blood glucose Flashcards
how does the pancreas deal with a hyper
- pancreas produces and secretes insulin
- glucose moves from liver into cells
- liver and muscle cells convert glucose to glycogen
how does the pancreas deal with a hypo
- pancreas produces and secretes glucagon
- glucose moved from blood into liver
- liver and muscle cells convert glycogen to glucose
what is glucose needed for in the body
- energy for basic functions
- neurones rely only on glucose so need for nervous system function
which organs are involved in glucose regulation
- pancreas
- liver
- adrenal gland
- thyroid gland
- anterior pituitary gland
which pancreatic cells are needed in glucose regulation
- alpha = glucagon
- beta = insulin
- delta = somatosatin
what is the function of insulin
- decreases blood glucose through GLUT4
- increased expression of glycogen synthase
- inactivation of phosphorylase, decreasing gluconeogenesis
- decrease expression of rate-limiting enzymes
what is the function of somatostatin
- decrease blood glucose by supressing glucagon release
- suppresses gastrin and pituitary tropic hormones
- decreases insulin release
which hormones are involved in insluin regulation
- insulin
- somatostatin
- glucagon
- cortisol
- adrenaline
- thyroxine
- growth hormone
- adrenocorticotropic hormone
what does glucagon do
increase blood glucose through increased glycogenolysis and gluconeogenesis
what does cortisol do
increase blood glucose levels via stimulation of glucogenesis by antagonism of insulin
what does adrenaline do
- increase glucose by glycogenolysis
- increase fatty acids from adipose tissue
what does thyroxine do
increase glucose through glycogenolysis and increase absorption in the intestine
what does growth hormone do
- promotes gluconeogenesis
- inhibits liver uptake
- stimulates thyroid
- inhibits insulin
what does adrenocorticotropic hormone do
- stimulates cortisol release
- stimulate fatty acid release
- feeds into gluconeogenesis
how is insulin regulated in beta cells
- GLUT2 cells transport glucose and glucokinase
- convert glucose into glucose-6-phosphate
what is glycolosis
the conversion of glucose to pyruvate creating free ATP
how is insulin move out of beta cells
- negative feedback on ATP sensitive K channels close
- Ca in through voltage gated channel
- activates calcium-calmodulin dependent protein kinase
- insulin secreted through exocytosis
what inhibits insulin release
- adrenaline
- galanin
- somatostatin
what stimulates insulin release
- acetylcholine
- bombesin
- glucagon like peptide 1
- glucagon
- cholecystokinin
- glucose dependent insulinotropic peptide
why are KATP channels open in low metabolism
- low ATP and elevated MgADP
- activity generates hyperpolarised membrane potential preventing electrical activity
what does insulin uptake promote
- increased glucose uptake
- increased glycogen storage
- promotes protein production
- promotes glycolysis
how does glucose enter into cells
through insulin activation of the GLUT 4 receptors
how does insulin affect glucose metabolism in the muscle and adipose
- increase glucose uptake
- increase glycogen synthesis
- inhibits glycogen breakdown
how does insulin affect glucose metabolism in the liver
- increases glycogen formation
- inhibits glycogen breakdown
- inhibits gluconeogenesis
how does insulin affect protein metabolism in the muscle and adipose
- increase amino acid uptake
- promotes protein synthesis
- inhibits degradation
how does insulin affect protein metabolism in the liver
- inhibits breakdown of amino acids
- decreases urea formation
how does insulin affect fat metabolism in adipose
- increased storage of triglycerides
- increased storage of fatty acids
how does insulin affect fat metabolism in the liver
- inhibits breakdown of fatty acids to ketones
what happens in the liver when there is high blood glucose
- increase glycogen storage
- decrease gluconeogenesis
- decrease glycogenolysis
what happens in the liver when there is a low blood glucose
- increase glycogenolysis
- increase gluconeogenesis
- decrease glycogen storage
what is glycogenolysis
glycogen to glucose
when is gluconeogenesis
amino acids, waste products and fats into glucose
what is ketosis
alternative fuel source by converting fast in starvation state
what are the different types of ketones
- acetoacetate
- beta hydroxybutyrate
- acetone
how is ketone formed
free fatty acids undergo hydrolysis to Acetly CO
converted into acetoacetate and other ketone bodies
how is acetone formed
from the breakdown of the other ketone bodies
what is type I diabetes
- autoimmune reaction
- destruction of B cell by cytotoxic T-lymphocytes
what are symptoms of type I diabetes
- thirsty
- increased urination
- tired
- losing weight without trying
- thrush
- blurred vision
- cuts and grazes not healing
- fruity smelling breath
what is type II diabetes
- normal or raise insulin secretion
- insulin receptor insensitivity
- liver does not react to signals of insulin
what are the symptoms of type II diabetes
- peeing more
- thirsty
- tired
- losing weight without trying
- itching around penis or vagina
- cuts take longer to heal
- blurred vision
what are symptoms of hypoglycaemia
- sweating
- tingling lips
- shaking or trembling
- dizziness
- tiredness
- palpitation
- irritibility
what are hyperglycaemia symptoms
- increased thirst
- dry mouth
- frequent urination
- tiredness
- blurred vision
- weight loss
- recurrent infections
what is DKA
absence of insulin and maintained glucagon causes a release in fatty acids which are rapidly converted to ketones which build up
what are symptoms of DKA
- fast/ deep breathing
- dry skin
- flushed face
- fruity breath
- headache
- stiffness
- vomiting
what is hyperosmolar hyperglycaemic state
severe dehydration caused by the body trying to get rid of excess sugar
what are the symptoms of hyperosmolar hyperglycaemic state
- urination
- thirst
- nausea
- dry skin
- disorientation
what is hypovolemia
- reduction of fluid volume
- changes to balance of electrolytes
what is grade 1 hypovolaemic shock
- 15% loss
- normal BP, and resps
what is grade 2 hypovolaemic shock
- 15-30% loss
- increase resps
- normal bp
narrowing pulse pressure
what is grade 3 hypovolaemic shock
- 30-40% loss
- systolic falls to 100
- tachycardic and tachypnoea
what is grade 4 hypovolaemic shock
- 40% loss
- tachy with weak pulse
- significant decreased systolic
what occurs in gestational diabetes
- oestrogen, cortisol and human placental lactogen have blocking effect on insulin
- 20-24 weeks pregnant
what is the target BM levels
- normal = 4-7
- diabetic = 4-9
how to manage diabetes
- focused history
- oxygen if needed
- take a BM
- give oral glucose, IV glucose or IM glucagon
