Pathophysiology of Diabetes

Question 1

What are the types of diabetes?

Answer 1

Type 1 - Juvenile or insulin-dependant diabetes

Type 2 - Mature or non-insulin dependant diabetes

Question 2

What is the autoimmune destruction of B-cells?

Answer 2

• Complete lack of insulin
• Requires exogenous insulin injections
• if untreated: severe hyperglycemia can occur leading to ketoacidosis
• if overtreated: Hyperglycemic shock leading to dizziness, sweating, tachycardia and coma

Question 3

What is Diabetic Ketoacidosis?

Answer 3

• High concentrations of ketone bodies formed by the breakdown of fatty acids and proteins
• common ketones produced in humans are acetoacetic acid and B-hydroxybutyrate
• Severe accumulation of ketones leads to ketoacidosis sich that the pH of the blood is decreased

Question 4

What is the Tx of T1D ?

Answer 4

• Insulin injections
• Pancreas Transplant which restores proper glucose regulation
• Islet Transplant

Question 5

What is the type 2 insulin resistance defect?

Answer 5

Tissues do not respond normally to insulin by increasing glucose uptake and inhibiting glucose production

Question 6

What is type 2 reduced insulin secretion defect?

Answer 6

• B cells do not secrete enough insulin for the levels of glycaemia

Question 7

What is the Tx of Type 2 diabetes?

Answer 7

• weight loss
• Diet
• Insulin sensisters: Metformin

Question 8

What is gestational diabetes?

Answer 8

• Occurs during pregnancy as a result of decreased sensitivity to insulin
• Typically remits after delivery, but women diagnosed with GD have a 50
  5 chance of developing type 2 disease within their life

Question 9

What happens with microvascular complication for diabetes?

Answer 9

Increase in blood glucose —> endothelial cells of the blood vessels take up more glucose , which results in basement membrane thickening leading to bleeding, protein leaking and slowing of blood flow

• Retinopathy can occur
• Nephropathy
• Nerve damage