T1 L13:Type 2 Diabetes Mellitus Flashcards
what is DM t 2 (3m)
A CONDITION WHERE
THE BLOOD GLUCOSE
IS ABOVE
AN INTERNATIONALLY ACCEPTED LEVEL
insulin resistance + Beta Cells
Which cannot produce enough Insulin
To keep the blood glucose Normal
what blood glucose levels are used to diagnose dm 2 (3m)
Glucose = or > 11.1 mmol/l +Symptoms
Glucose = or > 11.1 mmol/l x 2
HbA1c = or > 48 mmol/mol ( 6.5% )
what tests can be used to diagnose dm 2
esp if not sure ie pregnant patient
75 g Glucose Tolerance test
Diabetes Mellitus:
- Fasting plasma glucose = / > 7 mmol/l
- 2 hour plasma glucose = / > 11.1 mmol/l
- Impaired Glucose Tolerance
- -2 hour glucose between 7 -11 mmol/l
-Impaired Fasting Glucose
Fasting glucose between 6 – 6.9 mmol/l
what cells are damaged in the pancreas due to t2 diabetes
Islet cells
what are the characteristics of islet cells that signify t2
A deficit in β-cells
Increased β-cell apoptosis, Extracellular amyloid deposits derived from IAPP
what happens to IAPP (amylin) in t2
Islet amyloid polypeptide (IAPP, amylin) is secreted from pancreatic islet β-cells and converted to amyloid deposits in type 2 diabetes.
what colour stain are amylin when testing for t2
green
Islet amylin polypeptide Polymers(amylin is co-secreted with Insulin
what is the aetiology of t2
pre-birth
Genetic-polygenic
Fetal programming -epigenetic
- maternal hyperglycaemia
- intrauterine maternal growth retardation
Total: reduce the beta cell mass
what are other aetiological factors that are responsible for t2
Beta cell regression ( Sox 5 gene )
Old age
Change in the gut microbiota
what cells become resistant to insulin
liver
muscle
fat cells
where is fat deposited in t2 diabetes
Epicardial fat : - strong risk factor for CVD
Visceral fat
what are the effects of ectopic fat
(5m)
(& what are 2 of their effects )
Increase in:
Free fatty acids
-insulin resistance -atherogenic lipids
cytokines
- insulin resistance
- inflammation
Procoagulant factors (PAI1)
what physical trait statistic is vital in t2
waist circumference
what age groups are more likely for t2
age 55-64
prevalence is above 70% among from 45 upwards.
what are the side effects of t2 diabetes
(morbidity related )
(5m)
Hyperglycaemia per se
Dysregulation of Lipid metabolism
High levels of Proinflammatory cytokines
High levels of Free radicals
Increased susceptibility to Infection
