Introduction Flashcards
Describe type I diabetes
Absolute insulin deficiency 0.3% of British population Onset typically before 40 Normal weight or slim Onset is dramatic Family history Presence of ketones Insulin required to sustain life Autoimmune destruction of pancreatic beta cells
Describe type II diabetes
Insulin resistance Relative insulin deficiency 8% of British population Onset typically after 40 Genetic predisposition Associated with obesity Insidious onset of symptoms No ketones Insulin resistance of pancreatic beta cell dysfunction
What is the prevalence of diabetes in the UK?
3.7 million diagnosed
4.6 million total cases
90% Type II
10% Type I
What is the prevalence of diabetes globally?
382 million in 2012
2050 estimated: 592 million
What are the symptoms of diabetes?
Weight loss Extreme fatigue Prone to infections Osmotic symptoms Slow healing wounds Tingling pain or numbness in hands or feet
How do you diagnose diabetes?
Measuring urine glucose Measuring blood glucose: random >11.1mM fasting >7.0mM Oral glucose tolerance tests HbA1c >6.5%
What is the role of insulin in carbohydrate metabolism?
Increases: rate of glucose transport, rate of glycolysis, rate of glucose oxidation, rate of glycogen synthesis
Decreases: glycogen breakdown
Inhibits: glucogenolysis, gluconeogenesis
What is the role of insulin fat metabolism?
Inhibits: lipolysis, fatty acid oxidisation
Increases: fatty acid and triglycerol synthesis, VLDL formation, lipoprotein lipase activity, uptake of triglycerides, cholesterolgenesis
What is insulin?
Made in beta cells of the islets of Langerhans
Made as pre-pro-insulin
How is insulin released?
Glucose is transported into the beta cell by facilitated diffusion
Causes depolarisation
Influx of Ca2+
Exocytosis of insulin-containing granules
How is type 1 diabetes treated?
Lifestyle
Insulin injections
How is type 2 diabetes treated?
Lifestyle Reduce insulin resistance Increase insulin secretion Insulin injection Incretins
What is the cost of diabetes?
Cost to the NHS: £3.1 billion
Industry cost: £531 million
What are the complications of diabetes?
Diabetic retinopathy Diabetic neuropathy Limb amputation Kidney failure Heart disease and stroke
