Lecture 26 - Metabolic Syndrome and Diabetes

Question 1

Characteristics of insulin resistance?

Answer 1

subnormal glucose for given level insulin, high insulin w high glucose, per, post or receptor problem

Question 2

Insulin resistance associated with?

Answer 2

obesity, type II diabetes, endocrine disorders (cushings) and metabolic syndrome

Question 3

Diagnosis of metabolic syndrome?

Answer 3

central obesity (wide waist) + 2 of: hypertension, abnormal glucose, high triglycerides and low HDL

Question 4

Acanthosis nigricans?

Answer 4

dark velvety patches in body folds and creases

Question 5

3 diseases linked to insulin resistance?

Answer 5

acanthosis nigricans, metabolic syndrome cluster, polycystic ovaries

Question 6

Fat and insulin resistance?

Answer 6

stored triglycerides (fat) means large adipocytes, which are resistant to insulin suppression of lipolysis, leading to increased NEFA and glycerol, these with cytokines aggravate insulin resistance in muscle and liver

Question 7

Adiponectin?

Answer 7

play a role in development of insulin resitance and type II diabetes

Question 8

Resistin?

Answer 8

secreted by adipocytes and decreases glucose uptake

Question 9

Insulin resistance mechanism?

Answer 9

signalling blocked by inhibition of phosphorylation of IRS proteins

Question 10

Obestiy leading to diabetes?

Answer 10

DRAW THE CHART MOTHER FUCKER

Question 11

Consequences of insulin resistance - Glucose?

Answer 11

hepatic glucose output not suppressed, IMGU in muscle reduced - therefore only hyperinsulinaemia can maintain normal glucose levels

Question 12

Consequences of insulin resistance - fat?

Answer 12

metabolic (rise in FFA, triglycerides) and hormones (adipocytokines)

Question 13

Beta cell effect?

Answer 13

glucose toxicity and lipotoxicity from rise, beta cell failure leading to hyperglycaemia and hyperglucagonaemia from alpha cells, leading to less functions in release and incretin dysfunction -> progressively into type II diabetes

Question 14

The metabolic syndrome key causes?

Answer 14

excess energy intake, decreased physical activity, potential foetl programming and genetic predisposition

Question 15

Metabolic syndrome key effects?

Answer 15

type II diabetes, hypertension, dyslipidaemia, endothelial dysfunction (inflammation)

Question 16

Diabetes mellitus definition?

Answer 16

metabolic disorder characterised by the presence of hyperglycemia due to defective insulin secretion, action or both

Question 17

Diabetes diagnosis?

Answer 17

> 7 fasting and/or >11 2 hour; >50mmol/L of HbA1c

Question 18

Other classifications that type I and 2?

Answer 18

pancreatic disease, endocrinopathies (cushings), drugs, gestational

Question 19

Microvascular complications of diabetes?

Answer 19

retinopathy (blindness), peripheral neuropathy and nephropathy (proteinuria)

Question 20

Macrovascular complications of diabetes?

Answer 20

ischemic hear disease, peripheral vascualr disease and stroke

Question 21

Management of diabetes?

Answer 21

lifestyle changes (diet and exercise) and medication: insulin (type one and half of type II), metformin and sulphonylurea