Diabetes

Pip Barton
Mind Map by Pip Barton, updated more than 1 year ago
Pip Barton
Created by Pip Barton about 7 years ago
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BOD Mind Map on Diabetes, created by Pip Barton on 04/30/2013.
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Resource summary

Diabetes
1 Type 2
1.1 Characteristics
1.1.1 Hyperglycaemia
1.1.1.1 Causes
1.1.1.1.1 Increased gluconeogenesis in the liver
1.1.1.1.2 Decreased Insulin secretion
1.1.1.1.3 Reduced Insulin Sensitivity
1.1.1.1.3.1 Post receptor
1.1.1.2 Elevated Glucose
1.1.1.2.1 Random glycosylation reactions with amines on proteins
1.1.1.2.1.1 Protein oxidation
1.1.1.2.2 Test (HbA1c)
1.1.1.2.3 AGEs and RAGEs
1.1.1.2.3.1 Inflammation
1.1.2 Insulin Resistance
1.1.2.1 Hyperinsulanaemia
1.1.2.1.1 Normal Beta cells
1.1.2.1.1.1 Increased size and function
1.1.2.1.1.2 NGT
1.1.2.2 IGT & NIDDM
1.1.2.2.1 Beta cell dysfunction
1.1.2.2.1.1 Apoptosis
1.1.2.3 Hypertension
1.1.2.4 Dislipidaemia
1.1.2.4.1 Elevated lipids
1.1.2.4.1.1 Toxic to B cells
1.1.2.4.1.2 Inhibits insulin signalling
1.1.2.5 Hyperuricaemia and gout
1.1.2.6 Acanthosis Nigrans
1.1.2.7 Premature Atherosclerosis
1.1.3 Reduced Insulin secretion
1.1.4 Obesity
1.1.4.1 Decreased oxidative capacity
1.1.4.2 Reduced mitochodrial density
1.2 Genetic Predisposition
1.2.1 Familial ethnic predisposition
1.2.1.1 Many related genes
1.2.1.1.1 ABCC8 gene A1369 allele
1.2.1.1.1.1 K+ ATP channel
1.2.1.1.1.1.1 Reduced ATP sensitivity
1.3 NIDDM
2 Insulin action
2.1 Promotes anabolism
2.2 Increased carb and lipid storage
2.3 Increased protein synthesis
2.4 Suppress catabolism
2.5 Target tissues
2.5.1 Adipose
2.5.1.1 FA and glycerol-3 phosphate
2.5.1.1.1 Make triglycerides
2.5.1.2 Upreguate GLUT4
2.5.1.2.1 Increased glucose transport
2.5.2 Liver
2.5.2.1 Glycolysis and glycogen synthesis
2.5.2.2 Suppress lipolysis and glucogenesis
2.5.2.3 Fatty acid, triglyceride synthesis
2.5.2.3.1 VLDL - lipid to periphery
2.5.2.4 Upregulate GLUT4
2.5.3 Muscle
2.5.3.1 Upregulate GLUT4
2.5.3.1.1 Increase glucose transport
2.5.3.2 Increase glucose metabolism and glycogen synthesis
2.5.3.3 Increased amino acid uptake and protein synthesis
3 Insulin signalling
3.1 Insulin Receptor
3.1.1 Heterotetramer
3.1.1.1 2 EC alpha subunits
3.1.1.1.1 Binds insulin
3.1.1.1.1.1 Activates
3.1.1.1.1.1.1 Insulin Receptor phosphorylation
