Metabolism 3

Question 1

what is diabetes?

Answer 1

• it is a metabolic disease characterised by high blood glucose

Question 2

diabetes can lead to insulin resistance. TRUE OR FALSE?

Answer 2

TRUE

Question 3

Hyperglycemia can cause microvascular and macrovacular complications. true or false?

Answer 3

true

Question 4

What microvascular damage can occur?

Answer 4

• Damage to the endothelial wall of small blood vessles

Question 5

what macrovascular damage can occur in diabetes?

Answer 5

• Lead to oxidative stress

Question 6

what are the three mechanims in which hyoerglycemia causes microvascular damage?

Answer 6

• Sorbitol pathway
• Glycated protein (AGE)
• Fatty acid - diacy glycerol pathway

Question 7

what occurs in the soribtol pathway?

Answer 7

• Reduced NADPH - an important oxidative molecule
• Leads to production of sorbitol
• Leads to oxidative stress
• reduced vasoelasticity

Question 8

what occurs in the glycalated protein pathway?

Answer 8

• Increased protein stability
• Altered extracellular matrix
• Altered cellular interactions

Question 9

what occurs with fatty acid - diacyl glycerol pathway?

Answer 9

• Diacyl glycerol protein phosphorylation
• ALtered cellular signalling
• Multiple effects on vascular cells

Question 10

Diabetes is an indepedent risk factor for coronary artery diseas, cerebrovscaular disease, peripheral vascular disease. TRUE OR FALSE?

Answer 10

TRUE

Question 11

what are the other comorbity risk factors of diabetets

Answer 11

• obesity
• Hypertension
• Hyperlipidemia
• altered platelet function

Question 12

With type 2 diabetes most patients have macorvascular disease at diagnosis. TRUE OR FALSE?

Answer 12

TRUE

Question 13

With type 1 diabetes the age and duration of diabetes correlates with the degree of macrovascular disease. TRUE OR FALSE?

Answer 13

TRUE

Question 14

Most diabetes treatment target the hyperglycemia. TRUE OR FALSE?

Answer 14

TRUE

Question 15

Type 1 diabetes is an autoimmune disease. TRUE OR FLASE?

Answer 15

TRUE

Question 16

Type 1 diabetes is antibody immediated immune destruction of the beta cells. TREU RO FASLE?

Answer 16

True

Question 17

What are beta cells?

Answer 17

• Insulin secreting cells in the islet of langerhans

Question 18

When is type 1 diabetes marked?

Answer 18

• When 80-90% of the beta cells are lost

Question 19

what is insulitis?

Answer 19

• when beta cells start to destroy the islets of langerhans and beta cells start to get loss

Question 20

the first thing to go after beta cell loss is the loss of first phase insulin secretion. TRUE OR FLASE?

Answer 20

TRUE

Question 21

what are the complications of type 1 diabets?

Answer 21

• Chronic effectsof hyperglycemia
• Hypoglycemia - due to over administartion of insulin
• Diabetic ketoacidosis
• Both are very fatal

Question 22

the brain in the fasting state is relying upon energy from gluconeogenesis and ketone bodies. TRUE OR FALSE?

Answer 22

TRUE

Question 23

what occurs in a diabetic state in terms of metabolism?

Answer 23

• High blood glucose
• However, there is no insulin and very few insulin
• This means that lipolysis is not turned off
• Gluconeogensis is not turned off
• There is increased productin of ATP and B-oxidation leadting to more production of ketone bodies
• Leads to hyperglycemia and ketoacidosis
• Lead to coma and death

Question 24

What is type 2 diabetes?

Answer 24

• It is the inability of insulin to exert its effects in the liver and adipose tissue
• Resistance to insulin

Question 25

what causes type 2 diabetes/

Answer 25

- Obesity | - hyperglycemia and high free fatty acids

Question 26

what causes insulin resistance?

Answer 26

- Diet - Strong genetic component - Environemntal factors - cellular stress responses - alters insulin signalling pathways - Ectopic lipid accumulation - accumulation of lipid mediators - Inflammation - macrophages in adipose tissue cause release of inflammatory cytokines TNFa

Question 27

Ectopic lipid accumualtion underlies insulin resistance. TRUE OR FALSE? (fat stores are overwhlemed)

Answer 27

TRUE

Question 28

Diacyl glycerol and ceramides can block the effect of insulin which can lead to oxidative stress. TRUE OR FALSE?

Answer 28

TRUE

Question 29

TNFa released from macrophages can inhibit the effects of insulin. TRUE OR FALSE?

Answer 29

TRUE

Question 30

Complications caused from type 2 diabetes are mosly fom hyperglycemia and fatty acids. TRUE OR FALSE?

Answer 30

TRUE

Question 31

what are the microvascular complications lead to?

Answer 31

- Retina issues - blindness - Kidney failure - Nerve damage

Question 32

Why do peripheral neuropathies occur?

Answer 32

- Endothelial damage - This leads to wall thickening - Ischemia and nerve death - Slowed nerve conduction

Question 33

What are the two different branches of diabetic peripheral neuropathies?

Answer 33

- Autonomic | - Somatic

Question 34

Describe autonomic and somatic diabetic neuropathy?

Answer 34

Autonomic: - paralytic bladder - postural hypertension Somatic: - Numbness, tingling, loss of touch sense (heat/temp)

Question 35

Diabetic foot is common due impaired pain function. TRUE OR FALSE?

Answer 35

TRUE

Question 36

Diabetic peripheral neuropathy is an independent risk factor for cardiovascular diseases. TRUE OR FALSE?

Answer 36

TRUE

Question 37

hyperglycemia can lead to the transformation of the gowth factor beta in the glomeruli leading to hypertension. TRUE OR FALSE?

Answer 37

TRUE

Question 38

The combined effects of metabolic and hemodynamics can lead to renal damage. TRUE OR FALSE?

Answer 38

TRUE

Question 39

Diabetes can lead to increased risk of retinopathy, glaucoma and cataract. TRUE OR FALSE?

Answer 39

TRUE

Question 40

What are the risks factors of retinopathy?

Answer 40

- Poor glycemic control - Elevayed blood pressure - hyoerlidpidemia

Question 41

Macular odema leads to blurred vision. TRUE OR FALSE?

Answer 41

TRUE

Question 42

Microaneurysm can burst leading to macular oedema. true or false?

Answer 42

true

Question 43

what is the pathogenesis of diabetic retinopathy?

Answer 43

- Endothelial damage - Microaneurysm bursting - Ischemia - leading to weakened blood vessels