The Endocrine Pancreas- disrupted state Flashcards
RECAP- which tissues of the body are insulin dependant?
Skeletal muscle
Adipose tissue
What happens to the amount of glucose entering into skeletal muscle during exercise?
It increases, even in the absence of insulin
-> therefore, there is an insulin independent mechanism in which skeletal muscle can uptake glucose without insulin. This can be confusing as skeletal muscle is one of the insulin dependant tissues!
How does the insulin independent mechanism allow glucose into the cell during exercise without insulin?
Increased number of GLUT4 transporters incorporated into the muscle membrane
Why is exercise strongly advised for those who are type 2 diabetic?
Not the only reason but-
Exercise increases insulin sensitivity of muscle, persisting for several hours after exercise. Regular exercise can produce prolonged insulin sensitivity.
In a state of starvation, which tissue gets broken down to meet the energy needs of the body?
Adipose tissue- fat
-> this is because most tissues can use to free fatty acids from the broken down adipose tissue for energy
The brain cannot use free fatty acids for energy. What happens now?
Free fatty acids are converted into ketone bodies which the brain can use if absolutely necessary
Which process converts free fatty acids into ketone bodies?
Beta oxidation
Why does adipose tissue get broken down first in periods of starvation?
If not adipose tissue, protein would be broken down leaving the individual physically weak and more vulnerable to infection
Ketone bodies are only helpful to supply the brain when there is a functioning pancreas as the uptake of ketone bodies is insulin dependant.
What would happen if there was not a functioning pancreas?
Excess ketone bodies in blood which are acidic and can cause life-threatening ketoacidosis.
What is diabetes mellitus?
Loss of control of blood glucose levels
Briefly describe type 1 diabetes.
Pancreas no longer produces insulin and patients must take insulin manually via injection
Briefly describe type 2 diabetes.
Patients have developed insensitivity to insulin. Their pancreas often still produces it but tissues do not respond to it.
What is the pathology behind type one diabetes?
Autoimmune destruction of the pancreatic beta cells destroying their ability to produce insulin
If type one diabetes is not treated, what happens?
Complex changes but ultimately results in starvation and death.
In poorly controlled insulin-dependant diabetes, lack of insulin depresses what?
Ketone body uptake. They then build up rapidly in plasma and cause ketoacidosis.
->Ketoacidosis can cause death within a few hours if not treated
What pH is plasma at in life threatening acidosis/ ketoacidosis?
<7.1
->normal plasma pH is 7.4
Why might patients with type two diabetes have higher levels of insulin than normal?
Their cells are resistant to it. However, the body realises there is an increase in blood glucose so produces more insulin to try and compensate but the body does not respond.
What % of diabetic patients are insulin resistant?
90%
->10% are insulin dependant
Which other condition is type two diabetes commonly associated with?
Obesity
At what age does type two diabetes typically present?
Usually patient is >40yrs but age is decreasing
Which form of diabetes do genetics have a strong impact on risk?
Type 1
->much less likely in type 2, this is good news haha
What is the most diagnostic criterion for diabetes?
Hyperglycaemia
How is hyperglycaemia detected?
Glucose tolerance test
Hyperglycaemia is a concern in both type one and two diabetic patients because it can lead to further long term complications.
List some diabetic complications.
Retinopathy
Neuropathy
Nephropathy
Cardiovascular disease
Foot ulcers
Retinopathy?
Destruction of the retina
Neuropathy?
Destruction of nerve cells leading to loss of sensation
Nepropathy?
Destruction of kidneys
