Flashcards in Diabetes Deck (16)
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1
Type 1 diabetes
-juvenile diabetes
- genetic/ environmental component
- underlying mech involves autoimmune desruction of insulin prod beta cells
-5-10% of diabetes
2
Type 2 diabetes
Adult onset (50% are obese)
-insulin resistant skeletal muscle
-90-95% of diabetes
3
complications T2DM
-CVD
- lower limb amputation
-kidney failure
-cognitive dysfunction
4
symptoms of T2DM
-fatigue (not braking down energy sources)
-extreme thirst (to dialate glucose)
- extreme hunger
- lean body loss
5
flow or how muscle atrophy+ decreased insulin signaling happens due to T2DM
metabolic acidosis
increase FFA
Inflammation (IL6, TNfa)
increase glucose
all lead to decreased insulin signaling
6
normal insulin signaling
-when insulin binds to receptors phosphate sites open + autophosphorylation occurs
- IRS gets phosphorylates and activates P13K which converts PIP2 to PIP3
-PIP3 phosphorylates PDK1 which goes to AKT
-AKT travels to AS160 which dissociates from GLUT4
7
Non normal insulin signaling
-FFA will come into cell and block IRS1 and increase ROS which blocks P13K
-both cause PIP2 not to become PIP3
TNFa allso activates IKK which blocks IRS1
8
Ischemia affects
increase ROS, Ca, Calpain, H+, decrease ATP, inhibition of oxidative phosphorylation
9
reprofusion affects
increase ROS, Ca, Calpain, Caspase-3, opens MPTP which leads to cell death
10
both ischemia and reprofusion lead to
mitochondrial injury and cardiac cell death due to necrosis and apoptosis
11
exercise effects on CVD
- increase parasympathetic regulation protecting against ischemia-reprofusion injury
-promotes muscle derived myokines
-can improve myocardial regeneration capacity
- can reverse loss of muscle mass/strength
-angiogenesis (coronary collaterization)
12
Mediators for cardioprotection
- NO increases vasodialation (less likely for obstruction)
-HSP- increase immediatly following ex, protects pro from ROS
-ER stress pro- protects from calcium overload
cystolic antioxidants- fight against free rads in mitochondria
SODI1/2- found in matrix of mito, converts reactibe O2 rto H2O2
13
Endurance training effect against I-R injury
increases SOD2 which alters mito turnover and phenotype which provides cardio protection
14
Heart failure + symptoms
when heart is unable to pump sufficiently to maintain bf to the body
-shortness of breath, fatigue, swelling in legs, rapid/irregular heart beat
15
2 types of heart failure
HF w/ preserved ejection fraction
- stiff and thick chambers, maladaptive
HF w/ reduced ejection fraction
-stretched and thin chambers, can fill heart just not strong enough to pump blood out
16