Diabetes (Exam IV) Flashcards
What are the two types of secretory tissue found in the pancreas?
What are the functions of these two tissues?
- Exocrine Glands - Digestive enzymes
- Endocrine Glands - Hormones
What tissue type is located in the endocrine portions of the pancreas that produces secretory hormones? What cells make up this tissue.
Islet of Langerhans
- Alpha cells
- Beta cells
- Delta cells
- G cells
- F cells
What is produced in the Αlpha cells of the Islet of Langherhans?
What about the Βeta cells?
What about the Delta cells?
- α → Glucagon
- β → Insulin & Amylin
- δ → Somatostatin
How does proinsulin become insulin?
- Proinsulin is cleaved into Insulin and C-peptide.
What does Amylin do?
- Amylin is inhibitory to Glucagon (and a little to insulin as well)
What does Somatostatin do?
- Short acting (5min) inhibitory effect on both insulin & glucagon right after eating.
What receptor type are insulin receptors? What do they do when bound with insulin?
- Tyrosine Kinase Receptors
- Phophorylate effector proteins to promote GLUT transporters to bind to the cell surface.
What is the homeostatic level of blood glucose?
90mg/100mL
How quickly is glycogen used up?
Completely used up in 24 hours.
Why type of receptor is a glycogen receptor?
What organ takes in glycogen for energy storage & also breaks it down for use?
- GPCR.
- Liver.
What signs/symptoms are characteristic of diabetes mellitus? (particularly type I)
- Polyuria, Polydipsia, & Polyphagia
What characterizes Type 1 DM?
- Autoimmune destruction of βcells in the pancrease. Insulin dependent.
What characterizes Type 2 DM?
- Usual metabolic syndrome, non-insulin dependent but will convert to Type I if untreated.
What characterizes Type 3 DM?
- Temporary ↑ BG (pancreatitis, drug therapy, etc.)
What characterizes Type 4 DM?
- Gestational
At what level of βcell destruction is a diagnosis of Type I DM official?
What two types of Type 1 DM exist & which is more common?
- 80% of βcells destroyed.
1. Immune (more common)
2. Idiopathic (genetic)
Why do Type 1 diabetics often have weight loss?
What might occur if a Type 1 diabetic is not given insulin replacement.
- Due to the inability to process carbohydrates.
- Fatty acid oxidation → ↑ketones → ↓pH
Which Diabetes Mellitus sub-type is characterized by relative deficiency of insulin secretion & tissue insulin resistance?
What occurs at the cellular level with insulin resistance?
What would blood levels of insulin be in a type 2 DM patient?
- Type II DM (the artist formerly known as “adult onset DM”)
- Downregulation of GLUT transporters.
- Initial ↑ insulin level; ↓ insulin level developed over time.
What blood glucose levels would you expect to see with non-ketotic hyperosmolar syndrome?
What symptoms would be associated with this condition?
> 600mg/dL
- Dehydration & eventual coma/death.
What are three clinical manifestations of chronic type 2 DM?
- Recurrent infections
- Vision problems
- Neuropathy
What is nonenzymatic glycosylation?
- The process by which chronically high blood sugars attach to your hemoglobinA1C.
What is a normal Hemoglobin A1C?
What is a very abnormal one?
4-5%
> 7%
Describe the hyperglycemic effect on the polyol pathway.
Where is this effect most prominent?
- Sorbitol & Fructose increase intracellularly = ↑ osmotic pressure = Hypotonicity of the cell & cell rupture.
- Eye lens, nerves (neuropathy), & RBCs (anemia)