WEEK : LECTURE: DIABETES MELLITUS 4 BLOOD GLUCOSE HOMEOSTASIS INSULIN · Secreted From pancreatic beta B cells . Increases uptake of glucose into cells and conversion into glycogen . Increases uptake of Fatty acids into cells · Secretion is stimulated mainly by increased blood glucose GLUCAGON . Secreted From pancreatic Alfa a cells " In the liver it causes : Gluconeogenesis Breakdown glycogen (stored Form of glucose ) In adipose tissue it causes: Lipolysis Decreased blood glucose stimulate secretion EFFECTS OF INSULIN ON TARGET CELLS Blood Insulin Receptor - Glucose Insulin Sone insulin binds to the insulin receptor Blood Insulin Glucose Stwo More GLUT4 transporters are inserted into the cell membrane Insulin Receptor Glucose transporter Blood Three Sont Glucose enters the cell Insulin Receptor Insulin 1 Glucose Glucose is used by the cell OTHER EFFECTS OF INSULIN ON TARGET CELLS Speeds oh conversion of glucose to glycogen Speeds of protein and Fat synthesis Note: some cells don't require GLUT4 For example: Brain, red blood cells, kidney, lens This is because glucose into that a constant rate
LECTURE: DIABETES MELLITUS WEEK: 4 TYPES OF DIABETES MELLITUS ABSENCE OF INSULIN TYPE 1 DIABETES CLASSIFICATION: Typically presents in childhood Cages 4-7 years; 10-14 years Onset of symptoms usually acute CAUSES: Viral infections Genetic Factors Immune mediated destruction of b cells (autoantibodies against islet cells are present in 70-80% of cases Inadequate insulin production by B cells RESISTANCE TO INSULIN TYPE 2 DIABETES CLASSIFICATION: Mainly an adult 35 years and older Prevalent in those with obesity CAUSES: Decreased sensitivity of peripheral tissues to insulin ( insulin resistance) Insulin secretion may eventually decrease Onset is usually gradual Genetic Factors - Family history Lifestyle Factors overweight/obesity Physical inactivity Metabolic syndrome (abdominal obesity, hypertension, hypoglycaemia, dyslipidemia) Poor diet Smoking Prediabetes BLOOD GLUCOSE LEVELS Plasma glucose (mmol/L) (Fasting) 46.1 Normal Impaired fasting glucose (IFG)* Impaired glucose tolerance (IGT)" Diabetes mellitus (DM) * Pre -diabetes Plasma glucose (mmol/L) 2 hours after glucose ingestion ) < 7.8 6.1-6.9 < 7.8 < 7.0 7.8 - 11 ?7 >11.1 Hyperglycemia - + glucose levels in blood Hypoglycaemia - + glucose levels in blood
WorkShop: 1. Define diabetes Sweet substance passing through / sweet wine 2. Could Mr Ball have Type I diabetes? What factors will help you determine this? Draw up a table to compare and contrast TIDM and T2DM Age of onset Type of onset Pathogenesis Clinical Manifestations Both Type 1 Type 2 Early (4-7 and 10-14) Later ( 35 and above ) Gradual ( years ) acute , rapid ( weeks - months autoimmune response - destruction of beta cell Insulin resistance - insulin sensitivity damage > reduced insulin secretion polyphagia-urge to eat, weightless, DKA- diabetic Ketoacidosis , fatigue , polyuria - urge to pee , polydipsia - urge to drink , delayed wound healing , fruity breath , hypo > hyper glycemia, vascular diseases , peripheral navrophy, retinopathy, damage to kidneys Acute Complications DKA-diabetic ketoacidosis, hyper/ Hypoglycemia, Coma 3. List the risk factors for T2DM. Which of these are