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Metabolism, Endocrinology and Haematology > Session 7 - Endocrine Pancreas And Diabetes Mellitus > Flashcards

Session 7 - Endocrine Pancreas And Diabetes Mellitus Flashcards

1
Q

What are 4 functions of insulin?

A

Anti-gluconeogenic
Anti-lipolitic
Anti-ketogenic
Glycogenic

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2
Q

What are 4 functions of glucagon?

A

Ketogenic
Lipolitic
Gluconeogenic
Glycogenolytic

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3
Q

What are the 6 steps of insulin synthesis?

A
  1. Pre-proinsulin synthesized by ribosomes on rough ER
  2. Signal cleaved becomes proinsulin in ER
  3. Proinsulin packaged into storage vesicles in trans-Golgi apparatus
  4. Proteolysis removes C-peptide and breaks proinsulin into insulin - 2 chains held together by disulphide bridge
  5. Margination - vesicle moves to cell surface
  6. Exocytosis - vesicle content released
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4
Q

How is insulin stored in beta-cells?

A

Stored in beta-cell storage granules as crystalline zinc-insulin complex

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5
Q

What is Diabetes Mellitus?

A

Group of metabolic disorders characterized by hyperglycemia due to insulin deficiency, resistance or both

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6
Q

What are 8 key differences between type 1 and 2 diabetes?

A 
Childhood / middle age 
Sudden onset / gradual onset 
Severe / acute symptoms
Recent weight loss / no Weight loss
Usually lean / obese
Ketosis / non-ketotic
No C peptide / C-peptide detectable 
Markers for auto-immunity / no markers for autoimmunity
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7
Q

What is type 1 diabetes?

A

Progressive loss of all or most of pancreatic beta cells

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8
Q

What is type 1 diabetes caused by?

A

Genetic predisposition interacts with environmental trigger produces immune activation which destroys beta cells

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9
Q

What are 4 symptoms of type 1-diabetes?

A 
Polyuria 
Polydipsia
Weight loss 
Glucosuria 
Acetone breath
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10
Q

What is diabetic ketoacidosis?

A

High rates of beta oxidation of fats in liver and low insulin leads to production of many ketone bodies, causes keto acidosis which can be fatal

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11
Q

What is type 2 diabetes?

A

Slow progressive loss of beta cells and disorders of insulin secretion and tissue resistance to insulin

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12
Q

What causes type 2 diabetes?

A

Genetic predisposition

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13
Q

What are 9 possible symptoms of type 2 diabetes?

A 
Polyuria
Polydipsia
Weight loss
Lethargy
Thrush infection of genitalia
Infection of feet
Poor wound healing 
Visual problems
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14
Q

How to treat type 1 diabetes?

A

Insulin injections - appropriate doses and times
Diet and exercise
Frequent blood glucose measurement - glucometer

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15
Q

How to treat type 2 diabetes?

A

Diet and exercise
Insulin injection
Oral hypoglycemic drugs - sulphonylureas and metformin

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16
Q

How does sulphonylureas treat diabetes?

A

Increase insulin release from remaining beta cells and reduce insulin resistance

17
Q

How does metmorfin treat diabetes?

A

Reduce gluconeogenesis

18
Q

What is the effect of persistent hyperglycemia?

A

Abnormal metabolism of glucose by Aldiss reductase which depletes cellular NADPH and increases disulphide bond formation, affecting structure and function. Increased sorbitol also causes osmotic damage

Increased glycation of plasma proteins, affects function

19
Q

Why measure glycation of haemoglobin?

A

Glucose in blood will react with terminal valine of haemoglobin to produce glycated haemoglobin, %HbA1c reflects average blood glucose concentration over the past 3 months

20
Q

What are 3 macro vascular complications of diabetes?

A

Increased risk of stroke
Increased risk of MI
Poor circulation to the periphery

21
Q

What are 4 micro vascular complications of diabetes?

A

Diabetic eye disease - visual problems due to osmotic effects of glucose, retinopathy (damage to blood vessels in retina)
Diabetic kidney disease - damage to glomeruli, poor blood supply due to changes in blood vessels, infections of urinary tract
Diabetic neuropathy - damaged peripheral nerves, causing loss of sensation
Diabetic feet - poor blood supply, damage to nerves, increased risk of infection

22
Q

What is metabolic syndrome?

A

Group of symptoms including insulin resistance, dyslipidaemia, glucose intolerance and hypertension associated with central adiposity

23
Q

What are 2 effects of metabolic syndrome?

A

Type 2 diabetes

Heart disease

Metabolism, Endocrinology and Haematology (8 decks)

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