type 2 diabetes Flashcards

1
Q

what does insulin promote in cells

A

gene expression, dna replication, glycogen sythesis, glucose uptake in muscle and liver, fatty acid synthesis, protein sythesis

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2
Q

what does insulin reduce in cells

A

glycogenolysis in liver and muscle, lipolysis in adipose, cell apoptosis, (gene expression?)

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3
Q

describe insulin mechanism of action in cell

A

insuling binds to receptor, the receptor is autophosphorylated, ir catalyses tyrosine phosphorylation of insulin receptor substrates, irs1 activates several signalling pathways

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4
Q
the PI(3)K (phosphatidyl inositol 3 OH
kinase) pathway is involved in??
A

protein

carbohydrate and fat metabolism

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5
Q

• the MAP (mitogen activated protein)

kinase pathway is involved in?

A

cell growth

and differentiation through ras.

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6
Q

RS-1 binding and phosphorylation and

subsequent activation of PI3-K lead to

A

increase in glut4 oninsulin sensitive tissue, glut 4 transported via vesicles to surface

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7
Q

what is ras

A

ras is an oncogene product, a small GTPase
• it is a signal transduction protein
• it activates a number of pathways
• MAP kinase pathways particularly important

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8
Q

how does insulin alter dna expression

A

shc docking protein phosphorylates ras which activates raf, a cascade follows resulting in MAPK protein phosphorylation activating transcription factor affecting gene expression

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9
Q

how does Termination of insulin signal occur

A

protein phosphatases and phosphoinostide phosphatases inhibit at several points along the signalling pathway, phosphorylation of irs on serine/threonine sites is another turn off mechanism, these mechanisms are important in insulin resistance

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10
Q

defien insulin resistance

A
Condition in which normal amounts of
insulin are inadequate to maintain normal
concentrations of blood glucose
• both insulin and glucose are high
• often associated with obesity
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11
Q

what is the simplest explanation of insulin resistance

A

high conc of circulating insulin causes insulin receptors to be down regulated, interference with insulin signalling pathway and inflammation contribute to resistance

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12
Q

why are obese people at risk of diabetes

A

more adipose tissue and adipose tissue plays a significant role

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13
Q

what is the role of adipose tissue

A

produces metabolites, hormones, cytokines which modulate metabolism,

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14
Q

Characteristics of the obese state which are key in

development of insulin resistance

A

Chronic inflammation
• Oxidative stress
• Hyperinsulinaemia
• Lipotoxicity

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15
Q

the chracteristics of the obese state intefere with what mechanisms to do with insulin control

A

insulin secretion, insulin signalling pathways, glucose transport, insulin receptor numbers and binding affinity

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16
Q

leptin is produced in adipocytes what does it do for insulin

A

leptin is good it increase sensitivity however , obese are often leptin resistant

17
Q

what does adiponectin do

A

it increases insulin sensitivity however decreased in obese

18
Q

why are DAG and FFA from aipose tissue bad

A

FFA and DAG can impair insulin sensitivity by interfering with IRS activation

19
Q

TNFα effects IRS positively or negatively

A

TNFα also interferes with IRS activation which will inhibit insulin signal BAD

20
Q

how does inflammation effect insulin pathways and metabolism

A

Adipose expansion in obesity recruits monocytes which become
macrophages
• They secrete proinflammatory cytokines e.g. TNFα and IL-6
• They lead to increased secretion of FFA and ceramide
• and decreased secretion of adiponectin

21
Q

how does tnfa work

A

TNFα causes Ser phosphorylation through JNK kinase which

terminates insulin signal prematurely

22
Q

explain role of oxidative stress in obese individual effecting inuslin pathways

A

In obesity the oversupply of fatty acids and
glucose to the mitochondria leads to ROS
overproduction
• They interfere with PI3K activity.

23
Q

explain role of lipotoxicity in IR

A

increase of tag ffa ceramide in obese, intefere with phosphorylation of IRS causing premature sig termination causing IR. Thiazolidinediones inhibit lipolysis and can help to some extent

24
Q

does type 2 diabetes cause metabolic syndrome

I may not be completely right with this flashcard

A

no
Type 2 diabetes is considered a complication of
metabolic syndrome.

• In a patient with impaired glucose tolerance or
impaired fasting glucose who also has the
characteristics of metabolic syndrome the risk of
developing type 2 diabetes is twice as high

25
Q

what is metabolic syndrome

A

abdominal waist circumference that is large, high BP, high blood glucose, high serum TAG, low hdl conc