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BRS > week3-L6-intro to Diabetes Mellitus > Flashcards

week3-L6-intro to Diabetes Mellitus Flashcards

1
Q

GLUT4

A

highly insulin responsive common in muscle and adipocytes, recruited by insulin to uptake glucose

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2
Q

effects of insulin of cell metabolism

fed state

A

increase protein synthesis and inhibit protein breakdown and gluconeogenesis

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3
Q

effects of glucagon on cell metabolism

fasting state

A

opens channels to allow transport of pyruvate lactate
increase breakdown of proteins
increase gluconeogenesis

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4
Q

fuel stores

A

carbohydrate, fat and proteins

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5
Q

effects on insulin of adipocytes

A

increase activity of LPL lipoprotein lipase
increase Glycerol and NEFA intake to form triglyceride and inhibit triglyceride breakdown
NB cortisol and GH breakdown triglyceride during fast state

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6
Q

why short responsive time?

A

due to double circulation of the GI and hepatic portal circulation

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7
Q

gluconeogenesis

A

contribute to 25% hepatic glucose output HGO 10h after fasting
triglyceride into Gly-3P to glucose

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8
Q

brain fuel

A

glucose or ketone bodies

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9
Q

ketone bodies regulation

A

insulin inhibition

glucagon stimulate conversion of fatty acyl CoA into ketone bodies due to low glucose present for brain supply

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10
Q

hepatic glycogenolysis

A

conversion of liver glycogen store to glucose to increase the HGO

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11
Q

difference between glycogen in liver and muscles

A

only liver glycogen store can be broken down to glucose

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12
Q

hormone acting of muscle cells

A

cortisol and GH inhibit the glucose uptake but insulin hormone increase the uptake of glucose

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13
Q

fasted state process

A

increase lipolysis, proteinolysis glycogenolysis and gluconeogenesis to increase the HGO and prolonged state results in increase ketogenesis; low insulin to glucagon

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14
Q

fed state process

A

increase lipogenesis, protein synthesis and glycogen store
decrease proteinolysis and gluconeogenesis
high insulin to glucagon ratio

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15
Q

diabetes

A

too high blood glucose the the body cannot overcome

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16
Q

diagnosis of diabetes tests

A 
fasting tests
random glucose 
oral glucose 
HbA1c
requires 2 positive test or 1 positive and 1 osmotic symptoms
17
Q

fasting glucose

A

> 7.0mmol/L

18
Q

random glucose

A

morning glucose, 11.1mmol/L

19
Q

oral glucose tolerance test

A

any point of the day, fasting 75g load

20
Q

HbA1c

A

average glucose for the last 3 months based on haemoglobin turnover

21
Q

types 1 Diabetes

A

autoimmune condition, where no insulin is produced at all
resulting in diabetic ketoacidosis
pH< 7.3

22
Q

signs and symptoms of T1DM

A

weight loss, hyperglycaemia, glycosuria with osmotic symptoms, ketones in blood and urine

23
Q

Diagnostic test of T1DM

A

antibodies GAD and IA2
c-peptide
presence of ketones

24
Q

too much insulin administered

A

hypoglycaemia, no glucose output from liver

too much glucose muscles

25
Q

conterregulatory response to hypoglycaemia

A

increase HGO by glycogenesis and gluconeogenesis and increase lipolysis

26
Q

impaired awareness to hypoglycaemia

A

reduced ability to recognise symptoms
Loss of counter regulatory response
Recurrent hypoglycaemia

27
Q

signs and symptoms

A

autonomic: sweating, pallor, palpitations and shaking
neuroglycopenic: slurred speech, poor vision, confusion, seizures, loss consciousness

28
Q

severe hypoglycaemia

A

need 3rd party assistance

29
Q

type 2 diabetes

A

insulin resistance in liver, muscle and adipose tissues

suppress ketogenesis and proteolysis

30
Q

clinical symptoms of insulin resistnace

A

high triglyceride and low HDL, inflammatory state and energy expenditure, hypertension BP > 135/80
waist circumference men>102 and women >are 88
fasting glucose >6.0mmol/L

31
Q

type 2 diabetes signs

A

hyperglycaemia, overweight, dyslipdaemia, less osmotic symptoms, insulin resistance and later deficiency

32
Q

type 2 diabetes risk factors

A

age, high BMI family heritability, inactivity and ethnicity

33
Q

dietary recommendations and education

A

healthy eating and diet; calories control and reduce fat, reduce refined carbohydrate and increase complex ones
increase soluble fibres and decrease sodium

34
Q

type 1 diabetes management

A

exogenous insulin and self monitoring of glucose.

structured education and technology

35
Q

type 2 diabetes management

A

diet oral medication

structured education and insulin needs

36
Q

both type 1 and type 2 management

A

monitor and prevent retinopathy, neuropathy, nephropathya and cardiovascular

BRS (28 decks)

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