week3-L6-intro to Diabetes Mellitus

Question 1

GLUT4

Answer 1

highly insulin responsive common in muscle and adipocytes, recruited by insulin to uptake glucose

Question 2

effects of insulin of cell metabolism

fed state

Answer 2

increase protein synthesis and inhibit protein breakdown and gluconeogenesis

Question 3

effects of glucagon on cell metabolism

fasting state

Answer 3

opens channels to allow transport of pyruvate lactate
increase breakdown of proteins
increase gluconeogenesis

Question 4

fuel stores

Answer 4

carbohydrate, fat and proteins

Question 5

effects on insulin of adipocytes

Answer 5

increase activity of LPL lipoprotein lipase
increase Glycerol and NEFA intake to form triglyceride and inhibit triglyceride breakdown
NB cortisol and GH breakdown triglyceride during fast state

Question 6

why short responsive time?

Answer 6

due to double circulation of the GI and hepatic portal circulation

Question 7

gluconeogenesis

Answer 7

contribute to 25% hepatic glucose output HGO 10h after fasting
triglyceride into Gly-3P to glucose

Question 8

brain fuel

Answer 8

glucose or ketone bodies

Question 9

ketone bodies regulation

Answer 9

insulin inhibition

glucagon stimulate conversion of fatty acyl CoA into ketone bodies due to low glucose present for brain supply

Question 10

hepatic glycogenolysis

Answer 10

conversion of liver glycogen store to glucose to increase the HGO

Question 11

difference between glycogen in liver and muscles

Answer 11

only liver glycogen store can be broken down to glucose

Question 12

hormone acting of muscle cells

Answer 12

cortisol and GH inhibit the glucose uptake but insulin hormone increase the uptake of glucose

Question 13

fasted state process

Answer 13

increase lipolysis, proteinolysis glycogenolysis and gluconeogenesis to increase the HGO and prolonged state results in increase ketogenesis; low insulin to glucagon

Question 14

fed state process

Answer 14

increase lipogenesis, protein synthesis and glycogen store
decrease proteinolysis and gluconeogenesis
high insulin to glucagon ratio

Question 15

diabetes

Answer 15

too high blood glucose the the body cannot overcome

Question 16

diagnosis of diabetes tests

Answer 16

fasting tests
random glucose 
oral glucose 
HbA1c
requires 2 positive test or 1 positive and 1 osmotic symptoms

Question 17

fasting glucose

Answer 17

> 7.0mmol/L

Question 18

random glucose

Answer 18

morning glucose, 11.1mmol/L

Question 19

oral glucose tolerance test

Answer 19

any point of the day, fasting 75g load

Question 20

HbA1c

Answer 20

average glucose for the last 3 months based on haemoglobin turnover

Question 21

types 1 Diabetes

Answer 21

autoimmune condition, where no insulin is produced at all
resulting in diabetic ketoacidosis
pH< 7.3

Question 22

signs and symptoms of T1DM

Answer 22

weight loss, hyperglycaemia, glycosuria with osmotic symptoms, ketones in blood and urine

Question 23

Diagnostic test of T1DM

Answer 23

antibodies GAD and IA2
c-peptide
presence of ketones

Question 24

too much insulin administered

Answer 24

hypoglycaemia, no glucose output from liver

too much glucose muscles

Question 25

conterregulatory response to hypoglycaemia

Answer 25

increase HGO by glycogenesis and gluconeogenesis and increase lipolysis

Question 26

impaired awareness to hypoglycaemia

Answer 26

reduced ability to recognise symptoms Loss of counter regulatory response Recurrent hypoglycaemia

Question 27

signs and symptoms

Answer 27

autonomic: sweating, pallor, palpitations and shaking neuroglycopenic: slurred speech, poor vision, confusion, seizures, loss consciousness

Question 28

severe hypoglycaemia

Answer 28

need 3rd party assistance

Question 29

type 2 diabetes

Answer 29

insulin resistance in liver, muscle and adipose tissues | suppress ketogenesis and proteolysis

Question 30

clinical symptoms of insulin resistnace

Answer 30

high triglyceride and low HDL, inflammatory state and energy expenditure, hypertension BP > 135/80 waist circumference men>102 and women >are 88 fasting glucose >6.0mmol/L

Question 31

type 2 diabetes signs

Answer 31

hyperglycaemia, overweight, dyslipdaemia, less osmotic symptoms, insulin resistance and later deficiency

Question 32

type 2 diabetes risk factors

Answer 32

age, high BMI family heritability, inactivity and ethnicity

Question 33

dietary recommendations and education

Answer 33

healthy eating and diet; calories control and reduce fat, reduce refined carbohydrate and increase complex ones increase soluble fibres and decrease sodium

Question 34

type 1 diabetes management

Answer 34

exogenous insulin and self monitoring of glucose. | structured education and technology

Question 35

type 2 diabetes management

Answer 35

diet oral medication | structured education and insulin needs

Question 36

both type 1 and type 2 management

Answer 36

monitor and prevent retinopathy, neuropathy, nephropathya and cardiovascular