energy balance Flashcards
what is the primary control of insulin secretion
negative feedback between beta cells and glucose concentration in the blood
what does diabetes refer to
large volume of urine produced by diabetics
mellitus meaning
sweet urine- assocaited with hyperglycemia and glucose output in the urine
insipiddus meaning
tasteless urine- diabetes that is not associated with hyperglucemia but with ADH deficiency
IDDM
autoimmune destruction of B cells
in children or before 40 yrs
regular insulin injections required
what happens in IDDM when insulin absence is occuring
glucagon release from a cells is triggered- glucose sensing fails in the a cells leading to additional glucose in the blood thorugh glucagon action
what is possible therapy for IDDM
insulin and GHIH (somatostatin) to inhibit glucagon secretion
what is A1C a measure
glycosylation state of hemoglobin
how often is the turnover of Hb in RBC
every 3 months therefore testing is done every 3 months
what is %glycosylation a function of
average glucose levels over time (1-3 months prior)
what is the A1C value for non diabetics
5%
what is the A1C value for diabetics
greater than 6.5-7%
what is an important indicator of diabetes control
A1C monitoring
why is uncontrolled glucose a problem
advanced glycation end products- AGEs- interfere with physiological systems such as arterial stiffness in diabetes mellitus
gestational diabetes
gestational diabetes mellitus refers to glucose intolerance with onset or first recognition during pregnancy
what is a risk during GDM- gestational diabetes mellitus
fetal malformations at early gestational time points
risk of macrosomia and metabolic complications with late gestation GDM
what are the risk factors of GDM
> 35 yrs
on cortisol therapy
race
obesity
pre diabetic condition
T2DM in the family
PCOS
how many pathways lead to type D diabetes
multiple
what is a precursor state of diabetes type 2
prediabetes
what can happen in type 2 diabetes
progress to type 1
what is the normal fastsing range
less than 6mmol/L
what does chronic over eating lead to
inc in blood glucose
inc in insulin secretion
dec sensitivity of target cells to insulin- insulin resistance
what is type 2 diabetes assocaited with
hypertension and hyperlipidemia