Quiz Flashcards
What are the effects of insulin
Signals that youve been fed Switches on all pathways that use up glucose and store glycogen and fat Glycogen synthase on Glycolysis in liver and muscle on Gluconeogenesis switched off
What happens during starvation
Insulin levels fall, substrates available: glucose, glucogen, triglyceride
What is the pathology of type 1 diabetes?
Immune system destroys the islets of Langerhans in the pancreas, resulting in a total deficiency of insulin and all cells of the body therefore fail of taken up glucose. Plasma glucose therefore rises. Glucose leaks into ruine, large vol of urine result. Complete urine deficiency causes acidosis.
How does total absence of insulin cause death
When insulin levels are zero, the liver behaves wrongly as if there is no fuel for the brain and keeps working and makes huge amounts of ketones. The blood turns acidic with ketones in the urine and the brain cannot function in an acid pH
What happens in diabetic ketoacidosis?
Blood glucose high as it cannot get into cells. Blood full of ketone (acids) and leads to severe dehydration and air hunger
How do you treat diabetic ketoacidosis?
Give insulin and rehydrate with saline
How does type 2 diabetes happen
Resistance to insulin action, secondary rise in glucose. The pancreas makes lots of insulin to try and counteract this. Eventually the pancreas becomes exhausted and type 2 diabetes ensues
Why does T2DM never get DKA
Insulin sufficient to supress ketogenesis but not hyperglycaemia - so don’t get ketoacidosis
What are the common characteristics of patients with T2DM
Usually older and obese
How do T2DM patients develpo HONKC
glucose rises slowly over time, causing polyuria and polydipsia. Thirsty patients drink sweet drinks and become more hyperglycaemic. Eventually develop hyper osmolar non ketotic coma (HONKC)
How is HONKC managed
Rehydrate but be careful not too much because brain used to being dehydrated you can’t just pump them full of electrolytes
