Week 2

Question 1

What are the functions of insulin?

Answer 1

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

Question 2

What are normal glucose values?

Answer 2

<6, <7,8

Question 3

What are diabetic BG values?

Answer 3

> 7, >11

Question 4

What are BG values of IGT?

Answer 4

<7, 7,8-11

Question 5

What are BG values of IFG?

Answer 5

6-6,9

Question 6

What nutrients and foods have a protective effect on DM?

Answer 6

Vit D, cereal fibre, magnesium

Coffee, alcohol, whole grains, dairy, vegetables

Question 7

What nutrients and foods have a negative effect on DM?

Answer 7

glycaemic load, glycemic index, haem-iron

sugar-sweetened beverages, white rice, red meat

Question 8

When do micro/macrovascular complications start in the progress of DM?

Answer 8

Macro at pre-diabetes

Micro at DM diagnosis

Question 9

What results in the secretion of insulin?

Answer 9

Influx of calcium in beta-cell -> separation of C-peptide and pro-insulin -> secretion of insulin

Question 10

What happens when insulin is secreted?

Answer 10

Binds to insulin receptor in cellwall. AS160 is activated, GLUT4 is translocated to cell membrane. Glucose can

Question 11

What also stimulates AS160?

Answer 11

Excercise

Question 12

In what situations is insulin resistance also increased?

Answer 12

After fasting, when pregnant, when you have very little AT

Question 13

What causes insulin resistance?

Answer 13

Lipotoxicity -> impaired glut 4 translocation

Question 14

What are the results of insulin resistance?

Answer 14

Less sensitive to insulin, incomplete reduction of lipid breakdown -> increased FFAs -> ectopic lipids

Question 15

What is lipotoxicity?

Answer 15

Exceeding storage capacity of lipids in an organ -> interference with normal function of the cell

Question 16

What are the two results of adipocyte dysfunction?

Answer 16

• 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

Question 17

What are the two main adipokines?

Answer 17

Leptin; elevated in obesity, reduces appetite

Adiponectin; lower in obesity

Question 18

What is the athlete’s paradox?

Answer 18

Athletes have high IMCL to use as energy source, normal people can not use lipids in muscles.

Question 19

What happens when lipid intermediates accumulate?

Answer 19

They interfere with insulin signalling

Question 20

What is the OGTT?

Answer 20

Oral glucose tolerance test; measure BG 2h after eating 75 grams of glucose with 250 ml water.

Question 21

What is the HOMA index?

Answer 21

Insulin x glucose/22,5. Value above 1,5 means insulin resistance.

Question 22

What are normal fasting glucose and insulin values?

Answer 22

4,5 and 5

Question 23

What is the hyperinsulinaemic clamp?

Answer 23

Infusion of insulin at a high rate, infusion of glucose to keep BG constant. High need of glucose, no insulin sensitivity.

Question 24

What is the GIR?

Answer 24

Glucose infusion rate: amount of glucose you need to stabilize BG