diabetes mellitus biochemistry.txt
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What is the risk level and high level for diabetes in an FPG test?
- Risk = 100-125
- Diabetic level = >126
What is the risk level and diabetic level in an OGTT?
- Risk = 140-199
- diabetic = >200
What is the risk level and diabetic level in an HbA1c test?
- Risk = ≥6% but <6.5%
- Diabetic = ≥6.5%
What are the 3 causes of hyperglycemia in type I?
- 1) increased glycogenolysis
- 2) increased liver and kidney gluconeogenesis
- 3) decreased Glut-4 activity = less glucose uptake in muscle and adipose
What causes hyperTAG in Type I?
- increased lipolysis = more fatty acids converted into VLDL
- less LPL b/c of less insulin = more VLDL in circulation
What causes ketoacidosis in type I?
- Increased FA from lipolysis
- elevated B-oxidation = more Acetyl CoA
- Acetyl CoA shunted to Ketogenesis
- Dehydration + ketone bodies = ketoacidosis
Why is IV insulin potentially dangerous?
- Sometimes glucagon levels drop after administration
- This can lead to too much insulin which leads to HYPOGLYCEMIA
What are the two main causes of Type 2?
- 1) insulin resistance
- 2) slow B-cell death
What is the main cause of Type 2?
What are the two metabolic changes in Type 2?
- 1) Hyperglycemia
- 2) HyperTAG
Why no ketoacidosis in Type 2?
Still produce levels of insulin to induce anti-lipolysis so there is less B-oxidation and less Acetyl CoA to enter Ketogenesis
What is Hyperosmolar syndrome of Type 2?
The blood becomes so Hyperglycemic that it becomes viscous and leads to cerebral dehydration
What are the three negative results of AGE molecules (glycation)?
- 1) over-stimulated macrophage activity
- 2) neuropathy/nephropathy b/c of easy oxidation
- 3) infection b/c glycation = hard immune response
What is the polyol pathway?
- Increased glucose coming in contact with Aldose Reductase = Sorbitol
- Sorbitol goes in to the eye and causes cataracts b/c of the extra profusion of water and the shifting of crystalline structures.
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