Pip Barton
Mind Map by Pip Barton, updated more than 1 year ago
Pip Barton
Created by Pip Barton about 7 years ago


BOD Mind Map on Diabetes, created by Pip Barton on 04/30/2013.

Resource summary

1 Type 2
1.1 Characteristics
1.1.1 Hyperglycaemia Causes Increased gluconeogenesis in the liver Decreased Insulin secretion Reduced Insulin Sensitivity Post receptor Elevated Glucose Random glycosylation reactions with amines on proteins Protein oxidation Test (HbA1c) AGEs and RAGEs Inflammation
1.1.2 Insulin Resistance Hyperinsulanaemia Normal Beta cells Increased size and function NGT IGT & NIDDM Beta cell dysfunction Apoptosis Hypertension Dislipidaemia Elevated lipids Toxic to B cells Inhibits insulin signalling Hyperuricaemia and gout Acanthosis Nigrans Premature Atherosclerosis
1.1.3 Reduced Insulin secretion
1.1.4 Obesity Decreased oxidative capacity Reduced mitochodrial density
1.2 Genetic Predisposition
1.2.1 Familial ethnic predisposition Many related genes ABCC8 gene A1369 allele K+ ATP channel Reduced ATP sensitivity
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 FA and glycerol-3 phosphate Make triglycerides Upreguate GLUT4 Increased glucose transport
2.5.2 Liver Glycolysis and glycogen synthesis Suppress lipolysis and glucogenesis Fatty acid, triglyceride synthesis VLDL - lipid to periphery Upregulate GLUT4
2.5.3 Muscle Upregulate GLUT4 Increase glucose transport Increase glucose metabolism and glycogen synthesis Increased amino acid uptake and protein synthesis
3 Insulin signalling
3.1 Insulin Receptor
3.1.1 Heterotetramer 2 EC alpha subunits Binds insulin Activates Insulin Receptor phosphorylation IRS 1-4 recruitment and phosphorylation IRS1 bound p85 recruits p110 PIP2-PIP3 PIP3 binds PH domains PDK1&2 Akt Targets GSK3 Increased glycogen synth AS160 Translocation of GLUT4 to membrane Defects in aPKCs FOXO Regulatory TF Reduce gluconeogenic genes TSC1/2 Increased protein synth Impaired binding Phosphorylation @ ser312 Increased FFA exacerbates 2 TM Beta subunits Signal transduction Cytoplasmic Tyrosine Kinase domain Linked by disulphide bond
4.1 Diagnosis
4.1.1 OGTT
4.1.2 FPG
4.1.3 RPG
4.1.4 Insulin clamp Hyperglycaemic CT Index for insulin secretion Serum levels maintained Hyperinsulinaemia CT Index for glucose metabolism
4.2 Treatment
4.2.1 IR Diet & excersize Drug therapy Metformin Activates aMPK suppresses gluconeogenesis Increase GLUT4 Glitazones Target PPARgamma adipocyte differentiation Sulphonylureas Block ATP K+ channel Increased insulin secretion Gliptins Inhibit DPP4 Stimulates insulin release Inhibits glucogon release
4.3 Complications
4.3.1 Macrovascular Hear attack
4.3.2 Microvascular Nephropothy Long time Neuropathy Loss of myelination Diabetic foot Grade 5 = gangrene Of the autonomic systme Retinopathy
5 Types
5.1 Diabetes Mellitus
5.1.1 Markers Islet cell antibodies Insulin antibodies GAD
5.1.2 IDDM
5.2 MODY
5.2.1 Autosomal dominant
5.2.2 11 mutations Genes for pancreas development Genes for insulin secretion
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