Module 1.2 - Diabetes, Obesity and Microbiome

What is the function of the pancreatic islet cells?

Alpha cells - produce glucagon to increase BG levelBeta cells - produce insulin to decrease BG level

What immune cells cause the destruction of beta cells in T1D

CD8+ T cells

Is proinsulin a precursor to insulin?


T2DM glucose lowering therapies

SGLT2 InhibitorsLifestyleDietmetforminInsulin

What are AGEs?

AGEs are advanced glycation end products which are the non-enzymatic modification of macromolecules.Excess AGE production is linked with increased diabetic complications

What is precision medicine?

As individual responses to T2DM treatments can differ, precision medicine utilises subgroups of individuals with unique features to treat T2DM more effectively

SGLT2 inhibitors

Blockage of the Na-dependent glucose transporter 2 promotes glucose excretion into urine

What are some of the functions of the gut microbiota?

1. Vitamin production2. Fermentation of non-digestable carbohydrates3. Production of SCFAs4. Activation of immunity5. Villi macrovascularistation

How does the gut microbiota control appetite?

- Increased fibre intake = Increased SCFA production = Increased acetate and leptin (via FFAR2)- Increased acetate and leptin = decreased appetite

Difference in gut microbiota function in obese individuals?

- Increased inflammation and oxidative stress- Decreased intestinal barrier integrity, therefore, leaky gut- Increased SCFA production- Increased lipogenesis- Increased insulin resistance

Gut microbiota and T2D

T2D- Increased oxidative stress and BCAAs- Decreased cell motility and vitamin production


WAT- Energy storage- Visceral- Subcutaneous- Secretes hormones and inflammatory factorsBAT- Heat generation- Highly vascularised, generates heat from FFA and glucose

Describe the function of leptin

Inhibits hunger/appetite

What is the function of visfatin?

Insulin-mimetic action, decreasing BGL. Also anti-apoptotic in the endothelium and heart

Adipose tissue in obesity

1. Increased adipocytes and preadipocytes2. Increased inflammatory cells such as dendritic cells, macrophages and T cells

How does insulin resistance occur in obesity?

Increases FFA, triglyceride uptake and inflammatory cytokines leads to inhibition of insulin receptors