Lecture 35 - Coordinating Metabolism: Diabetes (Type II)

Question 1

What does HbA1c test measure?

Answer 1

How much glucose is bound to haemoglobin in RBCs

Question 2

Why is glycated haemoglobin the main diagnosis for diabetes?

Answer 2

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.

Question 3

Type 2 diabetes is insulin _______

Answer 3

resistance.

Question 4

Type 1 diabetes is ______ to produce insulin.

Answer 4

inability

Question 5

Type 1 diabetes onset during __________, type 2 after ______

Answer 5

childhood (rapid), age 35 (gradual)

Question 6

What is the defect/deficiency of type 1 diabetes?

Answer 6

Beta cells are destroyed, eliminating production of insulin

Question 7

What is the defect/deficiency of type 2 diabetes?

Answer 7

Insulin resistance combined with inability of beta cells to produce appropriate quantities of insulin

Question 8

What type of diabetes is ketosis common?

Answer 8

Type 1

Question 9

Plasma insulin in type 1 diabetes is…

Answer 9

low to absent.

Question 10

Plasma insulin in type 2 diabetes is…

Answer 10

high in early disease, low in disease of long duration

Question 11

What is the treatment for type 1 diabetes?

Answer 11

Insulin

Question 12

What is the treatment for type 2 diabetes?

Answer 12

Diet, exercise, oral hypoglycaemic drugs, insulin may be necessary. Reduction of risk factors.

Question 13

How do vascular pathologies arise from diabetes?

Answer 13

• Glycation of structural proteins in arteries making them less complient
• Formation of advanced glycation end products which promote inflammation

Question 14

What would a diabetic glucose tolerance test look like?

Answer 14

Elevated fasting blood glucose, ver impaired lowering

Question 15

What would a prediabetic glucose tolerance test look like?

Answer 15

Slightly elevated fasting level and impaired lowering

Question 16

What is insulin resistance a warning sign of?

Answer 16

Individual is heading towards diabetes

Question 17

What occurs over time as a result of hyperinsulinaemia?

Answer 17

diminished ability of beta cells to produce insulin to further increases blood glucose, individual becomes prediabetic and then diabetic

Question 18

What are some factors underlying type 2 diabetes?

Answer 18

Sensitive genotype, obesity, high levels of inflammation, metabolic stress

Question 19

The inability to use glucose in a type 2 diabetic results in the same response as ____________.

Answer 19

Starvation

Question 20

Insulin is important in stimulating LPL, therefore its resistance leads to:

Answer 20

less hydrolysis of TAGs in VLDL and chylomicrons, which leads to their accumulation and increase in blood TAGs.

Question 21

Decreased ________ uptake and increased ____________ are prominent featured of insulin resistance.

Answer 21

glucose, gluconeogenesis

Question 22

Diabetics can develop fatty livers which can lead to:

Answer 22

cirrhosis

Question 23

What occurs in cells during insulin resistance?

Answer 23

Reduced levels of phosphorylation and misphosphorylation of insulin signalling proteins which reduces GLUT4 translocation

Question 24

Exercise _______ insulin sensitivity.

Answer 24

enhances

Question 25

How do metformin and exercise sensitise you to insulin?

Answer 25

increase AMP levels, which activates AMPK which reduces gluconeogenesis, and reduces blood glucose levels.

Question 26

What do SLGT2 inhibitors do?

Answer 26

Block glucose reabsorption in the kidney, allows glucose to remain in urine for excretion and lowers blood glucose

Question 27

What does GLP-1 do?

Answer 27

Potentiates insulin secretion in beta cells. Acts through receptor to stimulate insulin secretion. (GLP-1 Agonists for diabetes)