Diabetes Mellitus + insulin resistance

What are the 4 ways that cats can become diabeteic

• autoimmunity of teh islets of langerhand

• pituratoyr GH

• meteoestrus

• diet

What is hormonal antagonism (opposing affect)

• receptor messenger inhibtion (same receptor)

• Opposing affect.. e.g. insulin + glucagon ( diff receptors)

What does diabetes mellitus mean (Pass through and sweet)

• rapid pass through system, glucose in urine.

If there is an insulin deficiency…

• reduce tissue glucose utilization, so more amino/ fatty acids will be used

Liver will wat to increase glucose in circulation, becuase

• Increase in glycogenolysis + gluconeogenesis.

• increase tissue utilization of amino + fatty acids…

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• characterised hypERglycaemia (relative or absulute insuline deficiency) Insulin allows the glucose to be uptaken

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Type 1 vs type 2

• autoimmune disease iodiopathic

• insuline resistance (obesity linked )

• gestation in babies..

Type 2 diabetes explained..

• not insulin dependent..

• Kidneys will overtime to flush out — Polyuria + polydipsia

• profound fatique + wieght loss + lens swelling

What happens to high glucose levels

glucose poisioning

foot ulcers, cataracts, blood vessels damage, neurone damage

• can burn fat exposively for fule — Ketones released + DIABETIC KETOACIDOSIS

Type 1 vs type 2 information

What are the 2 ways that diabetes can be developed

1) Inhibition in the PRODUCTION of insulin

2) Inhibition in the receptivness of the insulin

What happens if there is an increase of progesterone

• Increase insulin resistance

• Therefore not saity centre and glucose not being put away, change in bodies drive therfore craves sugary snacks.

Insulin resistance

(glucosuria) Type 2 diabetic cats.. rare in horses..

glucotoxicity + hyperglycaemia

How do dogs develop diabetes

• genetic susceptibility

• Immune mediated destruction

• Pancreatitis

• Obesity induced insulin resistance

• insulin antagonistic disease

• insulin antagonistic drugs (glucocorticoids have opposite affect of insulinon the dog) shounzer = predisposed

What is the pathogenesis of canine diabetes (disease origin)

• T cels will destroy beta cells. e.g. auto antibodies/ decrease in glucose - stimulated insulin secretion

• Pancreatitis + B cell destruction (pancrease inflammatio leads to beta cell destruction)

What is Insulin antagonism

• cortisol + growth hormone opposite action to insulin, increases th eblood sugar. hyperglycaemia induced.

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What are examples of counter regulatory hormones

Progesterone ALWAYS will increase insulin resistance. IF there is diabetes must neuter these dogs.

How do cats develop obesity..

pancreatitis + obesity induced insulin resistance + genetic comopent

What is the most common reason cats become diabeteic

DIET!! - Too much carbohydrates…

HOw do glucose metabolise glucose

no spike after meals, littel carbohydrates, only protein, therefore keeps a high proteins diet..

Obestiy —> insulin?

• Sturucture change (accumulation of fatty acids low grade chronic inflammation, physically blocking insulin signalling)

• not enough

• GLUT 4 pathway doesnt work e.g. inding/ translocation/ fucntion

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What do cats co secrete in proportion with insulin..

Amyline — slows gastric emptyling and promotes saiety, prevents insulin spikes…

too much, will be deposited at islets as amyloid = TOXIC can cause apoptosis of islets — if too progressive then will lead to diabetes mellitus..

Glucotoxicity

• prolonged exposure of pancreatic cell sto high level of glucose

• Initially reversible (not alwyas)

• There will be amylin accumulation

How does glucose toxicity occour

• hyperglaecemia

• amylin deposition

• beta cell apoptosis

• permeanent IDDM

What is insulin dependendt diabetes

most 100% of dogs

pernament insulin deficiency

needs insulininjected

How do cats develop diabetes

obesity/ diet and progressive

In dogs, it is insulin antagonism.. Grugs = glucoorticoids _ orogesterons

What is equine metabolic syndrome

Insulin resisntance

laminitsise - high insulin and glucose

disrupts blood flow and weakends the laminar attatchments

4 symptoms of diabetes mellitus

• polyuria

• polydipsia

• polyphagia

• wieght loss

Diabetes mellitu s

IF above a certain level, always poor glucose absorbtion poor diabetes use and osmotic diuresis..

wHAT HAPPENS IN POLYPHAGIA

saity centre = insulin dependent

therefore keep hunfer

What causes weight loss

Insulin will buils the fat stores, body cannot recognise glucse therefore will use other body parts for energy which is broken donw

Why does diabetes cause cataracts

glucose uptake into lens, metabolised into lactate,excess glucose turned to glucose + sorbitol . Cloudy protnines

What is ketoacidosis

• glucose does not enter cells easiely

• over relience on triglyceride break down for energy

• too many ketones present causing too many keto acids, ketoacidosis + metabolic acidosi s

What are the lab results to diagnose diabetes

Should be betwen 3.5 -5.5

Increases to 14-16 mmol/ l when there is an issue

What is feline stress - induced hyperglycemia

• cortisol + catecholamine

• not usually glocosuria

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What is fructosamine

• should be avoce 400 umol/ l

• high levels of glucose _ glycosylated serum proteins..

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What are other laboratory abnormalisties from mobilisation of fatty acids - adipose tissue

• hypercholestrolemia

• hypertriglycerdimeia

How can you analyses the glucose

urine specific gravity

glucose + ketones + UTIs.. white and rbcs../ ketons/ concentraiont

Diabeteic sysmtoms

• infection

• dehydration

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