Flashcards in Diabetes Pathogenesis Deck (9):
How does Type 1 diabetes develop?
Autoimmune condition in which lymphocyte infiltration of Islets of Langerhans causes insulitis, destroying B cells and compromising the ability to absorb Glc from blood.
Describe the aetiology of Type 1 Diabetes?
A combination of genetics and environmental factors.
Human leukocyte Antigens (HLA) + chemicals or viral infection
Describe the aetiology of Type 2 Diabetes?
A combination of insulin resistance due to visceral fat and genetic inability to secrete high levels of insulin
What causes insulin resistance in Type 2?
Visceral fat mass
-> Free FAs in the blood
-> FAs clog Insulin receptors
-> Reduced insulin sensitivity
Explain the genetic aspect of Type 2 diabetes?
Most peoples genes are capable of upscaling insulin production to match insulin resistance.
In some people a number of genes are 'defective variants' which code for Poor B cell 'high end' insulin secretion.
Essentially they can't produce enough insulin to match the new insulin resistance
If visceral fat triggers Type 2 diabetes, how come some slim people get it?
They're genes are so poor for insulin production that even a small amount of fat triggers diabetes
Explain the aetiology of MODY?
Autosomal dominant genetic syndrome.
A single gene leads to impaired B-cell function.
Either Glucokinase or Transcription Factor mutations.
What can cause secondary DM?
- Drugs e.g. CCS
- Pancreatic Destruction/removal
- Genetic syndromes
- Endocrine disorders e.g. cushings, acromegaly or pheochromocytoma