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Flashcards in Diabetes Deck (89)
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1

What is the blood glucose reading of a hypoglycaemic patient?

<2.5 mmol/L

2

What is the blood glucose reading of a hyperglycaemic patient?

>10 mmol/L sustained

3

What is healthy fasting normoglycaemia defined as?

3-5 mmol/L

4

What is healthy post-prandial normoglycaemia defined as?

7-8 mmol/L

5

Describe the homeostasis of hyperglycaemia

Rise in blood sugar due to food intake or endogenous glucose produced in liver.
Insulin released from B-cells in pancreas.
Acts on a number of different tissues including liver, muscle etc.
Blood glucose lowered - negative feedback loop

6

Describe the homeostasis of hypoglycaemia

Deliberate or overnight fasting leads to low blood glucose.
Glucagon released from the a-cells of the pancreas
Leads to endogenous glucose production by liver which will lead to rise in blood sugar

7

Insulin is metabolised by the kidney. True or false?

False - metabolised by the liver

8

What is the function of the the pancreas?

99% of the function is in production of enzymes to digest food. Other 1% lies with islets of langerhans which have 5 different cell types.

9

What are the 5 cell types in the islets of langerhans and what do they release?

a - release glucagon
B - release insulin
delta - release somatostatin
epison - release ghrelin
PP - release pancreatic polypeptide

10

What happens in the B-cells when glucose enters the blood upon intake of food?

Glucose uptake by selective glucose transporter on B-cells
Cells undergo electrical change as a result:
K-channels close
Cell depolarises
Ca2+ enters the cell
Insulin is released

11

What happens as a consequence of digestion and presence of sugar in the upper intestine?

Detection of sugar by endocrine cells in the gut results in the release of GLP-1 which travels to B-cells and upon encounter of GLP-1 receptor, it activates them which results in cell signalling and insulin release

12

How does insulin lower blood sugar?

Insulin released from B-cells -? binds to insulin receptors in tissues -> configuration change -> endogenous kinase activity switched on -> phosphorylation of receptors downstream -> transport protein on -> more glucose transported across membrane
More transporters placed on membrane -> increased efficiency of glucose uptake

13

How does insulin promote hypoglycaemia?

Increases the transport of glucose into cells
Converts glucose to glycogen
Decreases glycogen breakdown
Increases fat stores
Increases protein production

14

Describe the homeostasis of hyperglycaemia

Rise in blood sugar due to food intake or endogenous glucose produced in liver.
Insulin released from B-cells in pancreas.
Acts on a number of different tissues including liver, muscle etc.
Blood glucose lowered - negative feedback loop

15

Describe the homeostasis of hypoglycaemia

Deliberate or overnight fasting leads to low blood glucose.
Glucagon released from the a-cells of the pancreas
Leads to endogenous glucose production by liver which will lead to rise in blood sugar

16

Insulin is metabolised by the kidney. True or false?

False - metabolised by the liver

17

What is the function of the the pancreas?

99% of the function is in production of enzymes to digest food. Other 1% lies with islets of langerhans which have 5 different cell types.

18

What are the 5 cell types in the islets of langerhans and what do they release?

a - release glucagon
B - release insulin
delta - release somatostatin
epison - release ghrelin
PP - release pancreatic polypeptide

19

What happens in the B-cells when glucose enters the blood upon intake of food?

Glucose uptake by selective glucose transporter on B-cells
Cells undergo electrical change as a result:
K-channels close
Cell depolarises
Ca2+ enters the cell
Insulin is released

20

What happens as a consequence of digestion and presence of sugar in the upper intestine?

Detection of sugar by endocrine cells in the gut results in the release of GLP-1 which travels to B-cells and upon encounter of GLP-1 receptor, it activates them which results in cell signalling and insulin release

21

How does insulin lower blood sugar?

Insulin released from B-cells -? binds to insulin receptors in tissues -> configuration change -> endogenous kinase activity switched on -> phosphorylation of receptors downstream -> transport protein on -> more glucose transported across membrane
More transporters placed on membrane -> increased efficiency of glucose uptake

22

How does insulin promote hypoglycaemia?

Increases the transport of glucose into cells
Converts glucose to glycogen
Decreases glycogen breakdown
Increases fat stores
Increases protein production

23

What is used as first-aid treatment for severe hypoglycaemia?

Glucagon injection when oral glucose not possible or desired

24

What is diazoxide therapy used for?

Hypoglycaemia - it reverses the action of glucose on B-cells and therefore induces hyperglycaemia

25

What is the presentation of type 1 diabetes?

Polyuria
Polydipsia
Fatigue
Weight loss

26

What condition will the majority of T1DM patients present with?

Diabetes ketoacidosis

27

What happens in DKA in response to absence of insulin?

- Increased glycogenolysis and gluconeogenesis plus reduced uptake of glucose by tissues
- Increased urine output (to remove glucose)
- Suppressed lipolysis -> accumulation of free fatty acids -> ketones

28

In terms of DKA maintenance treatment for adults, when is insulin stopped/reduced?

When ketone levels drop below 3 mmol/L

29

If ketone levels are above 3 mmol/L in DKA patients, what needs to be done?

Give more glucose or give more insulin

30

In DKA patients, what happens when patient is ready to eat and drink?

Let patient eat, then administer insulin SC (30 mins before stopping insulin infusion) then stop glucose IV then stop insulin infusion