Diabetes Flashcards
(33 cards)
Description of glucagon
29 amino acid polypeptide
Potent hyperglycaemic agent
Major target = liver
What does glucagon promote?
- Glycogenolysis- glycogen to glucose
- Gluconeogenesis - synthesis of glucose from lactic acid and non carbs
- Release of glucose to blood from liver cells
Description of insulin
51 amino acid polypeptide
Two aa chains linked by disulphide bonds
Synthesised as part of pro insulin
Cleaved to make functional insulin
Potent hypoglycaemic agent
What does insulin promote?
Enhances transport of glucose into cells
Counters metabolic activity that would enhance BGL
Insulin is what type of receptor?
Tyrosine kinase enzyme
What does insulin binding trigger:
- Catalyses oxidation of glucose for ATP production
- Polymerises glucose to form glycogen
- Converts glucose to fat
What is the NHS definition of Diabetes
Diabetes is a lifelong condition that causes a persons blood sugar level to become too high
Overview of diabetes
A disease of high glucose, but also BP
Common and expensive
Associated with significant morbidity
With training and support can be an aged well
Diagnosing diabetes Mellitus
- Urine analysis for glucose
- Blood glucose values
- Oral glucose tolerance test - Gold standard
- Glycated haemoglobin - HbA1c
Are urine analysis for glucose useful
Useful but not enough
Not sensitive or specific
But glucose in urine should always be investigated
Values for random glucose test
Diabetes mellitus if more than 11.1 mmol/L
Values for fasting glucose test
Diabetes mellitus will have range bigger than 7.0 mmol/L
How to conduct oral glucose tolerance test
Fasting state
Measure glucose at time 0hrs
75g glucose drink over 5mins
Wait 2hrs
Measure glucose at time 2hrs
What is the normal range for glycated haemoglobin
48-58 mmol/mol
What is the role of insulin
Anabolic hormone
- maintain supply of glucose in tissues
- regulates metabolism in muscle
- promotes protein synthesis
- inhibit breakdown of fat
What is the precursor of insulin
Proinsulin
What is type 1 diabetes
Genetic cause
Where body’s IMS attacks and destroys the cells that produce insulin
What is type 2 diabetes
Where the body doesn’t prod enough insulin, or the body’s cells don’t react to insulin
What is gestational diabetes?
During pregnancy, some women have high levels of BG
Body unable to produce enough insulin to absorb it all
What is the onset of type 1 diabetes
Under 40 years
Population of Britain that have type 1
0.3%
Describe a glucose profile for diabetes patient
Dawn phenomenon in diabetes patient: high BG Cortisol levels high in the morning
Evening meal: BGL rise
Mean BG higher for patient with diabetes, peaks are more pronounced and more variability
Values for hypoglycaemia
4 mmol/L
Symptoms of both type 1 and type 2 diabetes
Weight loss
Tiredness/ coma: brain not getting enough glucose
Infection - as BGL increases, immunity deceases (candidiasis, urine infection, abscesses)
Osmotic symptoms
