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What is the normal range of blood glucose concentration?

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Blood glucose concentration is normally in range 4 mM (fasting) - 7 mM (fed)

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What is type 1 diabetes, what are its triggers and how is it treated?

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Type 1 diabetes accounts for approx 5% of cases in humans


Age of onset typically 3-20 years, peak at 11-12 years


Develops rapidly from asymptomatic stage to become severe and fatal if untreated


Caused by specific and irreversible destruction of insulin-producing beta cells in the pancreas by the body's own immune system (therefore an auto-immune disease)


Environmental trigger: unidentified but might be a virus or chemical


Genetic susceptibility: several genes identified which predispose or protect


Treated by: insulin injection several times a day (bovine, porcine or recombinant human)

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What are the three major long term complications of chronic hyperglycaemia?

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Microvascular disease (damage to small blood vessels), particularly affecting eyes
(retinopathy) and kidney (nephropathy) with risk of blindness and kidney failure


Neuropathy (damage to peripheral nerves) particularly affecting feet. In combination with microvascular disease, increases susceptibility to ulcers (caused by pressure or accidental damage) which are slow to heal and become infected, with risk of amputations


Macrovascular disease (increased atherosclerosis in large blood vessels) with increased risk of heart attack and stroke

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What are the other forms of diabetes?

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MODY (maturity onset diabetes of the young); mild form of the disease with early onset
• Relatively well understood in terms of underlying mechanism
• Simple autosomal dominant inheritance (link to medical genetics)
• Mutations in genes related to metabolism of glucose or development of tissues


Severe insulin resistance, and sometimes outright diabetes, can (very rarely) be caused by mutations in the insulin receptor protein


Gestational diabetes is a transitory form of the disease caused by the effects of pregnancy-associated hormonal changes on insulin secretion and sensitivity


Secondary diabetes may occur as a consequence of pancreatic disease (can be caused by alcohol abuse) or disturbances in hormones that antagonise insulin action

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What is hyper and hypoglycaemia?

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increased glucose concentration in blood (hyperglycaemia)


blood glucose falling too low
(hypoglycaemia)

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Why do diabetic people lose weight, have lower blood pH and feel thirsty / urinate more?

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lose weight because other metabolites are used to release energy since glucose cannot be used due to lack or insulin / response to insulin to release glucose for breakdown.


Lower blood pH because ketoacids produced from fat metabolism - ketoacidosis.


Thirsty because hyperglycaemia due to lack of glucose uptake into muscle and fat so glucose enters urine. More urination to release water = more thirst = dehydration.

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What is type 2 diabetes, what are its triggers and how is it treated?

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Type 2 diabetes accounts for approx 90% of cases in humans


Age of onset typically 40-70 years


Develops slowly and with variable severity; may be asymptomatic for many years


Results from decreased responsiveness of tissues to insulin (insulin resistance)
accompanied by decreased insulin secretion from the pancreas


Genetic component: no simple inheritance but "runs in families" and prevalence varies
widely between ethnic groups; many different genes might contribute


Environmental component: low birth weight and adult obesity are major risk factors


Mildest cases treated by diet and exercise to improve insulin sensitivity; moderate cases treated by drugs which stimulate insulin secretion (sulphonylureas) or improve insulin sensitivity (thiazolidinediones); severe cases require insulin injection

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How many polypeptide chains is insulin composed of and how are they joined?

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Insulin consists of two polypeptide chains linked by disulphide bonds between cysteine residues

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Where is insulin and glucagon produced?

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Insulin - beta cells of pancreas, initially as something called proinsulin


Glucagon - alpha cells of pancreas

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What type of hormone is insulin and how does it act on subcellular compartments?

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insulin is an anabolic hormone


Insulin actions on subcellular compartments:


stimulation of glucose uptake involves trafficking of intracellular vesicles to plasma membrane


stimulation of glycogenesis involves effects on cytosolic enzymes


stimulation of lipogenesis involves effects on both cytosolic and mitochondrial enzymes


inhibition of gluconeogenesis involves effects on gene transcription in the nucleus

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What are the three main target tissues of insulin?

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muscle, fat, liver

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What is Diabetes?

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A disease in which blood glucose concentration is inappropriately and persistently raised.

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Q:

What is the normal range of blood glucose concentration?

