Week 7 - Diabetes

Question 1

Who get Maturity Onset diabetes?

Answer 1

basically type 1 but occurs later in life

Question 2

What is latent autoimmune diabetes of adults?

Answer 2

it is genetic therefore people are genetically pre-disposed
- don’t need treatment

Question 3

What is Diabetes Insipidus?

Answer 3

dilute urine

Question 4

What are the non-clinical symptoms of diabetes?

Answer 4

polyuria - frequent urination

polydipsia - frequent thirst

<ketaoacidosis> only type one
</ketaoacidosis>

Question 5

How do clinicians diagnose diabetes?

Answer 5

ask for fasting blood glucose

urine glucose - glycosuria

glucose tolerance test

glycated haemoglobin

Question 6

What makes type 1 different?

Answer 6

type 1 is a heterogeneous group of syndromes characterised by an elevation of fasting blood glucose caused by absolute deficiency in insulin due to the breakdown of pancreatic beta cells

• type one cannot produce insulin which is why they need insulin pumps

Question 7

Type 1 Symptoms

Answer 7

polyuria

polydipsia

polyphagia - feeling of hunger

fatigue and weight loss

Question 8

In type one, why does polyphagia occur?

Answer 8

cells think they are in constant state of fasting

metabolically the body thinks it’s in the state of fasting and it actually releases fatty acids from the adipose tissue as a response.

Question 9

What does a type one feel fatigue?

Answer 9

no insulin

glycolysis doesn’t take place, or at least not very efficiently, and they have low ATP levels as a result

Question 10

What are the metabolic end points of type 1?

Answer 10

hyperglycaemia

ketoacidosis

hyperlipidermia

hypoglycemia

thin - fasting type

Question 11

Why does ketoacidosis take place?

Answer 11

No insulin, but we have got glucagon. Glucagon being the fasting response hormone.

Glucagon triggers the release of fatty acids from the adipose tissue

Those fatty acids, go to the liver where there are oxidised

One end point of beta-oxidation is acetyl-coA (feeds into the kerb cycle)

Another end point of glyucagon is gluconeogensis where we use oxaloacteyate as an intermediate for making new glucose

the over supply is redirected to ketogenesis
= acetacetate and acetone (this is a random breakdown)
pear drop

Question 12

What is an advantage of ketogenesis in the body?

Answer 12

in the brain
The erythrocytes and the muscle tissues can use ketones as an energy source.

Question 13

How is type 2 different?

Answer 13

a heterogeneous group of syndromes characterised by an elevation of fasting blood glucose caused by a relative deficiency in insulin

• insulin resistance

Question 14

Symptoms of type 2 diabetes

Answer 14

polyuria

polydipsia

obesity

Question 15

What is insulin resistance?

Answer 15

a condition in which peripheral tissue loses the ability to uptake plasma glucose efficiently at physiological concentrations of insulin

as a result the pancreas secreted more insulin to compensate

Question 16

How is obesity linked to type 2?

Answer 16

overloading adipocytes theory

Question 17

What is the overloading adipocytes theory?

Answer 17

we’ve got the adipose tissue with fat cells, and those fat cells will release fatty acids and the control of glucagon and storage with insulin.

as the fat cell stores grow they come pro-inflammatory - they produce monocyte chemotaxis protein (MCP1)

MCP1 attracts monocytes or macrophages that will secrete TNF alpha

TNF alpha is a pro- inflammatory cytokine

there is a lesser control of fatty acid to release
and inhibit insulin signalling in the liver and skeletal muscles

And by inhibiting insulin signalling, we therefore increase or the result is insulin resistance.