3.1.1.1.1.1.1.1 IRS 1-4 recruitment and phosphorylation
3.1.1.1.1.1.1.1.1 IRS1 bound p85
3.1.1.1.1.1.1.1.1.1 recruits p110
3.1.1.1.1.1.1.1.1.1.1 PIP2-PIP3
3.1.1.1.1.1.1.1.1.1.1.1 PIP3 binds PH domains
3.1.1.1.1.1.1.1.1.1.1.1.1 PDK1&2
3.1.1.1.1.1.1.1.1.1.1.1.2 Akt
3.1.1.1.1.1.1.1.1.1.1.1.2.1 Targets
3.1.1.1.1.1.1.1.1.1.1.1.2.1.1 GSK3
3.1.1.1.1.1.1.1.1.1.1.1.2.1.1.1 Increased glycogen synth
3.1.1.1.1.1.1.1.1.1.1.1.2.1.2 AS160
3.1.1.1.1.1.1.1.1.1.1.1.2.1.2.1 Translocation of GLUT4 to membrane
3.1.1.1.1.1.1.1.1.1.1.1.2.1.2.1.1 Defects in aPKCs
3.1.1.1.1.1.1.1.1.1.1.1.2.1.3 FOXO
3.1.1.1.1.1.1.1.1.1.1.1.2.1.3.1 Regulatory TF
3.1.1.1.1.1.1.1.1.1.1.1.2.1.3.1.1 Reduce gluconeogenic genes
3.1.1.1.1.1.1.1.1.1.1.1.2.1.4 TSC1/2
3.1.1.1.1.1.1.1.1.1.1.1.2.1.4.1 Increased protein synth
3.1.1.1.1.1.1.1.1.2 Impaired binding
3.1.1.1.1.1.1.1.1.2.1 Phosphorylation @ ser312
3.1.1.1.1.1.1.1.1.2.1.1 Increased FFA exacerbates
3.1.1.2 2 TM Beta subunits
3.1.1.2.1 Signal transduction
3.1.1.2.2 Cytoplasmic Tyrosine Kinase domain
3.1.1.3 Linked by disulphide bond
4 DTC
4.1 Diagnosis
4.1.1 OGTT
4.1.2 FPG
4.1.3 RPG
4.1.4 Insulin clamp
4.1.4.1 Hyperglycaemic CT
4.1.4.1.1 Index for insulin secretion
4.1.4.1.1.1 Serum levels maintained
4.1.4.2 Hyperinsulinaemia CT
4.1.4.2.1 Index for glucose metabolism
4.1.4.2.1.1
4.2 Treatment
4.2.1 IR
4.2.1.1 Diet & excersize
4.2.1.2 Drug therapy
4.2.1.2.1 Metformin
4.2.1.2.1.1 Activates aMPK
4.2.1.2.1.1.1 suppresses gluconeogenesis
4.2.1.2.1.1.2 Increase GLUT4
4.2.1.2.2 Glitazones
4.2.1.2.2.1 Target PPARgamma
4.2.1.2.2.1.1 adipocyte differentiation
4.2.1.2.3 Sulphonylureas
4.2.1.2.3.1 Block ATP K+ channel
4.2.1.2.3.1.1 Increased insulin secretion
4.2.1.2.4 Gliptins
4.2.1.2.4.1 Inhibit DPP4
4.2.1.2.4.1.1 Stimulates insulin release
4.2.1.2.4.1.2 Inhibits glucogon release
4.3 Complications
4.3.1 Macrovascular
4.3.1.1 Hear attack
4.3.2 Microvascular
4.3.2.1 Nephropothy
4.3.2.1.1 Long time
4.3.2.2 Neuropathy
4.3.2.2.1 Loss of myelination
4.3.2.2.2 Diabetic foot
4.3.2.2.2.1 Grade 5 = gangrene
4.3.2.2.3 Of the autonomic systme
4.3.2.3 Retinopathy
5 Types
5.1 Diabetes Mellitus
5.1.1 Markers
5.1.1.1 Islet cell antibodies
5.1.1.2 Insulin antibodies
5.1.1.3 GAD
5.1.2 IDDM
5.2 MODY
5.2.1 Autosomal dominant
5.2.2 11 mutations
5.2.2.1 Genes for pancreas development
5.2.2.2 Genes for insulin secretion
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