Metabolism 3 Flashcards
what is diabetes?
- it is a metabolic disease characterised by high blood glucose
diabetes can lead to insulin resistance. TRUE OR FALSE?
TRUE
Hyperglycemia can cause microvascular and macrovacular complications. true or false?
true
What microvascular damage can occur?
- Damage to the endothelial wall of small blood vessles
what macrovascular damage can occur in diabetes?
- Lead to oxidative stress
what are the three mechanims in which hyoerglycemia causes microvascular damage?
- Sorbitol pathway
- Glycated protein (AGE)
- Fatty acid - diacy glycerol pathway
what occurs in the soribtol pathway?
- Reduced NADPH - an important oxidative molecule
- Leads to production of sorbitol
- Leads to oxidative stress
- reduced vasoelasticity
what occurs in the glycalated protein pathway?
- Increased protein stability
- Altered extracellular matrix
- Altered cellular interactions
what occurs with fatty acid - diacyl glycerol pathway?
- Diacyl glycerol protein phosphorylation
- ALtered cellular signalling
- Multiple effects on vascular cells
Diabetes is an indepedent risk factor for coronary artery diseas, cerebrovscaular disease, peripheral vascular disease. TRUE OR FALSE?
TRUE
what are the other comorbity risk factors of diabetets
- obesity
- Hypertension
- Hyperlipidemia
- altered platelet function
With type 2 diabetes most patients have macorvascular disease at diagnosis. TRUE OR FALSE?
TRUE
With type 1 diabetes the age and duration of diabetes correlates with the degree of macrovascular disease. TRUE OR FALSE?
TRUE
Most diabetes treatment target the hyperglycemia. TRUE OR FALSE?
TRUE
Type 1 diabetes is an autoimmune disease. TRUE OR FLASE?
TRUE
Type 1 diabetes is antibody immediated immune destruction of the beta cells. TREU RO FASLE?
True
What are beta cells?
- Insulin secreting cells in the islet of langerhans
When is type 1 diabetes marked?
- When 80-90% of the beta cells are lost
what is insulitis?
- when beta cells start to destroy the islets of langerhans and beta cells start to get loss
the first thing to go after beta cell loss is the loss of first phase insulin secretion. TRUE OR FLASE?
TRUE
what are the complications of type 1 diabets?
- Chronic effectsof hyperglycemia
- Hypoglycemia - due to over administartion of insulin
- Diabetic ketoacidosis
- Both are very fatal
the brain in the fasting state is relying upon energy from gluconeogenesis and ketone bodies. TRUE OR FALSE?
TRUE
what occurs in a diabetic state in terms of metabolism?
- High blood glucose
- However, there is no insulin and very few insulin
- This means that lipolysis is not turned off
- Gluconeogensis is not turned off
- There is increased productin of ATP and B-oxidation leadting to more production of ketone bodies
- Leads to hyperglycemia and ketoacidosis
- Lead to coma and death
What is type 2 diabetes?
- It is the inability of insulin to exert its effects in the liver and adipose tissue
- Resistance to insulin
what causes type 2 diabetes/
- Obesity
- hyperglycemia and high free fatty acids
what causes insulin resistance?
- Diet
- Strong genetic component
- Environemntal factors
- cellular stress responses - alters insulin signalling pathways
- Ectopic lipid accumulation - accumulation of lipid mediators
- Inflammation - macrophages in adipose tissue cause release of inflammatory cytokines TNFa
Ectopic lipid accumualtion underlies insulin resistance. TRUE OR FALSE? (fat stores are overwhlemed)
TRUE
Diacyl glycerol and ceramides can block the effect of insulin which can lead to oxidative stress. TRUE OR FALSE?
TRUE
TNFa released from macrophages can inhibit the effects of insulin. TRUE OR FALSE?
TRUE
Complications caused from type 2 diabetes are mosly fom hyperglycemia and fatty acids. TRUE OR FALSE?
TRUE
what are the microvascular complications lead to?
- Retina issues - blindness
- Kidney failure
- Nerve damage
Why do peripheral neuropathies occur?
- Endothelial damage
- This leads to wall thickening
- Ischemia and nerve death
- Slowed nerve conduction
What are the two different branches of diabetic peripheral neuropathies?
- Autonomic
- Somatic
Describe autonomic and somatic diabetic neuropathy?
Autonomic:
- paralytic bladder
- postural hypertension
Somatic:
- Numbness, tingling, loss of touch sense (heat/temp)
Diabetic foot is common due impaired pain function. TRUE OR FALSE?
TRUE
Diabetic peripheral neuropathy is an independent risk factor for cardiovascular diseases. TRUE OR FALSE?
TRUE
hyperglycemia can lead to the transformation of the gowth factor beta in the glomeruli leading to hypertension. TRUE OR FALSE?
TRUE
The combined effects of metabolic and hemodynamics can lead to renal damage. TRUE OR FALSE?
TRUE
Diabetes can lead to increased risk of retinopathy, glaucoma and cataract. TRUE OR FALSE?
TRUE
What are the risks factors of retinopathy?
- Poor glycemic control
- Elevayed blood pressure
- hyoerlidpidemia
Macular odema leads to blurred vision. TRUE OR FALSE?
TRUE
Microaneurysm can burst leading to macular oedema. true or false?
true
what is the pathogenesis of diabetic retinopathy?
- Endothelial damage
- Microaneurysm bursting
- Ischemia - leading to weakened blood vessels
