Control Of Metabolism

Question 0

Maternal insulin?

Answer 0

Changes maternal metabolism

Increases conc as pregnancy proceeds to promot the uptake and storage of nutrients as fats in adipose tissue

Question 1

What is the metabolic response to pregnancy?

Answer 1

As growth increases, demand for nutrients increases to:
Supply fetus with nutrients required
Supplied at appropriate rate for each development stage
Minimal disturbance to homeostasis of maternal. Utile to
Foetus buffered for any disturbance of maternal nutrient supply
Long-term this is accomplished by maternal insulin

Question 2

Role of foetal-placental hormones?

Answer 2

Large oppose actions of insulin.

Number of effects on metabolism

Question 3

Metabolic changes in first half of pregnancy?

Answer 3

Preparatory increase in maternal nutrient stores - adipose, ready for rapid feotal growth, birth and lactation.
Hence increasing insulin to promote anabolism

Question 4

Metabolic changes during 2nd half of pregnancy?

Answer 4

Increased demand by foetal-placental units hence nutrients level must remain high by
Reducing maternal utilisation of glucose and switching to fatty acids
Delaying maternal disposal of nutrients after meals
Releasing FAs from stores built up during first half.

Insulin increases, but anti-insulin also increases at a faster rate, hence insulin:anti-insulin rate falls causing metabolic changes

Question 5

Maternal ketogenesis?

Answer 5

Decrease in insulin-anti-insulin ratio increases availability of FAs to liver hence increases production if ketone bodies in liver to fuel fetal brain

Question 6

What is gestational diabetes?

Answer 6

Maternal insulin controls metabolic response in pregnancy.

The ability of beta cells to meet the increase insulin secretion is achieved by beta cell hyperplasia and hypertrophy.

However some women endocrine pancreas can not meet thus deman hence pancreas fails to increase insulin causing loss of control of metabolism, blood glucose increase and diabetes occurs.

Question 7

What happens to gestational diabetes after birth?

Answer 7

The high metabolic demands removed and hormone levels change hence the pancreas can respond to metabolic needs hence the GD disappears

Question 8

Appropriate body glucose level in mmol/L?

Answer 8

Fasting:

3.3-6.0

Question 9

Appropriate body potassium level in mmol/L?

Answer 9

3.5-5.3

Question 10

Appropriate body sodium level in mmol/L?

Answer 10

133-146

Question 11

Appropriate body total cholesterol level in mmol/L?

Answer 11

3.5-6.2

Best is <5.2