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Gymnastics and tumbling > Chapter 30 (Blood Glucose and Diabetes) > Flashcards

Chapter 30 (Blood Glucose and Diabetes) Flashcards

1
Q

What is the pancreas?

A

Specialised gland in upper abdomen located behind stomach.
Act as:
- Endocrine gland = produce and secrete hormones direct into plasma. (ductless)
- Exocrine gland = Produce digestive enzymes (amylases, proteases and lipases) then release them via a duct into duodenum.

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2
Q

What are Islets of Langerhans (IoL)

A

Small patches of endocrine tissue within pancreas
found in clusters around blood capillaries
secrete hormones direct into blood plasma.
Made of two types of cells:
Alpha cells - larger - produce + secrete glucagon
Beta cells - smaller - produce and secrete insulin.

Important in regulating blood plasma glc concentrations.

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3
Q

Histology of pancreatic tissue

A

Differential staining enables different cell types to be observed
B cells stained blue, Alpha cells stained pink.

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4
Q

Specialisations of alpha and beta cells?

A
  1. Increased no. RER and 80s free ribosomes (for increased protein production (both insulin and glucagon are peptide hormones)
  2. Increased no. Golgi apparatus + Golgi vesicles (to secrete hormone by exocytosis)
  3. Increased mitochondria (for increased energy release for raised protein synthesis and exocytosis)
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5
Q

Increasing blood glucose concentration?

A

Glucose = small, soluble monosaccharide transported as its dissolved in plasma.
Normal blood glucose level - 90mg per 100cm3 blood.
Blood glucose level can rise due to:
- Diet - intake of high CBH diet (both sugars and starches
- Glycogenolysis - hydrolysis of stored glycogen in skeletal muscles and liver
- Gluconeogenesis - Production of new glucose from non-CBH sources (eg, production of glc by liver cells from glycerol, fatty acids, aa, lactate)

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6
Q

Decreasing blood glucose concentration?

A

Blood glucose level can decrease due to:
- Respiration - used by cells to release energy to ensure normal cell function. RoR will increase during exercise - glc levels fall faster.

  • Glycogenesis - Production of glycogen (when glc is in excess) which is stored in skeletal muscles and liver.
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7
Q

Action of insulin

A

Increases rate of absorption of glc into cells (especially in skeletal muscle cells)
Increases respiratory rate of cells
Increases rate of glycogenesis in liver for storage in liver cells and skeletal muscle cells.
Increases rate of glc to lipid conversion
Inhibits release of glucagon from Alpha cells in IoH.

Insulin is broken down by enzymes in liver cells, so need to be continually secreted to have an effect.
Ince glc levels drop below set level B cells reduce insulin production and secretion. NEGATIVE FEEDBACK

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8
Q

What is diabetes?

A

A disease in which the homeostatic control and regulation of blood glc levels does not function correctly.

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9
Q

When blood glucose concentration rises, what happens?

A
  1. B cells act as receptors and detect rising glc conc.
  2. B cells secrete insulin
  3. A cells stop secreting glucagon.
  4. Insulin binds to membrane-bound receptors on many cells but principally liver and muscle cells.
  5. These cells acts as effectors by increasing their uptake of glucose.
  6. More glucose is converted to fats or used in respiration in these cells.
  7. Liver cells convert some of the glc to glycogen by. glycogenesis which is stored.

Blood glc conc is reduced.

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10
Q

When blood glucose concentration drops, what happens?

A
  1. Alpha cells act as receptors and detect the following concentration of glucose
  2. B cells stop secreting insulin
  3. Alpha cells secrete glucagon
  4. Glucagon binds to membrane bound receptors on liver cells
  5. Less glucose is taken up by the liver cells (effector cells)
  6. The use of glucose for respiration in effector cells decreases so more fatty acids are used in respiration as alternative substrates
  7. Liver cells convert glycogen back into glucose by glycogenolysis which is released into the bloodstream
  8. Some aa and fats are converted into glucose by gluconeogenesis

blood glucose concentration is increased

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11
Q

Why must blood glc be regulated?

A

If levels are too high - decreases water potential of plasma - dehydration

If levels are too low - decreases respiration rate - potential cell and tissue death .

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12
Q

Common signs of diabetes?

A 
Excessive thirst
glc in urine
excessive need to urinate/ increased urine production
Weight loss
Tiredness
Blurred vision
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13
Q

Type 1 diabetes information.

A

Insulin-dependent diabetes
Age of onset - Childhood (juvenile-onset). Rapid onset
Little/no insulin produced by B cells, so build up of glc in blood plasma.

