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David's lecture > Metabolism 3 > Flashcards

Metabolism 3 Flashcards

1
Q

what is diabetes?

A
  • it is a metabolic disease characterised by high blood glucose
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2
Q

diabetes can lead to insulin resistance. TRUE OR FALSE?

A

TRUE

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3
Q

Hyperglycemia can cause microvascular and macrovacular complications. true or false?

A

true

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4
Q

What microvascular damage can occur?

A
  • Damage to the endothelial wall of small blood vessles
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5
Q

what macrovascular damage can occur in diabetes?

A
  • Lead to oxidative stress
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6
Q

what are the three mechanims in which hyoerglycemia causes microvascular damage?

A
  • Sorbitol pathway
  • Glycated protein (AGE)
  • Fatty acid - diacy glycerol pathway
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7
Q

what occurs in the soribtol pathway?

A
  • Reduced NADPH - an important oxidative molecule
  • Leads to production of sorbitol
  • Leads to oxidative stress
  • reduced vasoelasticity
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8
Q

what occurs in the glycalated protein pathway?

A
  • Increased protein stability
  • Altered extracellular matrix
  • Altered cellular interactions
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9
Q

what occurs with fatty acid - diacyl glycerol pathway?

A
  • Diacyl glycerol protein phosphorylation
  • ALtered cellular signalling
  • Multiple effects on vascular cells
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10
Q

Diabetes is an indepedent risk factor for coronary artery diseas, cerebrovscaular disease, peripheral vascular disease. TRUE OR FALSE?

A

TRUE

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11
Q

what are the other comorbity risk factors of diabetets

A
  • obesity
  • Hypertension
  • Hyperlipidemia
  • altered platelet function
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12
Q

With type 2 diabetes most patients have macorvascular disease at diagnosis. TRUE OR FALSE?

A

TRUE

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13
Q

With type 1 diabetes the age and duration of diabetes correlates with the degree of macrovascular disease. TRUE OR FALSE?

A

TRUE

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14
Q

Most diabetes treatment target the hyperglycemia. TRUE OR FALSE?

A

TRUE

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15
Q

Type 1 diabetes is an autoimmune disease. TRUE OR FLASE?

A

TRUE

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16
Q

Type 1 diabetes is antibody immediated immune destruction of the beta cells. TREU RO FASLE?

A

True

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17
Q

What are beta cells?

A
  • Insulin secreting cells in the islet of langerhans
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18
Q

When is type 1 diabetes marked?

A
  • When 80-90% of the beta cells are lost
19
Q

what is insulitis?

A
  • when beta cells start to destroy the islets of langerhans and beta cells start to get loss
20
Q

the first thing to go after beta cell loss is the loss of first phase insulin secretion. TRUE OR FLASE?

A

TRUE

21
Q

what are the complications of type 1 diabets?

A
  • Chronic effectsof hyperglycemia
  • Hypoglycemia - due to over administartion of insulin
  • Diabetic ketoacidosis
  • Both are very fatal
22
Q

the brain in the fasting state is relying upon energy from gluconeogenesis and ketone bodies. TRUE OR FALSE?

A

TRUE

23
Q

what occurs in a diabetic state in terms of metabolism?

A
  • 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
24
Q

What is type 2 diabetes?

A
  • It is the inability of insulin to exert its effects in the liver and adipose tissue
  • Resistance to insulin
25
Q

what causes type 2 diabetes/

A
  • Obesity

- hyperglycemia and high free fatty acids

26
Q

what causes insulin resistance?

A
  • 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
27
Q

Ectopic lipid accumualtion underlies insulin resistance. TRUE OR FALSE? (fat stores are overwhlemed)

A

TRUE

28
Q

Diacyl glycerol and ceramides can block the effect of insulin which can lead to oxidative stress. TRUE OR FALSE?

A

TRUE

29
Q

TNFa released from macrophages can inhibit the effects of insulin. TRUE OR FALSE?

A

TRUE

30
Q

Complications caused from type 2 diabetes are mosly fom hyperglycemia and fatty acids. TRUE OR FALSE?

A

TRUE

31
Q

what are the microvascular complications lead to?

A
  • Retina issues - blindness
  • Kidney failure
  • Nerve damage
32
Q

Why do peripheral neuropathies occur?

A
  • Endothelial damage
  • This leads to wall thickening
  • Ischemia and nerve death
  • Slowed nerve conduction
33
Q

What are the two different branches of diabetic peripheral neuropathies?

A
  • Autonomic

- Somatic

34
Q

Describe autonomic and somatic diabetic neuropathy?

A

Autonomic:

  • paralytic bladder
  • postural hypertension

Somatic:
- Numbness, tingling, loss of touch sense (heat/temp)

35
Q

Diabetic foot is common due impaired pain function. TRUE OR FALSE?

A

TRUE

36
Q

Diabetic peripheral neuropathy is an independent risk factor for cardiovascular diseases. TRUE OR FALSE?

A

TRUE

37
Q

hyperglycemia can lead to the transformation of the gowth factor beta in the glomeruli leading to hypertension. TRUE OR FALSE?

A

TRUE

38
Q

The combined effects of metabolic and hemodynamics can lead to renal damage. TRUE OR FALSE?

A

TRUE

39
Q

Diabetes can lead to increased risk of retinopathy, glaucoma and cataract. TRUE OR FALSE?

A

TRUE

40
Q

What are the risks factors of retinopathy?

A
  • Poor glycemic control
  • Elevayed blood pressure
  • hyoerlidpidemia
41
Q

Macular odema leads to blurred vision. TRUE OR FALSE?

A

TRUE

42
Q

Microaneurysm can burst leading to macular oedema. true or false?

A

true

43
Q

what is the pathogenesis of diabetic retinopathy?

A
  • Endothelial damage
  • Microaneurysm bursting
  • Ischemia - leading to weakened blood vessels

David's lecture (13 decks)

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