week 10

patho of diabetes

100

which cells produce insulin?

beta cells 

200

what is type 1 diabetes 

Autoimmune beta cell destruction. So no insulin production to absorb excess glucose in blood which keeps blood glucose levels high.  – Hyperglycaemia causes diabetic keto acidosis.

300

complications of diabetes type 2 (both macro and micro)

Eyes (endothelial cells) à micro

Cataracts

Retinal microaneurysms & haemorrhage, exudation

Microaneurysms à first clinically recognisable feature of diabetic retinopathy. Balloon-like outpouchings/retinal perfusion.

First histopathological change seen in diabetic retinopathy à thickening of vascular basement membranes

Blood vessels à macro mainly

Atherosclerosis, thrombus, infection, gangrene

Neuropathy (Axonal loss, axonal regeneration, demyelination, Schwann cells & small nerves)

Cardiac autonomic neuropathy (CAN) à silent MI, arrhythmias & death

Kidneys à mirco mainly

b (mesangial cells)

UTI lecture

100

modifiable CAD risk factors

• Hypertension
• Smoking
• Dyslipidaemia – high cholesterol in body

 

200

effects of insulin deficiency 

• Decreased anabolism -> hyperglycaemia
• Increased anabolism -> glycogenolysis, lipolysis, gluconeogenesis, diabetic ketoacidosis 

300

mechanism of action of Sulfonylurea

Bind and inhibit SUR1 (K+ channel) on Beta-cells, causing increased depolarisation of Ca2+ à increased insulin release (it’s an insulin secretagogue)

self regulation + pharm

100

mechanism of action of Sitagliptin

Blocks incretin breakdown via blocking DPP-4.

200

mechanism of action of Exenatide

Mimics incretin, acts as an agonist on GLP-1 receptor.

300

Illness representations – 6 elements:

• Identify – what is the disease
• Timeline – how does it progress/how long? (acute, chronic)
• Consequences – what will happen to me? (minor or major)
• Causes – how did I get it (external, hereditary, internal)
• Control/cure – does anything help? 
• Illness coherence: does it all add up? (hot/intense or cold cognition)