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T2DM (INSULIN RESISTANT (Pancreas produces enough insulin but something…
T2DM
INSULIN RESISTANT
Pancreas produces enough insulin but something goes wrong with either the receptor binding or insulin targeting (glucose transports) within the cells.
The cells are unresponsive to insulin therefore cannot take in glucose = glucose stays in the blood = increased levels of bloody glucose.
Causes
Obesity, genetics, hypertension and lack of exercise
Excess fat (adipose tissue) = fatty acids and adipokines which cause inflammation which causes insulin resistance.
In reaction to tissues not responding to normal amounts of insulin the body produces more insulin to get the same affect and move glucose out of the blood. Achieved through:
Hyperplasia (increased amounts of beta cells) & Hypertrophy (where beta cells actually grow in size)
This keeps insulin amounts high enough to keep blood glucose normal however, beta cells also produce ISLET AMYLOID POLYPEPTIDE (AMYLIN) which is increased when amounts of insulin produced is increased.
Amyylin builds up in the IOL and eventually overtime the maxed out beta cells grow exhausted and don't work anymore
= decreased insulin = increase blood glucose = hyperglycaemia = polyphagia, glycosuria, polyuria and polydipsia.
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Ketoacidosis doesn't usually occur as there is some circulating insulin therefore insulin and gluagon balance is stable