Session 1-diabetes Flashcards
What are the 3 symptoms of type 1 diabetes?
Polyuria (excess urine)
Poldipsia (thirst and drinking)-due to Polyuria
Weight loss due to fats and proteins being metabolised because insulin Is absent
what does a lack of insulin cause?
- decreased uptake of glucose into adipose tissue and skeletal muscle
- decreased storage of glucose as glycogen in muscle and liver
- increased gluconeogenesis in liver
what is it called when glucose appears in urine?
glucosuria
which type of diabetes is common in young people?
type 1
which type is characterised by a slow progressive loss of beta cells?
type 2
which type is fatal if not treated?
type 1
which type my not initially need to be treated with insulin but will do eventually?
type 2
what leads to high amounts of ketone bodies?
high rate of beta oxidation of fats in the liver with the low insulin ratio (e.g. acetone may be smelt on patients breath)
what are the symptoms of ketoacidosis (high levels of ketone bodies when body cannot produce enough insulin)?
hyperventilation,nausea,vomiting,dehydration,abdominal pain
where do you test for ketones?
urine
how can diabetics become hypoglycaemic?
insulin treatment with increased exercise, missed meals, overdose.
what are the symptoms of hypoglycaemia?
sweating,anxiety,confusion,drowziness,coma
which enzyme metabolises glucose?
aldose reductase
what is the equation for glucose metabolisation?
glucose + NADPH + H+ —–> sorbitol + NADP+
how does sorbitol accumulate and what is the effect of this?
depletion of NADPH leads to increased disulphide bond formation and protein alteration-causes osmotic damage to cells
what effect does glycosylation have on the body?
-addition of functional group to proteins changing their net charge, 3d structure and function
how can you check whether blood glucose control has been effective?
glucose attaches to Hb forming glycosylated Hb (HBA1C)
-Poorly controlled diabetes have a HbA1c value of above 10%
what are the macrovascular (large blood vessel diseases) complications of diabetes?
increased stroke risk, MI and poor circulation to peripheral parts of the body
what is diabetic eye disease?
- changes in lens due to osmotic effect of glucose (glaucoma) and cataracts (cloudy eye)
- RETINOPATHY-damage to blood vessels in retina leading to blindness
- bleeding in eye
what is diabetic kidney disease?(nephropathy)
- damage of gomeruli, poor blood supply due to change in vessels, or damage from urinary tract
- sign of neuropathy is increased protein in urine (microalbuminuria)
what are the problems associated with poor blood supply to the peripheral parts of the body? (peripheral neuropathy)
loss of sensation, foot problems (gangrene-death of tissue due to obstructed circulation or bacterial infection)
why does polyuria occur in type 1 diabetes?
excess glucose means kidney has to filter more..meaning its hard for the kidney to reabsorb all the glucose.
- Therefore lots of glucose gets left in the nephron (lowers WP) and so less water gets reabsorbed and more moves into the nephron.
- Lots of urine excreted via the collecting duct
what 4 tests can be done to determine presence of diabetes?
random plasma glucose concn (urine stick) >11.1 mmol=diabetes
fasting plasma glucose concn >7mmol=diabetes
OR
Plasma glucose concn >11.1mmol 2 hours after 75g anhydrous glucose in OGTT (oral glucose tolerance test)
OR
TYPE 2 elevated HbA1c>6.5%
Name 3 non insulin therapies of type 2 diabetes.
BAGS
B-biguanides-e.g. Metformin (prevents carb digestion)
AG-alpha glucosidase inhibitors (suppress glucose production in liver)
S-sulphonylureas (increase insulin production by beta cells)
