Diabetes

Question 1

What is polyuria?

Answer 1

Production of abnormally large volumes of dilute urine

Question 2

What is polydipsia?

Answer 2

Abnormally great thirst

Question 3

What does increased glucagon levels and enhanced hepatic sensitivity to glucagon contribute to?

Answer 3

The excessive glucose production by the liver

Question 4

What does insulin resistance in adipocytes result in?

Answer 4

Accelerated lipolysis and increased plasma free fatty acid levels both of which aggravate the insulin resistance in muscle and the liver and contribute to Beta cell failure

Question 5

What does Increased renal glucose reabsorption by the sodium/glucose co-transporter 2 (SGLT2) and the increased threshold for glucose spillage in the urine contribute to?

Answer 5

The maintenance of hyperglycaemia

Question 6

How does neurotransmitter dysfunction contribute?

Answer 6

-Resistance to the appetite-suppressive effects of a number of hormones, as well as low brain dopamine and increased brain serotonin levels contribute to weight gain, which exacerbates the underlying resistance. -To the earlier described ‘ominous octet’ must be added vascular insulin resistance and inflammation, making the ‘decadent decoplet’.

Question 7

What is prediabetes?

Answer 7

• Prediabetes means that your blood sugars are higher than usual, but not high enough for you to be diagnosed with Type 2 diabetes. It also means that you are at high risk of developing Type 2 diabetes.
• Prediabetes is also called:
  1. borderline diabetes
  2. Impaired Fasting Glucose (IFG)
  3. Impaired Glucose Tolerance (IGT)
  4. Impaired Glucose Regulation (IGR)
  5. Non-diabetic hyperglycaemia

Question 8

What are long term aims of NHS DPP?

Answer 8

1. Reduce incidence to T2 diabetes
2. Reduce complications e.g. stroke kidney eye and foot problems
   3, Reduce health inequalities assoicated with incidence of diabetes

Question 9

What are three core goals of NHS DPP Innervation?

Answer 9

1. Achieving healthy weight
2. Achievement of dietary recommendations
3. Achievement of CMO physical activity recommendations

Question 10

What is the distribution and function of GLUT-1?

Answer 10

• Endothelium and erthyocytes

- Basal transport (insulin independent)

Question 11

What is the distribution and function of GLUT-1?

Answer 11

• Kidney, SI, liver, pancreatic Beta cells

- Low affinity transport (insulin independent)

Question 12

What is the distribution and function of GLUT-3?

Answer 12

• Neurones, placenta

- High affinity transport (insulin independent)

Question 13

What is the distribution and function of GLUT-4?

Answer 13

• Skeletal muscle, adipose

- Insluin-regulated glucose transport

Question 14

How does glucose transport occur? What is the exception?

Answer 14

• Facilitated diffusion

- Luminal epithelial cells in kidney and intestine (which used active transporters SGLT1 and SGLT2)

Question 15

How does insulin act normally in liver?

Answer 15

Increase glucose uptake
Increase glycogenesis 
Decrease glyconeolysis 
Decrease gluconeogeenesis 
increase lipogenesis

Question 16

How does insulin act normally in fat?

Answer 16

Increase glucose uptake
Increase lipogenesis
Decrease lipolysis

Question 17

How does insulin act normally in muscle?

Answer 17

Increase glucose uptake
Increase glycogenesis
Increase protein synthesis
Decrease protein catabolism

Question 18

What happens in T2DM?

Answer 18

increase blood glucose and free fatty acid (beta cell dysfunction), (insulin resistance)

Question 19

What can cause T2DM?

Answer 19

Diabetes susceptibility genes 
Adipokines 
Inflammation 
Hyperglycaemia 
Free fatty acids

Question 20

What is HbA1C?

Answer 20

• Glycated haemoglobin
• Haemoglobin that has become glycosylated i.e. chemically linked to sugar
• This process occurs non-enzymatically and can occur with the monosccardide glucose, fructose and glacltose (glucose least easily)
• Occurs proportionality to plasma glucose levels and so HbA1C levels can be used to diagnose and monitor diabetes

Question 21

What are advantages of HbA1C as diagnostic too for diabetes?

Answer 21

Very quick, cheap, Can be done at anytime, exercise and stress does not affect

Question 22

What are disadvantages of HbA1C as diagnostic too for diabetes?

Answer 22

-If different erythrocytes pathology reference ranges may change / vary

Question 23

Why person more likely to develop T2DM?

Answer 23

Diet age lifestyle alcohol smoking pregnancy (temporary)

Question 24

Why metformin used in first line treatment of T2DM?

Answer 24

Cost well priced
Not drastic fall in blood sugar
Doesn’t cause weight gain

Question 25

Where does metformin act?

Answer 25

Directly in liver cell and mimics CBP (communicate between liver and pancreas)

Question 26

How are complications of diabetes grouped?

Answer 26

1. Microvascular (due to damage to small blood vessels) 2. Macrovascular (due to damage to larger blood vessels). Microvascular complications include damage to eyes (retinopathy) leading to blindness, to kidneys (nephropathy) leading to renal failure and to nerves (neuropathy) leading to impotence and diabetic foot disorders (which include severe infections leading to amputation

Question 27

What are examples of microvascular complications?

Answer 27

• damage to eyes (retinopathy) leading to blindness
• to kidneys (nephropathy) leading to renal failure and
• to nerves (neuropathy) leading to impotence and diabetic foot disorders (which include severe infections leading to amputation

Question 28

What are examples of macrovascular complications?

Answer 28

cardiovascular diseases such as heart attacks, strokes and insufficiency in blood flow to legs