Lecture 35 - Coordinating Metabolism: Diabetes (Type II) Flashcards
What does HbA1c test measure?
How much glucose is bound to haemoglobin in RBCs
Why is glycated haemoglobin the main diagnosis for diabetes?
It has a half life of 3 months, so even if glucose levels are in correct range is an indicator that past blood glucose was high.
Type 2 diabetes is insulin _______
resistance.
Type 1 diabetes is ______ to produce insulin.
inability
Type 1 diabetes onset during __________, type 2 after ______
childhood (rapid), age 35 (gradual)
What is the defect/deficiency of type 1 diabetes?
Beta cells are destroyed, eliminating production of insulin
What is the defect/deficiency of type 2 diabetes?
Insulin resistance combined with inability of beta cells to produce appropriate quantities of insulin
What type of diabetes is ketosis common?
Type 1
Plasma insulin in type 1 diabetes is…
low to absent.
Plasma insulin in type 2 diabetes is…
high in early disease, low in disease of long duration
What is the treatment for type 1 diabetes?
Insulin
What is the treatment for type 2 diabetes?
Diet, exercise, oral hypoglycaemic drugs, insulin may be necessary. Reduction of risk factors.
How do vascular pathologies arise from diabetes?
- Glycation of structural proteins in arteries making them less complient
- Formation of advanced glycation end products which promote inflammation
What would a diabetic glucose tolerance test look like?
Elevated fasting blood glucose, ver impaired lowering
What would a prediabetic glucose tolerance test look like?
Slightly elevated fasting level and impaired lowering
What is insulin resistance a warning sign of?
Individual is heading towards diabetes
What occurs over time as a result of hyperinsulinaemia?
diminished ability of beta cells to produce insulin to further increases blood glucose, individual becomes prediabetic and then diabetic
What are some factors underlying type 2 diabetes?
Sensitive genotype, obesity, high levels of inflammation, metabolic stress
The inability to use glucose in a type 2 diabetic results in the same response as ____________.
Starvation
Insulin is important in stimulating LPL, therefore its resistance leads to:
less hydrolysis of TAGs in VLDL and chylomicrons, which leads to their accumulation and increase in blood TAGs.
Decreased ________ uptake and increased ____________ are prominent featured of insulin resistance.
glucose, gluconeogenesis
Diabetics can develop fatty livers which can lead to:
cirrhosis
What occurs in cells during insulin resistance?
Reduced levels of phosphorylation and misphosphorylation of insulin signalling proteins which reduces GLUT4 translocation
Exercise _______ insulin sensitivity.
enhances
How do metformin and exercise sensitise you to insulin?
increase AMP levels, which activates AMPK which reduces gluconeogenesis, and reduces blood glucose levels.
What do SLGT2 inhibitors do?
Block glucose reabsorption in the kidney, allows glucose to remain in urine for excretion and lowers blood glucose
What does GLP-1 do?
Potentiates insulin secretion in beta cells. Acts through receptor to stimulate insulin secretion. (GLP-1 Agonists for diabetes)