A:

Blood glucose concentration is normally in range 4 mM (fasting) - 7 mM (fed)

Q:

What is type 1 diabetes, what are its triggers and how is it treated?

A:

Type 1 diabetes accounts for approx 5% of cases in humans


Age of onset typically 3-20 years, peak at 11-12 years


Develops rapidly from asymptomatic stage to become severe and fatal if untreated


Caused by specific and irreversible destruction of insulin-producing beta cells in the pancreas by the body's own immune system (therefore an auto-immune disease)


Environmental trigger: unidentified but might be a virus or chemical


Genetic susceptibility: several genes identified which predispose or protect


Treated by: insulin injection several times a day (bovine, porcine or recombinant human)

Q:

What are the three major long term complications of chronic hyperglycaemia?

A:

Microvascular disease (damage to small blood vessels), particularly affecting eyes
(retinopathy) and kidney (nephropathy) with risk of blindness and kidney failure


Neuropathy (damage to peripheral nerves) particularly affecting feet. In combination with microvascular disease, increases susceptibility to ulcers (caused by pressure or accidental damage) which are slow to heal and become infected, with risk of amputations


Macrovascular disease (increased atherosclerosis in large blood vessels) with increased risk of heart attack and stroke

Q:

What are the other forms of diabetes?

A:

MODY (maturity onset diabetes of the young); mild form of the disease with early onset
• Relatively well understood in terms of underlying mechanism
• Simple autosomal dominant inheritance (link to medical genetics)
• Mutations in genes related to metabolism of glucose or development of tissues


Severe insulin resistance, and sometimes outright diabetes, can (very rarely) be caused by mutations in the insulin receptor protein


Gestational diabetes is a transitory form of the disease caused by the effects of pregnancy-associated hormonal changes on insulin secretion and sensitivity


Secondary diabetes may occur as a consequence of pancreatic disease (can be caused by alcohol abuse) or disturbances in hormones that antagonise insulin action

Q:

What is hyper and hypoglycaemia?

A:

increased glucose concentration in blood (hyperglycaemia)


blood glucose falling too low
(hypoglycaemia)

Mehr Karteikarten anzeigen
Q:

Why do diabetic people lose weight, have lower blood pH and feel thirsty / urinate more?

A:

lose weight because other metabolites are used to release energy since glucose cannot be used due to lack or insulin / response to insulin to release glucose for breakdown.


Lower blood pH because ketoacids produced from fat metabolism - ketoacidosis.


Thirsty because hyperglycaemia due to lack of glucose uptake into muscle and fat so glucose enters urine. More urination to release water = more thirst = dehydration.

Q:

What is type 2 diabetes, what are its triggers and how is it treated?

A:

Type 2 diabetes accounts for approx 90% of cases in humans


Age of onset typically 40-70 years


Develops slowly and with variable severity; may be asymptomatic for many years


Results from decreased responsiveness of tissues to insulin (insulin resistance)
accompanied by decreased insulin secretion from the pancreas


Genetic component: no simple inheritance but "runs in families" and prevalence varies
widely between ethnic groups; many different genes might contribute


Environmental component: low birth weight and adult obesity are major risk factors


Mildest cases treated by diet and exercise to improve insulin sensitivity; moderate cases treated by drugs which stimulate insulin secretion (sulphonylureas) or improve insulin sensitivity (thiazolidinediones); severe cases require insulin injection

Q:

How many polypeptide chains is insulin composed of and how are they joined?

A:

Insulin consists of two polypeptide chains linked by disulphide bonds between cysteine residues

Q:

Where is insulin and glucagon produced?

A:

Insulin - beta cells of pancreas, initially as something called proinsulin


Glucagon - alpha cells of pancreas

Q:

What type of hormone is insulin and how does it act on subcellular compartments?

A:

insulin is an anabolic hormone


Insulin actions on subcellular compartments:


stimulation of glucose uptake involves trafficking of intracellular vesicles to plasma membrane


stimulation of glycogenesis involves effects on cytosolic enzymes


stimulation of lipogenesis involves effects on both cytosolic and mitochondrial enzymes


inhibition of gluconeogenesis involves effects on gene transcription in the nucleus

Q:

What are the three main target tissues of insulin?

A:

muscle, fat, liver

Q:

What is Diabetes?

A:

A disease in which blood glucose concentration is inappropriately and persistently raised.

A

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