Introduction to Diabetes Mellitus Flashcards
GLUT-4 transporters are commonly found where?
myocytes (muscle) adipocytes (fat)
GLUT-4 transporters have which 2 chains?
hydrophilic (inside) and hydrophobic (outside)
Insulin does what in the muscle cell?
decreases breakdown of protein
increases protein synthesis
GH and IGF-1 do what to protein synthesis?
increase
gluconeogenesis is …….. by insulin
inhibited
what happens to hepatic glucose output if gluconeogenesis is inhibited?
decreases
how long does it take for you to use stores of.... carbohydrate 0.5kg protein 8-9kg fat 9-10kg without eating?
16 hours
15 days
30-90 days
what does lipoprotein lipase (LPL) enzyme do?
breaks down triglycerides that would otherwise be unable to leave the circulation
what does insulin do to the fat cell?
increase glucose uptake into fat cell…
inhibits breakdown of triglycerides in the fat cell
what do GH and Cortisol do in the fat cell?
cortisol and GH increase breakdown of triglycerides
what does glycogen do in the liver?
-
which sources can your brain use for energy?
glucose (preferred) and ketone bodies
CANNOT use fatty acids (non esterified fatty acids - NEFA)
what happens when NEFAs enter the liver?
-
glycogen stimulates formation of fatty acyl-coa forming acetoacetate then acetone and 3 OH-B forming ketone bodies
What happens to glycogen if glucagon increases in the liver?
It’s broken down to form glucose, increasing hepatic glucose output
effects on muscle
-
In the fasted state, what happens to: insulin-to-glucagon ratio [glucose] [NEFA] [amino acid]
insulin-to-glucagon ratio decreases
[glucose] 3.0-5.5mmol/L
[NEFA] increases by fat cells
[amino acid] decreases?
After eating what happens?
increased insulin
Increased protein synthesis in muscles
increased storage of fat in fat cells
increased glycogenesis?
what are the diagnostic tests for diabetes mellitus?
fasting glucose >7mmol/L random glucose >11.1mmol/L oral glucose tolerance test -fasting glucose -75g glucose load ......
what causes type 1 diabetes?
autoimmune condition where you produce antibodies which attach beta cells
what happens during type 1 diabetes (pathophysiology)
proteolysis increases
hepatic glucose output increases
lipolysis increases –> glycerides and NEFAs
can cause diabetic ketoacidosis
what are the markers of diabetic ketoacidosis?
-
symptoms of type 1 diabetes
weight loss - due to proteolysis
hyperglycaemia
glycosuria with osmotic symptoms - osmotic diuresis (polyuria, nocturia, polydipsia)
ketones in blood and urine
diagnostic tests for T1DM
antibodies: GAD, IA2
C-peptide
presence of ketones
what happens in the liver and muscle respectively if too much insulin is administered?
hepatic gluconeogenesis is switched off so there is reduced glucose output
too much glucose is taken up by the muscles and keeps being taken up
how does your body respond to hypoglycaemia?
What are the effects of these responses?
increase in: glucagon catecholamines cortisol growth hormone causing: increased hepatic glucose output with glycogenolysis and gluconeogenesis
what is impaired awareness of hypoglycaemia?
loss of counterregulatory response and a reduced ability to recognise hypoglycaemia as upon repeated occurence the body gets used to it
signs of hypoglycaemia
autonomic: sweating pallor palpitations shaking
neuroglycopenic: slurred speech poor vision confusion ....
what is the difference between GLUT-4 and GLUT-2
GLUT-4 is insulin dependent GLUT-2 is not
compare adrenaline and cortisol as stress hormones?
adrenaline - fast acting and weak - acute stress
cortisol - slow acting and stronger effect - chronic stress
what is diabetes insipidus?
lack of vasopressin
