Diabetes mellitus physiology

Question 1

Describe type 1 diabetes

Answer 1

Autoimmune diseases destroying the beta cells of the pancreas that produce insulin

Question 2

Describe the development of ketoacidosis

Answer 2

1. When nutrients are scarce body relies on fat stores
   to break down into fatty acids (lipolysis)
2. FFA are converted into ketone bodies in the liver which provide energy for the brain
3. In type 1 the lack of insulin means that ketone body uptake is reduced leaving it in the blood
4. They build up in the plasma and create life threatning acidosis because they are acidic

Question 3

Describe type 2 diabetes

Answer 3

Insulin tissue has become insensitive to insulin (resistant)

- Muscle and fat no longer respond to normal levels of insulin

Question 4

Describe the treatment of diabetes

Answer 4

Initial treatment is lifestyle changes
- More exercise 
- Imporve diet
1st line
- Metaformin
2nd line
- Sulphonylureas

Question 5

Describe the MOA of Metaformin

Answer 5

• Inhibits hepatic gluconeogensis

- Antagonises actions of glucagon

Question 6

Describe the MOA of sulphonylureas

Answer 6

• Class of drug which close the Katp channels in B cells

- This causes Ca entry and insulin exocytosis

Question 7

Describe the Glucose tolerance test

Answer 7

• Patient ingests glucose after fasting
  Diabetes patient - [BG] levels are 2 hours will stay high
  Normal patient - [BG] Returns back to normal