Week 2 Flashcards
What are the functions of insulin?
Stimulate uptake of and suppress output of glucose in the liver and SM
Inhibit lipolysis in liver and VAT
Stimulate lipid formation in the liver and AT
Inhibit protein breakdown
Stimulate protein synthesis
Affect blood flow and vascular function
What are normal glucose values?
<6, <7,8
What are diabetic BG values?
> 7, >11
What are BG values of IGT?
<7, 7,8-11
What are BG values of IFG?
6-6,9
What nutrients and foods have a protective effect on DM?
Vit D, cereal fibre, magnesium
Coffee, alcohol, whole grains, dairy, vegetables
What nutrients and foods have a negative effect on DM?
glycaemic load, glycemic index, haem-iron
sugar-sweetened beverages, white rice, red meat
When do micro/macrovascular complications start in the progress of DM?
Macro at pre-diabetes
Micro at DM diagnosis
What results in the secretion of insulin?
Influx of calcium in beta-cell -> separation of C-peptide and pro-insulin -> secretion of insulin
What happens when insulin is secreted?
Binds to insulin receptor in cellwall. AS160 is activated, GLUT4 is translocated to cell membrane. Glucose can
What also stimulates AS160?
Excercise
In what situations is insulin resistance also increased?
After fasting, when pregnant, when you have very little AT
What causes insulin resistance?
Lipotoxicity -> impaired glut 4 translocation
What are the results of insulin resistance?
Less sensitive to insulin, incomplete reduction of lipid breakdown -> increased FFAs -> ectopic lipids
What is lipotoxicity?
Exceeding storage capacity of lipids in an organ -> interference with normal function of the cell
What are the two results of adipocyte dysfunction?
- cytokine and adipokine secretion -> macrophages -> low grade inflammation
- insulin resistant adipocytes -> increased release of FFA -> lipotoxicity in other organs
- —SM and liver: insulin resistance
- —pancreas: impaired beta-cell function
- —heart and vessels; affect endothelium
What are the two main adipokines?
Leptin; elevated in obesity, reduces appetite
Adiponectin; lower in obesity
What is the athlete’s paradox?
Athletes have high IMCL to use as energy source, normal people can not use lipids in muscles.
What happens when lipid intermediates accumulate?
They interfere with insulin signalling
What is the OGTT?
Oral glucose tolerance test; measure BG 2h after eating 75 grams of glucose with 250 ml water.
What is the HOMA index?
Insulin x glucose/22,5. Value above 1,5 means insulin resistance.
What are normal fasting glucose and insulin values?
4,5 and 5
What is the hyperinsulinaemic clamp?
Infusion of insulin at a high rate, infusion of glucose to keep BG constant. High need of glucose, no insulin sensitivity.
What is the GIR?
Glucose infusion rate: amount of glucose you need to stabilize BG
