Diabetes Pathophysiology Flashcards
What are the sources of glucose (a primary energy source)?
Food, Glycogen Stores, and Liver
What is the primary macronutrient used for energy?
Carbohydrate CHO
What is catabolism of CHO?
Glycogenolysis
What is the synthesis of CHO called?
Gluconeogenesis or Glycogenesis, it synthesizes glucose during glucose deficiencies
Glycogenolysis is what?
Process of breaking down CHO for QUICK energy
Glycogenesis is what?
Converting CHO to glycogen for storage (skeletal muscle, liver, fat)
Protein synthesis is stimulated by what?
Insulin, because insulin moves glucose from blood into storage
B-Cells in the pancreas produce what?
Insulin and Amylin
A-Cells in the Pancreas produces what?
Glucagon
What hormones are utilized to decrease glycemia?
Insulin, incretin hormones, and amylin
What hormones are utilized to increase glycemia?
Glucagon, epinephrine, cortisol, and growth hormone
What is the incretin effect?
Orally administered glucose CHO, is the primary stimulus for insulin secretion
Where does insulin go first when secreted?
Liver
Basal Release is what?
Continuously secreted insulin from the pancreas
Bolus Release is broken into what?
First Phase and Second Phase
First Phase Bolus is:
Peak in insulin secretion in response to meals, shuts down hepatic glucose production
Second Phase Bolus is:
delayed, mostly used in periphery
What is the key action of insulin?
Insulin promotes glucose uptake, without it there is no glucose uptake
What are the 3 general actions of insulin?
Lowering of blood glucose, promotes storage of glucose, and promotes potassium intake
What are the effects of insulin in the liver?
Promote glucose uptake, stimulate glycogen storage, synthesis of triglycerides, and inhibits glycogenolysis
Insulin Action in Muscle and Adipose
Both have increase glucose uptake, muscle = AA, adipose = triglycerides
What is the major source of elimination for endogenous insulin?
Liver
What are the insulin requiring tissues?
Muscle and Adipose
What is GLP-1?
Glucagon Like Peptide that is released by L-cells in the intestine in response to glucose
What is the action of GLP-1?
Stimulates insulin secretion (glucose dependent)
How is GLP-1 metabolized?
Rapidly by DPP-4 (dipeptidyl peptidase 4)
What is GIP?
Glucose Dependent Insulinotropic Peptide, released from K cells in response to glucose/fat intake
What is the action of GIP?
Promote insulin biosynthesis, insulin secretion (glucose dependent)
How is GIP metabolized?
Rapidly by DPP-4
What is the role of Amylin?
Promotes lowering of glucose by: slow gastric empty, suppression of glucagon, increase satiety
When are GLP-1 and GIP released?
As you eat/glucose consumption
What are glucose levels in an normal prior to a meal?
70-99