ENDO Quiz Flashcards
When fasting –> what happens to the blood glucose level ?
stays the same
note: glucose goes into pancreas–> pancreas releases insulin –> insulin binds to receptor on glut 4 –> pumps glucose into cells
-
What does Insulin release do to:
a) Glycogen synthase
b) glycolysis in liver + muscle
c) gluconeogenesis
What does Insulin release do to:
a) Glycogen synthase —-> turns on
b) glycolysis in liver + muscle —-> turns on
c) gluconeogenesis —> switches off
Note: Insulin stimulates Glycogen synthesis
-
When fasting –> what happens to the insulin ?
insulin levels fall - other substrates are used : glucose glycogen triglyceride protein
During starvation, what does the liver switch on?
gluconeogenesis –> SWITCHED ON
ketogenesis –> switched on
What does insulin do to:
a) keton production
b) fat generation
c) glucose uptake
insulin:
- suppresses ketone production
- stimulates fat generation
- stimulates glucose uptake from blood into tissue
T1DM causes / doesn’t cause acidosis
- it causes ACIDOSIS
What happens if there is total absence of insulin?
what does the liver do?
- when insulin = 0 liver produces large amounts of ketone
- -> causes DKA
can cause death
how would you manage DKA ?
how would you manage DKA
- rehydrate with normal saline
- IV Insulin infusion
How would you treat T1DM ?
treating T1DM
- insulin
- diet management
What is T2DM ?
- resistance to the action of insulin
What is T2DM ?
- resistance to the action of insulin
What happens in T2DM ?
- you make insulin
- but effect is weak
- so only some glucose are let in via GLUT 4
-SO patients are: hyperglycemic –> without ketosis
T2DM patient show DKA (true / false?)
FALSE
they dont
T2DM patients tend to be
younger / older
obese / thin
glucose rises rapidly/gradually causing polyuria + polydipsia
T2DM patients tend to be
older
obese
glucose rises gradually causing polyuria + polydipsia
SEVERE T2DM can get :
–> can cause HONKC
hyper-osmolar non ketotic coma
How would you manage HONKC ?
- rehydrate with normal saline slowly
How would you treat T2DM?
- lose weight
- avoid sugar
- slow absorption of carbohydrates
- medications (e.g metformin/ sulphonyl ure)
What is the diagnosis?
FG = 7.4 mM
following GTT 2 hr value = 7.7
*FG = fasting glucose level
diagnosis: Type 2 diabetes
if FG > 7.0 then you are 100% diabetes
With STRONG FAMILY HISTORY
- which is most likely
T1DM
or
T2DM
T2DM
With the obese
- which is most likely
T1DM
or
T2DM
T2DM
With the young
- which is most likely
T1DM
or
T2DM
T1DM
Compare between T1DM + T2DM
T1DM
- immune destruction of pancreas
- insulin dependent diabetes
- usually young
- DKA
- quite high glucose
T2DM
- resistance to insulin action
- non insulin dependent diabetes
- Maturity Onset Diabetes
- Often overweight
- very high glucose
6 Classes of drugs for diabetes
and in what order are they administrated
- Biguanide (Metformin)
- Sulphonylurea (Gliclazide, Glibenclamide)
- Thiozolidinediones (Pioglitazone)
- Incretins (GLP-1 analogues, exantide)
- Gliflozins (SGLT2 Inhibitors)
- Insulin
What is better than metformin at preventing diabetes?
Diet + exercise
