Type 1 Diabetes - Lecture 23 Flashcards
Different names for Type 1 Diabetes?
Pissing Evil Disease
Why was it called The Pissing Evil
Urine tasted sweet and frequent urination
Before insulin how long did one have to live if diagnosed with Type 1
1 Year; 100% of people died
When and where was insulin made?
1922 and UofT
What were symptoms seen with Type 1
- Sweet Smelling Breath (ketone byproduct)
- Weight Loss
- Sweet Urine
- Coma, Death
Why was Insulin Canada’s most important discovery
Won Canada a nobel prize
How much was the patent sold for?
1 dollar as a gift to medicine.
Who were the 4 that made this happen?
Frederick Banting, Charlie Best, Macleod and James Collip
Banting
Surgeon at UofT came up with idea after seeing lecture on diabetes.
How did Banting use animals to figure out insulin?
He made dogs diabetic and tried to extract chemical from pancreas of other donor dogs to see if it could treat the diabetic dog.
Charlie Best
Medical student who helped Banting discover insulin.
Who was Mcleod?
The supervisor who allowed Banting and Best to use his lab and discover insulin in it.
James Collip
He helped them with carefully isolating the hormone that was needed from the pancreas to get a pure extract for humans.
Who was the first thing/animal to get cured of diabetes
Marjorie
Who was Leonard Thompson
14 year old boy in 1921 diagnosed with Juvenille diabetes, a whole year later he was injected with Toronto insulin and it saved his life.
What’s the phenotype if you have no insulin in your body?
Skinny bone, no muscle mass or fat mass. Stunted growth and frailty.
How did Leonard live before insulin?
Eating 450 cals a day and mild exercise; but blood sugar was still high
Where did doctors get the insulin from when they needed more and more?
From beef and pork; but now synthesized in labs.
Who did the Nobel Committee decide to initially give the prize to?
Frederick Banting and Macleod
What happened to Best and Collip?
Did not get anything out of it.
Why did Banting punch Best?
Fighting over a nobel prize
How did they split the prize money?
Banting shared his half to Best and Macleod shared his half to Collip
Is Insulin a cure?
Not necessarily a cure as it’s more of a controller that needs to be injected every day.
What is the definition of Type 1?
Autoimmune-based metabolic disease that required insulin to live.
What age is Type 1 most common in?
Around teenage age
Are the genetic and environmental triggers for Type 1 known?
Unknown but certain ethnicities are more likely to be exposed to it.
What happens to the body when afflicted with Type 1?
Autoimmune system destroys beta cells because it sees them as foreign invaders.
Process (reasons) of how Type 1 Develops
50% Genetic susceptibility to Type 1 & 50% Environmental Triggers
What are the Environmental Triggers?
Not sure if there is one single trigger; may be multiple different triggers.
Identical Twin studies show what about Type 1
If one twin has type 1 then the other twin has a 50% chance of having it as well.
What are the HLA proteins?
It’s a protein specific to that cell that the immune system won’t attack. It’s on all cells.
What becomes of the HLA Protein with Type 1
It becomes a protein that isn’t specific to the cell which allows it become under attack by the immune cells.
Recognition cells? What do they with Type 1?
Recognition cells are your T-cells looking for viruses and think that the b cells associated with type 1 are invaders and attack.
Catabolism or Anabolism
Body goes into catabolism when insulin isn’t available it just keeps breaking the glucose into the bloodstream.
How does insulin work?
Takes glucose from blood stream and interstitial space and pushes it into cells.
Insulin and the receptor
Insulin is a key for the receptor to open the glucose channel.
What will too much insulin cause?
Causes you to get heavier with low blood sugar because its anabolic.
GLUT 4 Translocater
Where glucose enters through to get to cell.
What happens to the GLUT 4 with Type 1
It does not open because of no insulin production.
How many times should you take insulin?
3 times once after each meal particularly.
Basal Insulin
Your insulin while sleeping and at rest. Need to take insulin for overnight too.
What happens to life expectancy when blood sugar always peaks at a significantly high level
Life expectancy starts to decrease due to cell exposure to toxic levels of glucose.
Is low blood sugar bad for long term as well?
Immediately dangerous as it can cause delayed reactions, fainting and death.
Where does Riddell have to work on his blood sugar?
Before and after midnight
Benefits of an Insulin Pump
Can normalize life
- Don’t need to use needles it will apply insulin whenever it feels like its the right time to use it.
Is exercise good for driving blood sugar down?
It helps the effects of insulin to drive blood sugar down but too much can cause hypoglycemia.
What effects does exercise have overnight on blood sugar
Causes blood sugar to dip again in the middle of the night
What happens to glucose when doing endurance
It will cause glucose levels to drop
What happens with explosive exercise?
Blood sugar goes up because of cortisol and increased stress
What does HIIT Training or Resistance Training do to blood sugar?
It levels out glucose levels as it’s a bit of anaerobic and aerobic.
The worse your blood sugar is the more you will die prematurely. What are some possible effects on the body that might allow for this?
Failing Kidneys, Blindness, Neuropathy, Microalbuminuria (urinating protein)
HbA1c test?
Measures blood sugar levels to see if they have diabetes; highly recommended to pregnant females to check for gestational diabetes.
Islet Transplant?
Surgically harvest the insulin producing cells of the islets of langerhaans and surgically infuse them into the portal vein of the person with Type 1
Why doesn’t the transplant last long?
Because Type 1 is an autoimmune disease so the immune systems will recognize islets as invader cells.
What surgical procedure is better? Artificial Pancreas or Islet Transplantation
Islet transplantation as it keeps the sugar very heavily controlled in the 5-9 range.
