Podcast
Questions and Answers
Which of the following is a modifiable risk factor for type 2 diabetes?
Which of the following is a modifiable risk factor for type 2 diabetes?
Impaired fasting glucose is characterized by elevated insulin levels due to β-cell dysfunction.
Impaired fasting glucose is characterized by elevated insulin levels due to β-cell dysfunction.
False (B)
What accounts for approximately 80-85% of the overall risk of developing type 2 diabetes?
What accounts for approximately 80-85% of the overall risk of developing type 2 diabetes?
Obesity
A high intake and low expenditure of energy will lead to ______.
A high intake and low expenditure of energy will lead to ______.
Signup and view all the answers
Match the following risk factors with their categories:
Match the following risk factors with their categories:
Signup and view all the answers
What is the primary strategy for individuals with genetic risk and no autoantibodies?
What is the primary strategy for individuals with genetic risk and no autoantibodies?
Signup and view all the answers
Islet transplantation guarantees long-term insulin independence for recipients.
Islet transplantation guarantees long-term insulin independence for recipients.
Signup and view all the answers
What is the outcome of insulin treatment in individuals with multiple autoantibodies?
What is the outcome of insulin treatment in individuals with multiple autoantibodies?
Signup and view all the answers
The _____ system, also known as the 'artificial pancreas', combines continuous glucose monitors with insulin pumps.
The _____ system, also known as the 'artificial pancreas', combines continuous glucose monitors with insulin pumps.
Signup and view all the answers
Which type of diabetes is characterized by insulin deficiency?
Which type of diabetes is characterized by insulin deficiency?
Signup and view all the answers
Match the type of diabetes with its main characteristic:
Match the type of diabetes with its main characteristic:
Signup and view all the answers
Stem cells from adipose tissue can be cultured to produce pancreatic hormones.
Stem cells from adipose tissue can be cultured to produce pancreatic hormones.
Signup and view all the answers
What current efforts are being made to reverse pancreatic cell destruction?
What current efforts are being made to reverse pancreatic cell destruction?
Signup and view all the answers
What is the first step in the hexosamine biosynthetic pathway (HBP)?
What is the first step in the hexosamine biosynthetic pathway (HBP)?
Signup and view all the answers
Excess O-GlcNAcylation enhances the function of key insulin signaling proteins.
Excess O-GlcNAcylation enhances the function of key insulin signaling proteins.
Signup and view all the answers
What enzyme converts Glucosamine-6-Phosphate into UDP-N-acetylglucosamine?
What enzyme converts Glucosamine-6-Phosphate into UDP-N-acetylglucosamine?
Signup and view all the answers
Elevated levels of __________ can lead to insulin resistance due to increased O-GlcNAcylation.
Elevated levels of __________ can lead to insulin resistance due to increased O-GlcNAcylation.
Signup and view all the answers
Match the following factors with their effects on insulin resistance:
Match the following factors with their effects on insulin resistance:
Signup and view all the answers
Which of the following is a clinical implication of understanding the HBP's role in insulin resistance?
Which of the following is a clinical implication of understanding the HBP's role in insulin resistance?
Signup and view all the answers
Obesity usually leads to decreased insulin resistance due to increased physical activity.
Obesity usually leads to decreased insulin resistance due to increased physical activity.
Signup and view all the answers
High levels of free fatty acids are a consequence of __________.
High levels of free fatty acids are a consequence of __________.
Signup and view all the answers
What is typically the first step in insulin therapy?
What is typically the first step in insulin therapy?
Signup and view all the answers
Engaging in moderate physical activity can reduce the risk of diabetes by approximately 20-30%.
Engaging in moderate physical activity can reduce the risk of diabetes by approximately 20-30%.
Signup and view all the answers
List one benefit of the Mediterranean diet regarding diabetes prevention.
List one benefit of the Mediterranean diet regarding diabetes prevention.
Signup and view all the answers
Resveratrol is found in the skin of ______.
Resveratrol is found in the skin of ______.
Signup and view all the answers
Match the following lifestyle intervention with its corresponding benefit:
Match the following lifestyle intervention with its corresponding benefit:
Signup and view all the answers
A diet high in which of the following is part of the Mediterranean diet?
A diet high in which of the following is part of the Mediterranean diet?
Signup and view all the answers
Effective weight management is not an important strategy for preventing type 2 diabetes.
Effective weight management is not an important strategy for preventing type 2 diabetes.
Signup and view all the answers
What enzyme does resveratrol activate that plays a role in cellular energy homeostasis?
What enzyme does resveratrol activate that plays a role in cellular energy homeostasis?
Signup and view all the answers
What is the primary mechanism of action for SGLT2 inhibitors?
