Pathophysiology of T1 and T2 diabetes Flashcards
How to calculate BMI
Body weight / height squared
What should a healthy fasting glucose be?
> 7
What happens when you eat?
Insulin secretion from B cells
Liver takes up glucose and stores as glycogen
Insulin inhibits lipolysis
Blood glucose levels decreases
Impact of insulin on potassium
Sodium is transported with glucose into cells via SGLT2 pump
Therefore you want max concentration of sodium in blood to move max glucose into cells
Lots of sodium in blood means potassium must move into cells
= hypokalaemia
What happens when you starve?
A cells release glucagon
Liver breaks down glycogen and releases glucose
Blood glucose levels rise
How does glucose move into cells via GLUT4?
Glucose is polar and so doesn’t move into cells easily
Instead insulin binds to the receptor and the glucose transporter moves to the membrane
Glucose can then enter
Exocrine function of pancreas
Acinar cells and ductal epithelial cells
Endocrine function of pancreas
Islets of Langerhans (A, B, D and PP cells)
Profile of T1D
B cells are depleted = reduced insulin
Usually young onset
Sx: reduced insulin, underweight, DKA, autoantibodies
Triggered by genetics, environment, viruses etc
What is insulitis?
Autoimmune attack on B cells caused by CD8
Symptoms of diabetes
tiredness
thin
thirsty
toilet
What is DKA?
Insufficient glucose in cells means fats are converted to ketones for energy rather than glucose
High levels of ketones = acidic
DKA sx
polyuria, polydipsia, fruity smelling breath, hypotension, Kussmal breathing
Factors influencing insulin resistance
Diabetic genes
Glucotoxicity and lipotoxicity
Inflammation
Reduced adipokines and B cell function
Where are GLP-1 and GIP released?
Gut
