Endocrine Pancreas Flashcards
Which type of GLUT receptor requires insulin
GLUT-4
on sk muscle and adipose tissue
Where are alpha and beta cells located within the islets
alpha: peripheral
beta: central
T1D results from what type of hypersensitivity
type IV
T1D HLA associations
HLA-DR3 and -DR4
Autoantibodies to this can been seen years before T1D develops
autoantibodies to insulin
How does stress or infection lead to diabetic ketoacidosis
high epi leads to lipolysis
FA converted to ketones in liver
ketones put into blood
Etiology of hyperkalemia in diabetic ketoacidosis
- insulin normally brings K+ into cells and
- K+ buffers H+ in blood, so H+ enters cells and K+ leaves cells to buffer this
- *but overall body K+ is actually low because much of the K+ is lost in the urine
Tx of diabetic ketoacidosis
fluids
insulin
electrolyte monitoring and replacement (esp K+)
K+ status in diabetic ketoacidosis
high serum K+
low total body K+
**low because much is lost in urine
Etiology of T2D
end organ insulin resistance
due to decreased # of insulin receptors
Insulin levels in T2D
initially high insulin levels
then low as beta cells become exhausted (reason for use of exogenous insulin late in disease)
**amyloid deposits in pancreatic islets
Dx of diabetes
random glucose >200
fasting > 126
Risk in T2D
hyperosmolar non-ketotic coma
- high glucose leads to severe diuresis
- diuresis leads to hypovolemia
- hypotension
- coma
- death
2 types of complications from diabetes
non-enzymatic glycocylation -atherosclerosis -hyaline arteriolosclerosis osmotic damage (Glc -> sorbital via aldose reductase) -Schwann cells -retinal pericytes -lens of eye
Hyaline arteriolosclerosis preferentially affects what part of the renal artery
efferent (reason for using ACE inhibitors, ATII also affects efferent arteriole preferentially)