What is the primary mechanism of action for SGLT2 inhibitors?
Signup and view all the answers
SGLT2 inhibitors increase the reabsorption of glucose in the bloodstream.
SGLT2 inhibitors increase the reabsorption of glucose in the bloodstream.
Signup and view all the answers
What effect do SGLT2 inhibitors have on blood pressure?
What effect do SGLT2 inhibitors have on blood pressure?
Signup and view all the answers
SGLT2 inhibitors are used to manage type 2 diabetes by targeting the __________.
SGLT2 inhibitors are used to manage type 2 diabetes by targeting the __________.
Signup and view all the answers
Which of the following is a benefit of SGLT2 inhibitors?
Which of the following is a benefit of SGLT2 inhibitors?
Signup and view all the answers
SGLT2 inhibitors are contraindicated in patients with renal impairment.
SGLT2 inhibitors are contraindicated in patients with renal impairment.
Signup and view all the answers
What negative effect might SGLT2 inhibitors have on uric acid levels?
What negative effect might SGLT2 inhibitors have on uric acid levels?
Signup and view all the answers
Match the following effects of SGLT2 inhibitors with their descriptions:
Match the following effects of SGLT2 inhibitors with their descriptions:
Signup and view all the answers
What is the main effect of AMPK on fatty acids?
What is the main effect of AMPK on fatty acids?
Signup and view all the answers
Insulin resistance is characterized by increased PI3K activity in the liver and muscles.
Insulin resistance is characterized by increased PI3K activity in the liver and muscles.
Signup and view all the answers
What is the outcome of decreased phosphorylation of GSK3β?
What is the outcome of decreased phosphorylation of GSK3β?
Signup and view all the answers
The molecule that engages in the pathway leading to glycogen synthesis is called __________.
The molecule that engages in the pathway leading to glycogen synthesis is called __________.
Signup and view all the answers
Which transcription factor is involved in increasing gluconeogenesis during insulin resistance?
Which transcription factor is involved in increasing gluconeogenesis during insulin resistance?
Signup and view all the answers
Match the following pathways with their outcomes:
Match the following pathways with their outcomes:
Signup and view all the answers
Glycerol is utilized in the liver for glucose production through the process called __________.
Glycerol is utilized in the liver for glucose production through the process called __________.
Signup and view all the answers
High levels of glycerol lead to increased glycogen synthesis in the liver.
High levels of glycerol lead to increased glycogen synthesis in the liver.
Signup and view all the answers
Study Notes
Diabetes Physiology 364 Study Notes
- These notes are supplementary. They are intended to help with understanding the topic, but should not replace primary study materials.
- Theory-based questions are expected.
- All information was reviewed, but the material does not claim to be definitively correct.
Fasting Blood Glucose Levels
- Normal: Less than 5.6 mmol/L
- Pre-diabetic: 6.0–6.9 mmol/L
- Diabetic: Greater than 7.0 mmol/L
Glycosylated Hemoglobin (HbA1c)
- Normal: Less than 5.7%
- Pre-diabetic: 5.7–6.4%
- Diabetic: Greater than or equal to 6.5%
Oral Glucose Tolerance Test (OGTT)
- Impaired Glucose Tolerance (IGT) (pre-diabetic): 7.8–11.0 mmol/L
- Diabetic: Greater than 11.1 mmol/L
Conversion of Glucose Values
- mg/dL × 0.0555 = mmol/L
- mmol/L = mg/dL ÷ 18.0182
Postprandial Glucose Effects
- The degree of glucose excursion (spike) depends on the meal type.
- Repetitive and large excursions are associated with cardiometabolic diseases.
- The degree of postprandial glucose excursion is likely mediated by oxidative stress and inflammation.
- Diabetic patients exhibit elevated glucose excursions, while displaying reduced insulin levels when compared with healthy patients.
- Normal insulin levels often stated in μIU/mL or pmol/L, where 1 μIU/mL = 7.715 pmol/L
- Mean fasting level of insulin in US individuals is 60 pmol/L (μIU/mL /7.715).
Metabolic Processes (Summary)
- Glycogenesis: Glucose → glycogen
- Glycogenolysis: Glycogen → glucose
- Gluconeogenesis: Amino acids → glucose
- Protein Synthesis: Amino acids → protein
- Protein Degradation: Protein → amino acids
- Fat Synthesis (Lipogenesis or Triglyceride Synthesis): Fatty acids + glycerol → triglycerides
- Fat Breakdown (Lipolysis or Triglyceride Degradation): Triglycerides → fatty acids + glycerol
Insulin Secretion (Regulation)
- Insulin is secreted biphasically.
