Diabetes Mellitus notes from part 2

Question 1

The most important marker is ________ and you will often here everybody refer to this as A1C…but know that its HbA1c because Hb stands for hemoglobin

Answer 1

HbA1c

Question 2

The higher the sugar in your blood the more likely it is to _________…at glucose to hemoglobin…if that level is high its our major marker for diabetes

Answer 2

glycosylate

Question 3

Why do we look at HbA1C as a major marker for diabetes…glucose is hanging around for too long…what does that indicate to us it tells us…it gives levels over time..diabetes is a chronic disease…our insulin levels are changing we eat a goldfish and some levels are going to rise when our goldfish runs out its going to decrease…what matters is over this 3 month time frame is it really high or not we don’t want snapshots and so the whole point of A1C is it gives us a view over longer term this is a more accurate view of whether the glucose is too high

Question 4

Why is HbA1C insight into a 3 month period? That’s how long the red blood cells last…red blood cells last 3 months…so that red blood cell is glycosylated and then when it gets broken down its no longer glycosylated anymore so it lasts much longer than a protein does

Question 5

We use HbA1c test because it gives level over a time period and we are talking about a chronic disease we need to measure levels over a time period so the higher the A1C the higher correlation the blood sugar is…blood sugar is too high if A1C is too high

Question 6

(Somatostatin as causing stasis to the somatotrophs stopping them from releasing growth hormone

Question 7

What does it mean that insulin is released into the bloodstream through the portal vein?portal vein is liver and liver will ________ the insulin

Answer 7

metabolize

Question 8

50% of insulin that we put into the portal vein never even makes it to the bloodstream.Insulin is very quickly metabolized

Question 9

Insulin leads to glycogen synthesis (taking glucose and making it into a starch to be stored getting it out of the bloodstream
**Protein synthesis **(is taking amino acids and making proteins and not allowing them to be broken into glucose
Lipogenesis (making fat…taking free fatty acids that are not broken by glucose but they are stored as adipose…taking glucose and removing it from the blood and all the different ways that it can…it takes amino acids and turns that into a protein…we do have ways where amino acids can be converted to glucose. Insulin prevents that from happening

Regulation of insulin responsive genes

Question 10

Glucose homeostasis

Balance between hepatic glucose production and glucose uptake and utilizaiton

____________is most important regularator

Answer 10

Insulin

Question 11

When insulin is unable to work what happens? We get ________

Answer 11

diabetes

Question 12

Pathogenesis of Type 2
-There’s some genetic predisposition that** leads to the pancreas to not release insulin properly,**insulin resistance: muscle no longer responds to the signals (ex:come on take this glucose up…skeletal muscle is like nope leave me alone)…they still take some up but cell signaling pathways gets altered…liver can’t keep storing so much and its putting more out

Question 13

Insulin Resistance
* Linked between obesity and type 2 DM
Increased FFA (free fatty acid) storage