Diabetes (Slide Deck 1) Flashcards
What is the function of Beta Cells?
Produce insulin and amylin
Insulin released in response to elevated blood glucose levels
What is the function of Alpha Cells in the pancreas?
Produce glucagon
Glucagon released in response to low blood glucose levels
What is the normal range of blood glucose levels?
4-7 mM
If I eat a meal __ is released Glycogenesis __ and Gluconeogenesis __
- Insulin
- Increase
- Decrease
If blood glucose decreases throughout the night Glycogenolysis __ and Gluconeogenesis __
Increases
Increases
What is glycogenolysis?
Its the breakdown of glycogen into glucose-1-phosphate and eventually into glucose
What is gluconeogenesis?
It is the generation of glucose from various sources (G1P)
What is gluconeogenesis?
It is the generation of glucose from various sources (G1P)
What are the other important regulatory hormones for glucose/insulin control?
Epinephrine, growth hormone, cortisol
What does the presence of insulin stimulate the production of in skeletal muscle?
Proteins from AA
What is the process of glycogenesis?
Glucose to glycogen
What is the process of Glycogenolysis
Liver glycogen is split back into glucose
In starvation or insulin deficiency what process does this lead to?
Lipolysis
What is Lipolysis
- TG’s split back to glycerol and FAs ->Metabolism of FFA’s -> β-hydroxybutyrate, acetoacetic acid, and acetone (ketone bodies)
- These ketone bodies can be used as an energy source
Insulin is a __ storing hormone. How?
Fat
It stimulates the conversion of glucose to glycerol phosphate
& free fatty acids (FFA’s) and is stored as TG’s in fat cells
What are the two classifications of prediabetes?
- Impaired glucose tolerance (IGT)
- Impaired fasting glucose (IFG)
What is the prevalence of T1DM?
10%
What level of beta cell destruciton do we see hyperglycemia occur?
80-90%
What is the Honeymoon Phase of T1DM?
- Correction of hyperglycemia causes insulin secretion to recover temporarily & insulin requirements may be quite low
What is Prediabetes
- An intermediate state between normal glucose levels and diabetes
Prediabetes is a strong predictor of?
T2DM & CVD
TD2M is a combination of?
impaired insulin secretion and insulin resistance
What happens to the Beta cells in T2DM patients?
↓ β-cell mass, as well as a β- cell secretory defect….this continues to deteriorate with time
What occurs in the skeletal muscles due to T2DM
Muscle is resistant to insulin actions hence there is decreased glucose uptake by it
What occurs in the Liver during T2DM
- Resistance to insulin action on the liver results in the inability to suppress hepatic glucose production
What occurs in the Adipose Tissue during T2DM
*Adipocytes become resistant to antilipolytic effects of insulin which leads to ↑ lipolysis (Increase in TG in blood)
- Leads to elevated FFA’s in the circulation which can stimulate liver glucose production, impair skeletal muscle sensitivity & impair insulin release
What types of symptoms are generally associated with T1DM?
Acute symptoms of short duration!
* Polyuria
* Polyphagia
* Polydipsia
* Weight loss
* Fatigue
* Blurred vision
* Infections
What types of symptoms are generally associated with T2DM?
- Is commonly discovered incidentally, as patients may be asymptomatic
- May have nonspecific symptoms (i.e. fatigue) or:
- polyuria
- polydipsia
- nocturia
What is DKA and where is it most common?
Diabetic ketoacidosis and it is prevalent in T1DM
What genes (HLA Class II Genes) are associated with which form of diabetes?
T1DM
What is gestational diabetes mellitus?
Develops during pregnancy due to insulin resistance, and increases the risk of developing T2DM in both mother/child
Risk factors of GDM?
- Previous GDM
- Member of high-risk population
- Previous delivery of macrosomic infant
- Age ≥ 35yo
- Obesity
- PCOS
- Acanthosis nigricans
- Corticosteroid use
What weeks of pregnancy should women be screened for GDM?
between weeks 24-28 weeks of pregnancy; earlier if risk factors are present
How is T2DM screened?
Fasting plasma glucose or A1C as initial screening tests
What is the criteria for screening for T2DM without intervention (When is rescreening required)
FPG <5.6mmol/L or A1C <5.5
Rescreen as recomended
What is the criteria for “At Risk rescreen more often” T2DM
FPG 5.6-6.0mmol/L or A1C 5.9
What is the criteria for Prediabetes rescreening more often? T2DM
FPG 6.1-6.9mmol/L or A1C 6.4
What is the criteria for being TD2M diagnosed?
FPG >7.0mmol/L or A1C >6.5 or 2hrs PG in a 75g OGTT >11.1
Or random PG >11.1mmol/L
