Insulin Resistance and Diabetes - Bikman Flashcards
How has diabetes and obesity changed thoughout the years?
It has increased
What is extremely important about obesity?
It increase every chronic disease usually from insulin resistance
High insulin levels causes what?
High weight gain
Insulin is secreted by what cells?
Beta Islets of Langerhans cells
Which glucose transporter is regulated by insulin and where is it found?
GLUT4
Skeletal muscle, Adipocytes, and Cardiac muscle
What is the “dawn phenomenon?”
When insulin spikes when a person wakes up, in anticipation of a meal
What does insulin do in the liver
Inhibition of ketogenesis
Lipogenesis
Glycogenesis
What does insulin do in the adipocytes?
Increased glucose uptake
Adipogenesis
Lipogenesis
What hormones balance out insulin?
Glucagon Epinephrine Norepinephrine GH Cortisol
What organs does glucagon affect?
Liver and Fat
Do physicians normally test insulin
No; usually test glucose levels
What are signs and symptoms of insulin resistance?
Hyperinsulimia, hypercholesterimia, Hypertension, reduced muscle
How does a person develop insulin resistance?
Too much fat or environmental factors can increase inflammation which causes insulin resistance
Does a person want more subcutaneous or visceral fat?
Subcutaneous
Visceral fat starts developing pro-inflammatory cytokines that makes foam cells which can causes damage to circulatory system
How can we lower insulin resistance?
Diet, drugs, exercise
What are some insulin lowering drugs?
Metformin, sulfonylureas, anti-inflammatory
What is Type 2 Diabetes?
Diabetes Mellitus
Too many Beta cells that creates too much insulin
Makes Alpha cells insulin resistant and other cells insulin resistant
Too much glucose in blood
Usually later in life
What is Type 1 Diabetes?
Diabetes Mellitus
Juvenille Diabetes
Pancreas cannot make enough insulin because of an autoimmune attack on Beta cells, and therefore too much glucose in the blood
What is MODY?
Mature Onset Diabetes of the Young
Genetic Disorder- Autosomal Dominant
Penetrance- has the disease, but doesnt manifest
Have enough Beta cells, but not enough of them to function correctly
What is nonketotic coma?
Hyperglycemia allows for dehydration (water follows solute)
Gestational Diabetes
Pregnancy is a insulin resistant state to allow for nutrients and glucose to pass onto the fetus
Ketones are critical for what organ?
The brain
What is the difference between ketosis and ketoacidosis?
Ketosis- regulated and controlled production of ketones; stops gluconeogenesis
Ketoacidosis- change in pH is dangerous
