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Dig > L17: Absorptive Post State Diabetes > Flashcards

L17: Absorptive Post State Diabetes Flashcards

1
Q

What is the absorptive state

A

Food in gut

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2
Q

What is the post absorptive state

A

Fasting state where nutrients aren’t being absorbed

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3
Q

How is insulin secreted in the absorptive state

A

1) insulin is released by beta cells
2) glucose enters by GLUT-2 into beta cells
3) glucose is metabolised and produces ATP
4) calcium influx occurs
5) calcium causes exocytosis of more insulin

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4
Q

When insulin is secreted how does glucose concentration fall

A

Glucose is taken into cells by GLUT-4

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5
Q

Which cells taken in glucose

A

Adipose
Liver
Muscle
Other

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6
Q

What type of a transporter is GLUT4

A

Insulin sensitive transporter

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7
Q

Which cells use GLUT4 for glucose entry

A

Adipose

Muscle

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8
Q

How is glucose taken up into the liver/hepatocytes in the fed state

A

Glucose enters hepatocytes by GLUT-2 (non-insulin dependent)

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9
Q

What is the role of insulin in hepatocytes in the fed state

A

Insulin converts glucose to glycogen (glycogen synthesis)
Insulin inhibits the breakdown of glycogen
Promotes protein synthesis
Promotes lipogenesis

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10
Q

How is glucose taken up into muscle in the fed state

A

By GLUT4 (insulin sensitive transporter)

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11
Q

What is the role of insulin in muscle in the fed state

A

Stimulate glycogen synthesis
Stimulate lipogenesis
Stimulate Protein synthesis

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12
Q

How does glucose enter adipocytes in the fed state

A

GLUT4

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13
Q

What is the role of insulin in adipocytes in the fed state

A

Stimulate glycolysis

Stimulate lipogenesis

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14
Q

What process does insulin inhibit in adipocytes in the fed state

A

Lipolysis (breakdown of fat)

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15
Q

How does insulin enter hepatocytes, muscle, adipocytes in the fed state

A

Via insulin receptor

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16
Q

What is lipogenesis

A

Fat synthesis

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17
Q

What reactions occur in the post absorptive state

A

Glycogenolysis
Gluconeogenesis
Beta oxidation

18
Q

What is gluconeogenesis

A

Make glucose from amino acids, lactate and glycerol

19
Q

Which organ carries out glycogenolysis and gluconeogenesis

A

Liver

20
Q

Where does amino acids and lactate come from for gluconeogenesis

A

Muscle

21
Q

Where does glycerol come from for glucoeneogenesis

A

Adipose tissue

22
Q

What is the main aim of beta oxidation

A

Breakdown fat into ketone bodies and convert ketone bodies to acetyl CoA for the krebs cycle

23
Q

What is type 1 diabetes

A

Young onset

Beta cell destruction

24
Q

What is type 2 diabetes

A

Insulin resistance

Insulin levels are high/normal but activity is low

25
Q

What happens in hepatocytes for diabetics

A

No insulin means
Decreased glycogen synthesis
Increased glycogenolysis
Because you are no longer inhibiting or promoting so activity inside is the opposite

26
Q

What happens in adipocytes for diabetics

A

Decreased glucose uptake

Increased lipolysis

27
Q

Why is there decreased glucose uptakes

A

GLUT4 is insulin sensitive and insulin in not present for glucose uptake

28
Q

What happens in muscle cells for diabetics

A

Decreased glucose uptake

Breakdown of protein

29
Q

What state does the body think you are in during diabetics

A

Fasted state because there is no insulin so it breaks down stores resulting in serum glucose levels to increase

30
Q

What happens to increased fatty acids in diabetics

A

Enter beta oxidation to give acetly coA
Increased acetly coa inhibits Krebs cycle and instead undergoes ketogeneiss (production of ketone bodies)
Ketone bodies are taken up by extrahepatic tissues to become broken down and converted back to acetly coa for Krebs cycle

31
Q

What does the breakdown of ketone bodies in extra hepatic tissues lead to

A

Smell in breath

32
Q

What is the clinical features of uncontrolled diabetes

A 
Dehydration 
Polyuria 
Infections 
Weight loss 
Kerosine
33
Q

What is the treatment of diabetes

A

Rehydration
Insulin
Treat infections

34
Q

What happens to haemoglobin in diabetes

A

Becomes glycated (HBA1C)

35
Q

What are the long term consequences of diabetes

A

Retinopathy
Nephropathy
Neuropathy

36
Q

What is retinopathy

A

Poor quality blood vessels in the Reina that lead to vision loss

37
Q

What is nephropahty

A

Damage to the kidney which leads to chronic renal failure

38
Q

What is neuropathy

A

Abnormal and decreased sensation with feet hands and fingers

39
Q

What are the macro vascular consequences of diabetes

A 
Atherosclerotic 
Strokes
Heart attacks
Peripheral vascular disease 
Hyperlipidemia
40
Q

What is the long term treatment of diabetes

A 
Lipid lowering drugs 
Reduced blood pressure 
Avoid smoking 
Diet 
Home monitoring 
Tablets/insulin

Dig (20 decks)

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