Diabetes Mellitus Flashcards
(29 cards)
Why is diabetes mellitus characterized by?
High blood sugar levels and an insufficiency of insulin
What is the difference between type 1 and 2 diabates?
Type 1 - insulin deficiency caused by pancreatic beta cell destruction (autoimmune)
Type 2 - insulin insufficiency caused by insulin resistance in normal target tissue and beta cell exhaustion
What is diabetes mellitus’ metabolism disorders?
Hyperglycaemia
Ketonemia/ketonuria
Glucosuria
Ketoacidiosis or HONK/HHS
What is diabetes mellitus’ symptoms?
Polydipsia
Polyuria
Blurred vision
Hyperglycemia
Glucosuria
Long term micro and macrovascular complication
How can you diagnose diabetes mellitus?
Elevated 2h post glucose load
Fasting hyperglycemia
How is glycosylated Hb formed?
Spontaneous reaction between glucose and Hb
Non-enzymatic
over 8.0 is bad
What are characteristics of type 1 diabetes?
Early onset
autoimmune destruction of beta cells - loss of insulin production
complex metabolic derangements
hyperglycemia
protein breakdown
ketoacidosis
What is the treatment for type 1 diabetes?
Lifelong insulin replacement therapy
What is the genetic susceptibility for type 1?
Linkage to HLA locus (chromosome 6)
DR3 allele increases risk X5
DR4 allele increases risk X8
What are environmental triggers in type 1?
Childhood viral infections eg coxsackie, mumps and rubella
What does reduced glucose entry lead to?
Hyperglycemia
What does insulin deficiency lead to?
Hepatic gluconeogensis -> increasing plasma glucose
cells are ‘starved’ of glucose (energy)
What does switching to FA metabolism as an energy source lead to?
Excessive FA oxidation leads to increased production of ketone bodies
What happens in diabetic ketoacidosis?
Increased protein breakdown, lipolysis, beta oxidation (acetyl CoA) and ketone bodies
leads to drop in pH and acidosis
What causes diabetic ketoacidosis?
Insufficient insulinisation
How does respiratory compensation reverse metabolic acidosis?
Lowering CO2 by hyperventilation will drive bicarbonate buffering system away from H+ correcting acidosis
What two factors lead to diabetes type 2?
Genetic predisposition and obesity
How is insulin resistance overcome?
Continued secretion of insulin -> after a while beta cells become exhausted
What are the 2 types of fat distribution?
Android (visceral)
Gynoid (subcutaneous)
Which fat is more metabolically active?
Visceral - constant flux of TG and FA between liver and visceral adipose tissue
How does expanded and inflamed adipose tissue affect the liver?
Increases FFA, inflammatory cytokines, insulin resistance
Lowers adiponectin
What are the 7 oral hypoglycemic agents?
Biguanides and Thiazolidinediones - improve insulin sensitivity
Sulfonylureas GLP-1 receptor agonists - increase insulin secretion
alpha glucosidase inhibitors - reduce glucose GIT absorption
SGLT2 inhibitors - reduce renal glucose reabsorption
What is retinopathy?
Changes in retinal microvasculature due to poor glycemic control
What is non-proliferative retinopathy?
Increased vascular permeability/macular oedema
