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Diabetes Mellitus - Biochemistry
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Diabetes Mellitus - Biochemistry

DIAGNOSIS
  • Diabetes: fasting blood glucose > 126 mg/dl
  • Normal: fasting blood glucose < 100 mg/dl
  • Prediabetes: 125 > fasting blood glucose > 100
TYPES OF DIABETES
Type I
Type II
  • Most common type
  • Symptoms tend to be milder than Type I
  • Gradual onset of symptoms
  • Normally insulin-sensitive tissues become insulin resistant
BIOLOGICAL MARKERS OF TYPE I AND TYPE II DIABETES
Hyperglycemia: elevated blood glucose
1. Tissues cannot use glucose (no insulin or insulin resistance) 2. Liver increases gluconeogenesis
  • Adipose breaks down TAG to FFA & glycerol (gluconeogenic)
  • Skeletal muscle breaks down proteins: releases glucogenic amino acids
  • Pancreatic alpha cells secrete abnormally high levels of glucagon
Dyslipidemia: elevated blood lipid levels
  • Adipose breaks down TAG and releases FFA & glycerol
  • Liver releases TAG in VLDL
  • VLDL & chylomicrons accumulate because of low lipoprotein lipase (LPL) concentrations
  • Insulin normally stimulates LPL synthesis
Ketoacidosis: Type I only
  • Increased glucagon secretion promotes ketogenesis
  • Adipose FFA shunt into ketogenesis
  • Type II diabetics: hyperglycemia & hypertriglyceridemia w/o ketoacidosis
HYPERGLYCEMIA PRESENTATION
Polyphagia: extreme hunger
  • Mass mobilization of adipose TAG & muscle proteins
  • Overproduction of glucagon
Polyuria: frequent urination
  • Ketoacidosis and hyperglycemia inhibit kidney urine filtration
  • Glycosuria (glucose in the urine)
  • Ketonuria (ketone bodies in the urine): Type I ONLY
  • Leads to extreme thirst
Polydipsia: extreme thirst
  • Extreme conditions: polyuria can lead to volume depletion
  • Volume depletion and ketoacidosis can produce diabetic coma