Diabetes: Medications, Pathophysiology & MNT

Question 1

The islets of Langerhans secret what hormones & from what cell type?

Answer 1

Is the endocrine function of the pancreas. Insulin, B-cells. Glucagon, a-cells. Somatostatin, delta-cells. Pancreatic polypeptide, F or PP cells

Question 2

Insulin

Answer 2

Produced by the beta-cells of the islets of Langerhans. Targets most cells, promotes cellular uptake, use, and storage of absorbed nutrients.

Question 3

Glucagon

Answer 3

produced by the alpha-cells of the islets of

Langerhans. Targets most cells, Important for maintaining nutrient levels in blood during post absorptive state.

Question 4

Somatostatin

Answer 4

Produced by the ∆ - cells of the islets of Langerhans. Targets the digestive system - inhibits digestion & absorption of nutrients; pancreatic islet cells - Inhibits secretion of all pancreatic hormones; and in the anterior pituitary gland - controls secretion of growth hormone.

Question 5

Pancreatic polypeptide

Answer 5

Produced by the F, or PP cells of the islets of Langerhans. Targets the pancreas where is plays a possible role in reducing appetite and food intake by inhibiting postprandial pancreatic exocrine secretion.

Question 6

What two hormones do the alpha cells secrete?

Answer 6

Glucagon and GLP-1 are secreted by the alpha-cells of the endocrine pancreas in the islets of Langerhans.

Question 7

What is the function of insulin?

Answer 7

Directs cellular activities that favor storage of nutrients. In general, acts on hepatic, muscle, and adipose cells to allow for the uptake of glucose into the cells. Stimulated protein synthesis, glycogen synthesis, and triglyceride synthesis. Net effect is the decrease in serum BG.

Question 8

GLUT-4

Answer 8

Is insulin dependent glucose transport molecule. Found in skeletal & cardiac muscle, and in adipocytes.

Question 9

GLP-1 and GLP-2

Answer 9

Incretins derived from a precursor of glycogen. Stimulate the action of insulin and inhibit that of glucagon.

Question 10

GADA

Answer 10

Glutamic acid decarboxylase autoantibodies (GADA) - Found in 70-80% of individuals with T1DM. Most sensitive marker for identifying persons at risk of developing T1DM.

Question 11

Islet Cell Autoantibodies (ICA)

Answer 11

Found in 70-80% of individuals < 30 yo newly diagnosed with T1DM. Levels decrease the longer an individual has the disease. Is a risk factor in those who do not have T1DM.

Question 12

Insulin autoantibodies (IAA)

Answer 12

The presence of IAA is evidence of ongoing destruction of beta-cells. Must be preformed prior to stating insulin therapy. Is an early predictive marker in children developing T1DM.

Question 13

C-peptide

Answer 13

The peptide chain released when insulin is activated. If present, insulin is still being produced.

Question 14

Initial insulin does is figured how?

Answer 14

0.3-0.5 units/kg is common starting point for pt. within 120% of IBW. Must be adjusted based on BG patterns.

Question 15

adrenocortical hormones

Answer 15

steroids derived from the precursor cholesterol.

Question 16

alpha-glucosidase

Answer 16

A digestive enzyme found in the brush boarder cells of the small intestine that cleaves more complex CHOs into sugars.

Question 17

amylin

Answer 17

A hormone synthesized by pancreatic B-cells that contributes to glucose control during the postprandial period.

Question 18

catecholamines

Answer 18

The chemical classification of adrenomedullary hormones.

Question 19

dawn phenomenon

Answer 19

An increase in blood glucose in the early morning, most likely due to increased glucose production in the liver after an overnight fast.

Question 20

epinephrine

Answer 20

A hormone that is secreted from the adrenal medulla; regulates arterial blood pressure & prepares the body for “fight or flight” responses.

Question 21

What does glycogen promote, inhibit?

Answer 21

Promotes glycogenolysis, gluconeogensesis, and lipolysis. Inhibits glycogenesis and triglyceride synthesis.

Question 22

myxedematous

Answer 22

Refers to non-pitting edema.

Question 23

negative nitrogen balance

Answer 23

net loss of protein in the body

Question 24

neuroglycopenia

Answer 24

inadequate glucose supply to the brain

Question 25

norepinephrine

Answer 25

A neurotransmitter released from sympathetic postganglionic fibers; a stress hormone that affects parts of the brain where attrition and responding actions are controlled.

Question 26

positive nitrogen balance

Answer 26

net accumulation of protein in the body

Question 27

renal threshold

Answer 27

a concentration level of glucose in the blood above which the kidneys pass it through into the urine.

Question 28

secretagogues

Answer 28

medications that increase secretion of insulin

Question 29

somatostatin

Answer 29

a hormone produced in the gamma-cells of the Islets of Langerhans in the pancreas to control secretion of growth hormone from the anterior pituitary gland.

Question 30

tropic hormone

Answer 30

a hormone that regulates secretion of another homome

Question 31

vasopressin

Answer 31

The primary endocrine factor that regulates urinary H2O loss & overall H2O balance; regulated blood pressure via this hormone’s pressor effects on blood vessels; also known as antidiuretic hormone (ADH).

Question 32

What stimulates the release of insulin?

Answer 32

Increased blood glucose. Action of counter-regulatory hormones, including growth hormone.