- A first phase (rapid) occurs within a few minutes, followed by a sustained second phase.
- The first phase results from readily releasable insulin granules at the plasma membrane.
- The sustained release requires synthesis of new insulin granules to regulate blood glucose levels.
Regulation of Insulin Secretion
- Factors influencing insulin secretion:
- Gastrointestinal hormones
- Food intake
- Blood glucose concentration
- Blood amino acid concentration
- Parasympathetic stimulation
- Sympathetic stimulation (e.g., epinephrine)
First Phase Insulin Release
- Glucose is transported into the beta cells.
- Glucose metabolism produces ATP.
- ATP closes ATP-sensitive potassium (KATP) channels.
- Depolarization opens voltage-gated calcium (Ca2+) channels.
- Calcium influx triggers exocytosis of insulin granules, releasing insulin.
Effects of Insulin on Target Tissues
- Glucose uptake, triglycerides (fatty acids + monoglycerides), and amino acid usage.
- Glycogen, glycogen synthesis and utilization.
Type 1 Diabetes Pathogenesis Model
- Multifactorial, involving genetic, environmental, and immunological factors.
- HLA region on chromosome 6 is significant.
- Autoantibodies, such as those reacting with glutamic acid decarboxylase (GAD65), are typical indicators.
- Environmental factors are implicated, yet uncertain.
Metabolic Effects of Type 1 Diabetes
- Starvation in the midst of plenty: despite high blood sugar levels, tissues don't have adequate glucose availability.
- Hormonal imbalances: Low insulin and high glucagon levels dominate catabolic processes.
- Increased breakdown of carbohydrates, proteins, and fats: leading to elevated blood sugar levels, triglycerides, ketoacidosis, and dehydration.
Clinical Symptoms of Type 1 Diabetes
- 3 Ps: polyuria, polydipsia, polyphagia
- Ketoacidosis: weight loss, fatigue, nausea, vomiting
Type 2 Diabetes
- Insulin resistance: Body cells don't respond efficiently to insulin, leading to elevated blood glucose levels.
- Impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) indicate a tendency toward diabetes.
Causes and Risk Factors for Diabetes
- Modifiable: Physical activity, sugar intake, sleep quality, high fat/low fiber diets, Obesity
- Unmodifiable: Age, ethnicity, family history of diabetes, and gestational diabetes history.
- Energy intake/expenditure impacts weight.
Glucose Uptake Response to Insulin
- Glucose uptake is increased with insulin, potentially due to the administration of antioxidants which may increase the efficiency of glucose utilization.
Mechanisms of High Glucose-induced Myocardial Insulin Resistance
- Oxidative stress is implicated.
- Consumption of 75g of glucose leads to an increase in oxidative stress markers.
- Hyperglycemia increases the generation of reactive oxygen species.
Metabolic Effects of Type 2 Diabetes
- High glucose levels increase oxidative stress and lead to increased Non-Oxidative Glucose Pathways (NOGPS).
- These pathways (e.g., pentose phosphate pathway) are activated to divert from the normal glucose catabolism pathways.
Insulin Deficiency in Type 2 Diabetes
- Overnutrition/inactivity contribute to obesity.
- Increased FFAs cause lipotoxicity and glucotoxicity, leading to cell death (apoptosis) and inflammation in beta cells.
- This results in a decrease in beta cell mass and function over time ultimately leading to insulin deficiency.
Therapeutic Targets
- Various classes of drugs target different aspects of diabetes, such as insulin secretion stimulation or enhancement of insulin sensitivity or reducing glucose absorption from the gut.
- Drug therapy is often combined with lifestyle modifications to manage the condition effectively.
Lifestyle Interventions
- Physical activity (30 mins/day 5 days/week) may reduce diabetes risk.
- Dietary modifications to reduce fat, increase fruit/vegetable/fibre consumption, and weight management are crucial.
- The traditional Mediterranean diet is beneficial with its fibre, antioxidant, and magnesium content, and helps in weight control.
Resveratrol and Insulin Sensitizing Effects
- Resveratrol, found in red grapes, may activate AMPK and increase mitochondrial number.
- This may lead to improved insulin sensitivity.
Reducing Risk of Type 2 Diabetes/CVD
- Strategies to control lipids, blood pressure, and glucose levels, as well as lifestyle modifications, may reduce the risk of diabetes and related complications.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz covers key concepts and markers related to diabetes physiology, including fasting blood glucose levels, glycosylated hemoglobin (HbA1c), and the oral glucose tolerance test. It is designed to supplement your understanding of diabetes management and evaluation. Review these notes to enhance your comprehension and preparation.
