Flashcards in Type II diabetes Deck (13):
1
What are the features of Type II diabetes mellitus?
Non-insulin dependent diabetes
Insulin resistance and pancreatic failure
Usually develops over 30 years of age
Most patients are overweight
2
What are the two mechanisms by which type II diabetes develops?
Insulin resistance
Beta cell dysfunction
3
Characteristics of insulin resistance
As insulin resistance increases, body compensates by increasing insulin secretion from beta cells in the pancreas
Rise in plasma insulin = hyperinsulinemia
4
Characteristics of beta cell dysfunction
Resistance to insulin increases and beta cells fail to compensate fully for increase in glucose
Glucose levels begin to rise
In type II diabetes - plasma insulin falls dramatically above threshold of plasma glucose
Theory = protein important to insulin becomes modified inapropriately as excess glucose is toxic to b cells
Modified protein competes for phosphorylation by tyrosine kinase receptor
5
Causes of insulin resistance
Weight gain - main cause
Physical inactivity - contributes to weight gain and is individual component
Genetic predisposition
Ethnicity
Some medications
Age
Sleep disturbance - people who work late shifts are prone to type II diabetes
Sleep apnoea
6
Complications of type II diabetes
2-4 fold increase of hear attack, stroke and peripheral vascular disease
Common cause of blindness
Most common reason for dialysis
Leading cause of lower-limb amputations
7
What features are beneficial to control in order to decrease complications of diabetes?
Blood sugar levels
Blood pressure
8
What is metabolic syndrome?
Insulin resistance and high insulin levels have a multitude of effects apart from diabetes
Elevate blood pressure
Elevate cholesterol and triglycerides
Associated with inflammatory response
Non-alcoholic fatty liver disease
9
What are the two main mechanisms of treatment of type II DM?
1. Increase insulin levels - promotes further weight gain, increases insulin resistance => vicious cycle but more effective
2. Improve insulin sensitivity - preferred approach
10
Drugs commonly used to treat type II diabetes
Metmorfin - improves insulin sensitivity
Sulphonylureas - increases insulin release
Insulin injection
DDP 4 ihibitors - decrease breakdowm of GLP 1
GLP 1 agonists
11
How do DDP 4 inhibitors work
GLP1 is an intestinal peptide that stimulates insulin release
Also inhibits glucagon secretion by alpha cells
Results in decrease in glucose concentration
The DDP 4 breaks down GLP 1
So inhibiting DDP 4 means more GLP 1 is available
12
How do sulphonylureas work?
Inhibit the potassium ATPase in beta cells
Causes increase in intracellular potassium concentration
In return, more insulin is released
13