Pathology of Diabetes Mellitus

Question 1

What should a normal pancreas look like?

Answer 1

Lobules of glandular tissue surrounded by fat

Question 2

What is the effect of the destruction of islets?

Answer 2

Decreased insulin

Question 3

What is the process of type 1 diabetes?

Answer 3

Can’t distinguish own cells from other cells causes autoimmune attack on B cells
Autoimmune attack on islet cells causes lymphocyte infiltration of islets thus destruction of B cells.

Question 4

What is the aetiology of type 2 diabetes?

Answer 4

Reduced tissue sensitivity to insulin
Inability to secrete very high levels of insulin
(a failure of the B cells to meet an increased demand for insulin in the body)

Question 5

What is an environmental aetiology of type 2 diabetes?

Answer 5

Expanded upper body visceral fat mass (pot belly)

Question 6

How does expanded upper body fat relate to type 2 diabetes?

Answer 6

Increased free fatty acids in blood, leads to decreased insulin receptor sensitivity, decreased removal of glucose from blood, raised glucose

Question 7

How does diabetes accelerate atherosclerosis?

Answer 7

Glucose attaches to low density lipoprotein, stops it binding its receptor. LDL not removed from liver cells so stay in blood

Question 8

How does diabetes effect small arteries and arterioles?

Answer 8

Molecules flux into sub endothelial space but find it hard to flux back to blood.
Build up of trapped molecules under endothelial cells.
Basal lamina becomes thickened

Question 9

What is arteriolar disease also known as?

Answer 9

Hyaline change

Question 10

How does small vessel disease occur?

Answer 10

Glucose added to proteins
Glycosylated collagen binds to albumin.
Albumin accumulates in sub endothelial space and becomes trapped.
Glycosylated proteins bind to neighbouring proteins and link cant be removed easily