Type 1 diabetes facts Flashcards
Target of anti diabetic treatment
glycated hemoglobin to <7%
issue with diabetes
ketoacidosis, making ketones which acidifies your blood
Fatty acids from adipose tissue are oxidized to ketone bodies in liver
Insulin metabolism
Liver removes 60%
kidney removes 40%
reverses if artificial insulin
insulin absorption
likes to form large hexamers which are too large to diffuse into blood flow
Properties of glargine insulin
has 2 ionizable arginine molecules that are in solution at low pH at injection time. but at physiological pH (7.4) they precipitate and stay for a long time up to 24h
insulin receptors
Have intrinsic tyrosine kinase that promote glucose uptake, metabolism and storage in muscle. also reduces glucose production in liver (increased storage)
-can also increase protein synthesis
Akt
Activated by insulin binding
acts on FOX01, GSK3, mTOR, Glut4, PDE 3B and acetyl CoA carboxylase
Glut 4
activated by Akt it enters the membrane and increases glucose uptake into muscle and fat cells
GSK 3
inhibited by Akt which disinhibits glycogen synthase to increase storage of glucose
FOX 01
inhibited by Akt it reduces transcription of gluconeogenesis genes in liver
mTOR
activated by Akt is a master protein synthesis regulator and increases muscle mass
Phosphodiesterase 3B (PDE 3B)
Akt increases activity, degrading cAMP and reducing lipolysis in adipose tissue lowering fatty acids, which in turn reduces ketone production as no fatty acids to oxidize
acetyl CoA carboxylase (ACC)
Prevents malonyl CoA production which inhibits fatty acid oxidation and promotes fatty acid biosynthesis further removing fatty acids
Glucagon receptor
Gs GCPR increasing cAMP and increasing PKA
activates glycogen phosphorylase to mobilize glycogen
used for acute hypoglycemias within 15 min
Insulin acylation
lets insulin reversibly bind serum albumin allowing a circulating depot insulin dose
