Flashcards in Metabolic: Insulin Resistance and Diabetes Deck (22):
Describe the insulin receptor?
4 glycoproteins--> 2 are alpha that bind insulin and 2 are beta that have tyrosine kinase activity
When insulin stimulates MAPk what results?
Endothelin -1 production
Factors contributing to insulin resistance?
high visceral fat, impaired mitochondrial lipid oxidatoin
What are the criteria for "metabolic syndrome"
1- abd adiposity
2- mild HTN
3- Impaired fasting glucose levels
4- inc TG and dec HDL
Criteria for diagnosing diabetes?
1- HbA1C >6.5%
2- FPG > 126
3- 2hour plasma glucose >200
4- symptoms of hyperglycemia
"insulin resistance of pregnancy combined with a beta cell defect"
Why does hyperglycemia occur in T2DM?
insulin resistance + inadequate insulin secretion from the pancreas
"rare AD form of inherited diabetes associated with genetic beta cell defects"
Maturity Onset Diabetes of the young
"peptides secreted by the gut in response to meals that increase insulin secretion and decrease glucagon secretion"
most important incretin?
What inactivates GLP-1?
When do you see this patholgy?
"destroyed islets that are ribbonlike cords with little fibrosis or amylin deposition"
Link between T1DM and viral infections?
Possible molecular mimicry--> mumps or Coxsackie B
Is T1DM humoral or cell mediated immune issue?
What is seen in Pre-type 1 diabetes?
anti-islet cell antibodies in the months to years before insulin production decreases
What is the preferentially metabolized fuel in T1DM?
Fat--> leads to ketone production
What are the cellular changes seen in diabetes?
1- Increased ROS and cellular injury
2- protein glycation
3- increased use of the aldose reductase pathway
4- PKC activation bia DAG (increased cytokines)
Where in the body does diabetic atherosclerosis occur?
1- retina and lens of the eye
2- Kidney: glomerulus (glomerulosclerosis) and papilla (mecrotizing papillitis)
4- PVD (amputation/ gangrene,/ chronic ulcers)
What are the neuro dysfunctions seen in diabetes?
Focal demyelination--> neuropathy
GI problems--> gastroparesis and diarrhea
autonomic dysfunction--> cardiovascular prolems
Symptoms of Diabetic glomerulonephritis?
Microalbuminemia + proteinuria
Do T1 or T2 diabetics have a higher risk of diabetic retinopathy?