Diabetes Flashcards
(39 cards)
Diabetes can occur when..
- Pancreas does not produce enough insulin
- When the body cannot effectively use the insulin in produces
Where does hyperglycaemia especially cause damage?
especially the nerves, kidneys, and blood vessels
How many people have diabetes?
About 10% of the global population has diabetes (422 million in 2014)
Prevalence of diabetes is rising more rapidly in countries with which socio-economic state?
Prevalence has been rising more rapidly in low- and middle-income countries than high-income
How many deaths are directly caused by diabetes? (2019)
1.5 million deaths worldwide were directly caused by diabetes (2019)
What types of diabetes are there?
- Type 1 (young, thin people)
- Type 2 (obese, middle-aged, family members hereditary)
- Gestational diabetes (after delivery),
- Rare types (purely genetic, associated with other diseases)
What types of diabetes are there?
- Type 1 (young, thin people)
- Type 2 (obese, middle-aged, family members hereditary)
- Gestational diabetes (after delivery),
- Rare types (purely genetic, associated with other diseases)
T2 diabetes accounts for …% of all diabetes cases
90%
How is blood glucose regulated in the body?
After ingesting meal -> glucose enters blood -> triggers beta-cells of pancreas, insulin stimulates uptake in skeletal muscle, liver, adipose tissue. At same time: insulin suppresses glucose output liver.
After a while, insulin levels go down, liver makes glucose again. Glucose uptake reduced
Which organs are involved in blood glucose regulation?
Liver, skeletal muscle, adipose tissue, intestine, pancreas
What is the meaning of hyperglycemia, insulin resistance, ß-cell dysfunction
= high blood glucose. Insulin resistance = cells don’t respond well to insulin -> cannot easily take up glucose
Beta-cell dysfunction = beta cells secrete insulin, but when this fails = dysfunction
Explain the development of type II diabetes over time
Insulin resistance slowly develops over time, in response the beta-cells secrete more insulin for glucose to enter the cells. Then, in the long run, beta-cell function fails. Secretion finally goes down. Control blood glucose is disturbed, hyperglycemia starts to develop. Initially after meal, ultimately also in the fasting state. Diabetes is diagnosed.
- the difference between type I and II diabetes?
= type 1 diabetes is a genetic condition that often shows up early in life, and type 2 is mainly lifestyle-related and develops over time.
What is the incidence of diabetes?
1.5 mil new patients/year (US), Lifetime incidence: 40% of patients develop t2 diabetes during their lifetime
What is the prevalence of diabetes worldwide and its trend
463 mil people (90-95% t2), rising (700 mil 2045) bc populations are ageing and growing, high increase in Africa, but everywhere worldwide
What are the three main reasons why the prevalence of type II diabetes is rising
- ageing
- growing population
- increase in obesity
What are the two explanations for differences in the % of people with diabetes across different ethnicities?
Differences in socio-economic status
Genetics
- how is blood glucose regulated in a healthy state and how this is dysregulated in type II diabetes
Healthy state: glucose in the blood stimulates the pancreas, which secretes insulin that binds to insulin-receptors. This triggers a cascade of events within cells, leading to increased uptake of glucose in these organs (muscle, adipose tissue, liver).
Insulin also promotes glucose storage (glycolysis and glycogenesis in liver, or storage as fat)
In T2 diabetes: insulin resistance. Receptors don’t work properly, insulin does not work properly on liver, adipose tissue, skeletal muscle. -> results in high blood glucose levels for longer times. Pancreas is therefore told to secrete more insulin.
- why people with untreated type II diabetes have polyuria and increased thirst?
Glucose travels to kidneys and is secreted out (= glucosuria), which results in osmotic diuresis. -> glucose drags water with it, person pees more (polyuria) = loss water + electrolytes = dehydration + hyperosmolar state. This leads to increased thirst.
how can untreated type II diabetes lead to kidney failure?
high blood sugar from diabetes can damage blood vessels in the kidneys as well as nephrons so they don’t work as well as they should
- how insulin resistance may lead to ß-cell atrophy, and its consequences for treatment
Body does not respond to insulin properly, therefore beta cell atrophy happens. Need to be on insulin injections.
What are the four symptoms of uncrontrolled diabetes?
- Polyphagia = eating more because of hunger / weight loss.
Mechanism: cells cannot use glucose from the blood, and therefore the fat tissue starts to break down fat and muscle tissue breaks down proteins. This leads to weight loss. This catabolic state makes people feeling hungry and eating more. - Glucosuria = glucose spill-over into the urine
- Polyuria = when glucose gets excreted into urine, it attracts water due to osmosis → more urine → more frequent urination
- Polydipsia = thirst → drinking more because of the increased frequency of urination
What does glucagon do?
increase blood glucose levels
- describe how type 1 diabetes results from a genetic abnormality in the function of T-cells
There is a type 4 hypersensitivity immune response where a persons own T-cells attack the pancreas. There is a loss of self-tolerance that target the beta-cell antigens.
People with diabetes T1 often have specific HLA genes in common with each other (human leukocyte antigen
