Diabetes metabolic consequences

It is well known that obesity, especially abdominal obesity, has a number of metabolic consequences, including insulin resistance (Frayn, 2005). Insulin resistance is a state that occurs when normal concentrations of insulin produce a subnormal biological response and the decay of glucose regulation, which eventually leads to type 2 diabetes (Krentz, 1996). Insulin sensitivity varies in healthy individuals, but obese individuals are very often insulin resistant (Frayn, 2005). 

Anemia has both direct and indirect effects on left ventricular function and growth. Cardiac output increases because of a combination of increased cardiac preload and a reduction in afterload. Such changes lead to ventricular remodeling, with initial left ventricular dilation followed by subsequent hypertrophy. In ESRD other factors also contribute to LVH, including hypertension, volume expansion, and the metabolic consequences of uremia, to which maybe added the effects of diabetes. By the time patients with diabetes reach ESRD, they are more likely to have concentric LVH, more likely to have had ischemic heart disease, and more likely to have experienced cardiac failure than nondiabetic subjects. ... 

Much recent evidence points to the fact that the metabolic consequences of insulin lack and, more specifically, hyperglycemia lead to the pathophysiology of diabetic complications. Currently available treatments of diabetes that seek to correct this insulin lack and resulting hyperglycemia consist of oral hypoglycemic drugs, diet and insulin injection. 

Insomnia is characterized as being primary where there is no obvious medical or psychiatric cause. It is a common clinical problan wherein 10-20% of people have chronic insomnia, characterized by trouble sleeping more than three nights a week. It has been directly linked to numerous impacts on individuals such as daytime fatigue, inattention, irritability, poor mood, and reduced energy levels. Consequently, they have reduced productivity, higher woik absenteeism, and an increased risk of depression or substance abuse. There is also a greater risk of traffic and woik-related accidents. Furthermore, studies have shown direct links between circadian rhythm disturbance and an increased risk in health problems, such as diabetes, metabolic disorders and depression. Insomnia is considered secondary if it is caused by external factors such as health conditions, for example, cancer, heart problems, depression, asthma, arthritis, or pain, or as a side effect of medication, or a substance, such as alcohol. 

Heal DJ, Gosden J, Jackson HC, Cheetham SC, Smith SL. Metabolic consequences of antipsychotic therapy predinical and clinical perspectives on diabetes, diabetic ketoacidosis, and obesity. Handb Exp Pharmacol 2012 212 135-64. 

Diabetes results from a lack of insulin secretion by the pancreas. Without insulin, cells take up glucose very slowly. The lack of insulin results in an inability to use blood glucose for fuel. Consequently, the body behaves as if it were starving even though food is available. The metabolic responses of the untreated insulin-dependent diabetic are essentially the metabolic responses of starvation. 

By definition all hormones affect the behavior of their target cells. Examples of the interplay between endocrine disturbances and their biochemical consequences are provided by some of the diseases of the thyroid, which directly affects basal metabolic rate, and diabetes mellitus, where glucose metabolism is deranged. 

Details of plasma lipoproteins and their metabolism are given in Section 5.5. Most of the cholesterol in the blood is carried as part of low density lipoprotein (LDL) or high density lipoprotein (HDL), whereas most triglyceride, in the fasting state, is carried by very low density lipoprotein (VLDL). The relative concentrations of these lipoproteins constitute the lipid profile and determine CVD risk. Diabetics are more likely to show an unhealthy profile with elevated concentrations of LDL and triglyceride but reduced HDL concentration. This pattern can be partly explained by enhanced fatty acid liberation from adipocytes as a consequence of insulin resistance in that tissue and due to reduced removal from the circulation of triglycerides, which is also insulin dependent. 

There are limitations in the use of FDG for viability assessment. Normal myocardium (normal perfusion and normal metabolism) in diabetics may not take up FDG due to insulin resistance associated with elevated free fatty acids in blood. Consequently, there is no FDG uptake anywhere in the heart and the study is uninterpretable. Flowever, giving insulin intravenously at the time of glucose loading enhances myocardial uptake, reduces free fatty acids in blood, and provides diagnostic images. 

The answer is A. Recent research has revealed that excess visceral fat deposits secrete several factors that have direct effects on the brain as well as directly on muscle to produce peripheral insulin resistance. Some of these newly identified factors are leptin, re-sistin, and adiponectin, whose mechanisms of action are still under active investigation. Death of pancreatic beta cells is a hallmark feature of type 1 diabetes and may occur only in very advanced stages of type 2 diabetes. Excess adipose in the thighs and buttocks does not contribute as strongly to insulin resistance as does visceral fat, presumably due to a lower level of endocrine activity of such fat depots. Dysfunction of liver lipid metabolism is more a consequence of excess activity of adipose than a cause of insulin resistance. A sedentary lifestyle contributes to build-up of excess fat stores but does not act directly to induce insulin resistance. 

In type I diabetes, the disease begins early in life and quickly becomes severe. This disease responds to insulin injection, because the metabolic defect steins from a paucity of pancreatic /3 cells and a consequent inability to produce sufficient insulin. IDDM requires insulin therapy and careful, lifelong control of the balance between... 

Transient diabetes and hyperlipidemia have been reported. Metabolic acidosis is probably a consequence of heavy, cholera-like diarrhea. Progressive reduction of libido was attributed to colchicine in patients with familial Mediterranean fever (312). 

Diabetes mellitus is a disease caused by insufficient insulin secretion or a decrease in the peripheral effects of insulin. This disease is characterized by a primary defect in the metabolism of carbohydrates and other energy substrates. These metabolic defects can lead to serious acute and chronic pathologic changes. The term diabetes mellitus differentiates this disease from an unrelated disorder known as diabetes insipidus. Diabetes insipidus is caused by a lack of antidiuretic hormone (ADH) production or insensitivity to ADH. Consequently, the full terminology of diabetes mellitus should be used when referring to the insulin-related disease. Most clinicians, however, refer to diabetes mellitus as simply diabetes. ... 

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