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Summary Anorexia, obesity and diabetes
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Fat, cholesterol & atherosclerosis
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Anorexia, obesity and diabetes1. diabetes type 1 (DM1)
Insulin and glucagon control the blood glucose levels. After a prolonged period of fasting,
ketone bodies kick in. DM1 resembles fasting, degrading fat and muscle, BUT in DM1 the
glucose levels are really high.
After a meal insulin production decreases the
glucagon. So if someone cannot make insulin (so
in DM1), they also cannot suppress the glucagon.
So no levels of glucose that can drop.
The levels get so high that the glucose is leaked
out in the urine.
DM1: because there is no insulin in the system,
muscle and adipose tissue cannot take up the
glucose by the GLUT4 > without insulin it cannot
act on the cell surface.
This is usually to make sure the cells do not take
immediately.
Because there is no insulin, glucagon gets very high > mobilization of AA from muscles and
also mobilizes FA by an active lipase from the adipose tissue. Due to this extreme fasting
state the body is in, also KB kicks in.
Difference in fasting and DM1: in fasting there is little insulin present, but in DM1 there is
NONE. So enormous KB production by extreme glucagon > acetone breath…
Looking at lab values, excessive glucose, ketone, urea secretion & extreme glucagon…
Can lead to diabetic ketoacidosis: a lot of KB > pH drops > COMA
> treatment: well timed insulin injections.
Differences between DM1 and extreme fasting:
in blood DM1 extreme fasting
insluin NONE little
glucagon extreme high increased
glucose extreme high decreased
KB extreme high increased
FFA very high normal
2. Hypercatabolic states
- Anorexia or suppressed appetite (inflammation)
- Sarcopenia: loss of muscle in eldery or immobilized people
- Cachexia wasting disease, very severe illnesses.
Mechanism of sarcopenia and cachexia are very different, but both are loss of muscle.
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