Metabolic: Insulin Resistance and Diabetes Flashcards
Describe the insulin receptor?
4 glycoproteins–> 2 are alpha that bind insulin and 2 are beta that have tyrosine kinase activity
When insulin stimulates MAPk what results?
Endothelin -1 production
Factors contributing to insulin resistance?
high visceral fat, impaired mitochondrial lipid oxidatoin
What are the criteria for “metabolic syndrome”
1- abd adiposity
2- mild HTN
3- Impaired fasting glucose levels
4- inc TG and dec HDL
Criteria for diagnosing diabetes?
1- HbA1C >6.5% or 2- FPG > 126 or 3- 2hour plasma glucose >200 or 4- symptoms of hyperglycemia
“insulin resistance of pregnancy combined with a beta cell defect”
Gestational diabetes
Why does hyperglycemia occur in T2DM?
insulin resistance + inadequate insulin secretion from the pancreas
“rare AD form of inherited diabetes associated with genetic beta cell defects”
Maturity Onset Diabetes of the young
“peptides secreted by the gut in response to meals that increase insulin secretion and decrease glucagon secretion”
incretins
most important incretin?
GLP-1
What inactivates GLP-1?
DD4 enzyme
When do you see this patholgy?
“destroyed islets that are ribbonlike cords with little fibrosis or amylin deposition”
T1DM
Link between T1DM and viral infections?
Possible molecular mimicry–> mumps or Coxsackie B
Is T1DM humoral or cell mediated immune issue?
Cell mediated!
What is seen in Pre-type 1 diabetes?
anti-islet cell antibodies in the months to years before insulin production decreases
