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4
Q

GLUT 4

A

insulin-dependent glucose transporter found on adipose tissue and muscle: clears glucose from blood

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5
Q

insulin effect on adipose tissue

A

promotes lipid/adipose tissue storage, and inhibits breakdown of stored lipids

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6
Q

insulin effect on the liver

A

glycogen synthesis

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7
Q

what is the most common cause of type 2 diabetes

A

insulin resistance due to development of obesity

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8
Q

sorbitol dehydrogenase enzyme promotes what product?

A

fructose

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9
Q

uncontrolled type 2 DM shows…

A

gluconeogenesis in the liver AND blood levels of VLDL

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10
Q

higher than normal A1c test result interpretation

A

mostly not controlling blood glucose

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11
Q

factor that contributes to development of diabetic retinopathy

A

glucosamine 6-phosphate

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12
Q

cause of diabetes type 1

A

autoimmune disease destroy cells that create insulin (cannot activate GLUC4)

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13
Q

signs/symptoms of diabetes type 1

A

polyuria, polydipsia, polyphagia, weight-loss, blurred vision

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14
Q

diabetic ketoacidosis

A

side effect presents mainly in DM1, over production of ketones

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15
Q

diabetes type 1 treatment

A

insulin injections

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16
Q

acanthosis nigricans

A

brown skin lesions a sign/symptom of DM2

17
Q

most common side effect of DM type 2

A

hyperosmolar hyperglycemic nonketotic syndrome

18
Q

diabetes type 2 treatment

A

lifestyle modification and medications

19
Q

gestational diabetes signs/symptoms

A

hypertension, macrosomia, preterm birth

20
Q

gestational diabetes treatment

A

meal planning, exercise, glucose monitoring, insulin

21
Q

diabetic eye diseases

A

diabetic retinopathy, cataract, and glaucoma

22
Q

polyol pathway (pathology of diabetic retinopathy)

A

hyperglycemia leads to increased sorbitol > sorbitol directly damages cells or indirectly through depletion of glutathione

23
Q

hexosamine pathway (pathology of diabetic retinopathy)

A

increased glycosylation of Sp1 transcription factor (pro-inflammatory)

24
Q

protein kinase C signaling (pathology of diabetic retinopathy)

A

increased synthesis of diacylglycerol and activation of protein kinase C (pro-inflammatory)

25
Q

role of polyol pathway

A

detoxification of toxic aldehydes

aldose reductase converts aldehyde to alcohol (glucose to sorbitol)

26
Q

enzyme that converts aldehyde to alcohol

A

aldose reductase

27
Q

hexosamine pathwya

A

minor pathway

fructose 6-phosphate > UDP-N-acetylglucosamine

28
Q

UDP-N-acetylglucosamine

A

product of hexosamine pathway - causes glycosylation of protiens including Sp1 transcrition factor

29
Q

UDP-N-acetylglucosamine

A

product of hexosamine pathway - causes glycosylation of protiens including Sp1 transcrition factor

30
Q

Glycosylated hemoglobin

A

(A1c test) hemoglonin glycosylation (non-enzymatic) measured and reported as percentage of total hemoglobin
“% of Hb with glucose attached”
- non-fasting- look at glycemic control over 3 mo span

31
Q

Oral glucose tolerance test

A

overnight fast - blood glucose measured before and 2 hours after glucose solution consumption

32
Q

Fasting plasma glucose test

A

diagnosing diabetes/managing diabetes - plasma glucose measured after 8 hour fast

33
Q

random plasma glucose test

A

non-fasting glucose test, used in acute settings when dm symptoms present – usually further testing required

34
Q

carbohydrate metabolism in DM1

A

increased gluconeogenesis, decrease (lack of increase) of GLUT4 transporter activity in skeletal muscle and adipose tissue
»hyperglycemia

35
Q

lipid metabolism in DM1

A 
>increased hormone-sensitive lipase
>increased VLDL synthesis
>decreased lipoprotein lipase (extracellular adipose)
>increase ketone synthesis (liver)
>>hyperlipidemia + diabetic ketoacidosis
36
Q

carbohydrate metabolism in DM2

A

increased gluconeogenesis, decrease GLUT4 transporter activity
»hyperglycemia

37
Q

lipid metabolism in DM2

A

> increased hormone-sensitive lipase
increased VLDL synthesis
decreased lipoprotein lipase
>hyperlipidemia

Biochem (14 decks)

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