Causes - most caused by auto-immune response.
Person’s own immune system produces antibodies that destroy B cells in IoL.
Inheritable condition cause by several gene variants, eg, various HLA antigen genotypes.
can also be triggered by environmental factors, eg viral infections.

Person may lose consciousness -> hyperglycaemic coma

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14
Q

Diagnosing diabetes

A

2 ways

  1. Fasting blood glc test
  2. Glc tolerance test.
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15
Q

Fasting blood glc test info?

A

Person eats + drinks nothing (other than water) for 8-12 hours
Blood sample taken and blood glc levels measured.

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16
Q

Glc tolerance test info?

A

Person eats normally until evening before test.
Fast from midnight until test.
Initial blood sample taken + glc measured.
Person drinks glc solution.
Further blood samples taken + glc measured every 30 minutes for 3 hours.
Results indicate how effective insulin is at restoring glc levels to normal.

17
Q

Type 2 diabetes information?

A

More common type.
Non-insulin dependent diabetes
Age of onset - adulthood (late-onset)
Signs - insulin resistance (reduced sensitivity to insulin in effector cells - liver and skeletal muscle cells

Often caused by glycoprotein receptor in csm doesn’t work properly - Reduced glc uptake - glc remains in blood plasma - elevated glc levels

Symptoms less severe than in type 1 but can result in hyperglycaemic coma.

Risk factors:
Obesity - High BMI, high body fat
Genetics - Inc risk when family history of type 11 diabetes.
Increasing age
High blood pressure
Low birth weight.
18
Q

Ways of monitoring glc levels?

A

Use biosensor

Glycosylated haemoglobin

19
Q

Using a biosensor information?

A
  • Small drop of blood collected by pin prick on finger.
  • Blood collected onto test strip, which is inserted into biosensor.
  • Biosensor contains glucose oxidase that converts glc to gluconolactone, resulting in small electric current that reaches an electrode and digital reading of blood glc conc shown

Can be carried out self. May store data for long term monitoring

20
Q

Glycosylated haemoglobin information?

A

Glc molecules can attach to Hb in blood to form Glycosylated haemoglobin.
As plasma glc conc increases, so does conc of glycosylated haemoglobin.
Average blood glc can be monitored.
Test carried out by medical staff
Data monitored over several weeks.

21
Q

Treating type I diabetes information?

A
  • Controlled by regular injections of insulin via insulin pen 2-4 times a day, or insulin pump (battery operated and dispenses insulin continuously over 24 hour period)
  • Regularly testing own glc by finger-prick test.
  • If inject too much – hypoglycaemia - unconscious - coma - fatal
22
Q

Treating type II diabetes

A
  • Regulate CBH intake through diet and exercise levels.
  • Reduced intake of refined sugars
  • Small and regular meals to prevent glc surges in plasma.
  • Try and lose weight and inc. physical activity levels
    Medication:
    Metformin:
  • doesn’t cause weight gain
  • Reduces quantity of glc produced by liver
  • Lowers conc of plasma glc.
  • Reduces quantity of glc absorbed in small intestine

Sulfonylureas
- Stimulate B cells to produce more insulin

23
Q

The role of health professionals - Diabetic nurses

A
  • Provide education, advice and support
  • Important for people newly diagnosed with hypoglycaemia
  • Support diabetic with any changes in treatment
24
Q

Health care provided information

A

Monitor all aspects of health

  • Diabetics have more than double the risk of developing CHD
  • Annual eye exam needed due to increased risk of damage to capillaries in retina -> blurred vision
  • Increased risk of bladder and kidney infections
  • Podiatry: Decreased blood supply to feet -> loss of feeling in feet and decreased healing time for any food injuries. Advice given on appropriate footwear.
25
Q

Evidence based practice?

A
  • Use of clinical data and research to inform practice.

Has moved diabetic care from anecdotal experience to scientifically founded advice

26
Q

The long term future…

A

Prevalence of diabetes in children is increasing
Rising obesity levels will see further increases
Increase standard of living -> increased food intake, increased intake of processed food, decreased physical activity levels
Average age of pop increasing - increased prevalence of type II diabetes
Causes strain to NHS.

27
Q

Potential treatments for diabetes?

GMB

A

Genetically modified bacteria.

  • Production of Humulin increasing
  • More effective than insulin from pigs/cattle.
  • Ethically preferred by vegans/vegetarians
  • Less religious objections
28
Q

Potential treatments for diabetes?

SC

A

Stem cells from embryo developed into B cells.
B cells then implanted into Type 1 diabetic person’s pancreas.
Person starts to produce insulin as normal.

29
Q

Action of glucagon?

A

Glycogenolysis occurs in liver cells
Reduces quantity of glc absorbed by liver cells
Increases gluconeogenesis.

Gymnastics and tumbling (29 decks)

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