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MED 310 > endocrine pancreas and glucose regulation > Flashcards

endocrine pancreas and glucose regulation Flashcards

1
Q

functional anatomy of the pancreas

A

98% exocrine
-digestive enzymes and bicarbonate
-secreted thru pancreating duct

2% endocrine
-peptide hormones regulating glucose and other intermediary metabolism
-secreted by exocytosis- drains into hepatic portal vein

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2
Q

what are the exocrine cells of the pancreas

A

duct and acinar cells
-NaHCO3 and digestive enzymes

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3
Q

what cells are the endocrine portion of the pancreas

A

islets of langerham

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4
Q

hormones secreted by islet cells

A

B/ beta cells secrete insulin and amylin
A/ alpha cells secrete glucagon
D cells secrete somatostatin GHIH
PP cells secrete pancreatic polypeptide

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5
Q

role of insulin

A

stimulate uptake and storage of energy substrates

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6
Q

role of glucagon

A

stimulates production of glucose by liver- gluconeogenesis

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7
Q

somatostatin role

A

general inhibition of exocrine and endocrine pancreatic secretion/ acts in paracrine fashion

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8
Q

panceatic polypeptide role

A

inhibition of exocrine pancreatic secretion

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9
Q

what is the role of pancreatic hormones

A
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10
Q

what is the role of pancreatic hormones

A

provide constant supply of glucose to CNS

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11
Q

what do pancreatic hormones respond to

A

feasting and fasting

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12
Q

when does the absorptive or fed state occur

A

first hours after eating

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13
Q

when does the postabsorptive or fasted state occur

A

between meals

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14
Q

what is the most significant regulated variablee

A

blood glucose concentration

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15
Q

what does excessive glucose in the brain do

A

has detrimental effects long term due to inapproperiate glycosylation reactions

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16
Q

what controls insulin and glucagon secretion

A

blood glucose concentration

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17
Q

what hormone is dominant in the fed state

A

insulin

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18
Q

what does insulin do

A

cellular uptake of nutrients
carb and fat storage
protein anabolism

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19
Q

what does glucagon do

A

catabolism
breakdown of fat, car, and protein

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20
Q

when is glucagon dominant

A

in the fasted state

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21
Q

what are some factors that affect insulin secretion

A

high aa level

glucose entry in small intestine stimulating
-GIP- gastric inhibitory peptide/ glucose dependent insulinotropic peptide
-GLP1- glucagon like peptide 1

higher parasympathetic activity- innervation of beta cells

22
Q

what accomplishes passive facilitated diffusion of glucose across cellular membranes

A

GLUTs 1-6

23
Q

what GLUTs are alwyas present in their respective cell membranes and what is this called

A

all but 4
limited tissue distribution

24
Q

where does glut 1 transport glucose

A

across BBB

25
Q

GLUT 4

A

insulin depepndent transporter that is recruited to membrane upon insulin binding to its receptor— reversible process

26
Q

where does GLUT4 transport glucsoe

A

skeletal muscle and adipose

27
Q

is insulin needed for glucose uptake in exercising muscle

A

no
muscle contraction caues insertion of GLUT 4 into cell membranes

28
Q

what does the brain and liver not need for glucose uptake

A

insulin

29
Q

what does chronically high insulin level lead to

A

down regulated receptors

30
Q

what decreases affinity of receptors

A

excess glucocorticoids- stress response

31
Q

what upregulates insulin receptors

A

starvation

32
Q

what increases affinity of insulin receptors

A

chronically low insulin levels or adrenal gland insufficiency

33
Q

major effects of insulin on carbohydrate metabolism

A

decreases blood glucose and increases carb storage

34
Q

major effects of insulin on carbohydrate metabolism detail

A

inc glycogenesis in skeletal muscle and liver
dec in hepatic glucogoneogenesis
inc in glucose uptake by fat cells and resting skeletal muscle

35
Q

how do atheletes abuse insulin

A

inject insulin and then eat high sugar good attemtping to increase glycogen storage in skeletal muscle

36
Q

what is the risk of injecting insulin

A

hypoglycemia and coma bc they get the fast acting insulin

37
Q

synthetic insulin allowance

A

it is banned for atheletes and is sensed by sensitive assays

38
Q

insulin effect on fat metabolism

A

decreaes bloody fatty acids and inc triglyceride storage

inc transport of fa into fat cells
inc triglyceride synth by increasing glycose transport into gat cells
activates enzymes that catalyze synth of fa from glucose

inhibits lipolysis

39
Q

insulin effect on protein metabolism

A

dec blood AA and inc protein synthesis

inc transport of blood AA into muscle and other cells
inc protein synth
inhibits protein degradation

40
Q

what are some other factors influencing insulin secretion

A

inhibition of insulin by somatostatin- paracrine from D cells
-inc sympathetic activity
-during exercise or acute stress
-ensures glucose supply to brain and active muscle

41
Q

primary control of glucagon secretion

A

negative feedback bw alpha cells and blood glucose concentratino
-dec in blood glucose inc glucagon secretion

42
Q

what are some factors that increase secretion of glucagon

A

sympathetic activity
inc in AA counteracts insulin effect and prevents hypoglycemia after high protein low carb meal

43
Q

effect of glucagon on fat and carb metabolism

A

opposite of insulin
inc blood glucose by inc liver gluconeogenesis and glycogenolysis

inc blood FA and ketone bodies by increasing production in liver and fat
-inc lipolysis and metabolism of FA to ketone bodies
-dec triglyceride synthesis

44
Q

glucagon relatino to hypo and hypersecretion of pancreatic hormones

A

no known assocaited with glucagon

hypersecretion of insulin- hypoglycemia

45
Q

hypoglycemia

A

beta cell tumor
overdose of insulin in diabetics
CNS effects- sweating, palor, inc heart rate, anxiety, confusion, convulsions, coma

46
Q

diabetes mellitus

A

undesecretion or resistance of insulin- HYPERGLYCEMIA

47
Q

what does high glucose do to blood vessels

A

damages them by glycosylation reactions

neuropathy, nephropathy, cardiovascular disease

48
Q

how many diabetics are type 1

A

10%- IDDM

49
Q

how many diabetics are type 2

A

90% NIDDM- non insuolin dependant

50
Q

how is diabetes mellitus diagnosed

A

glucose tolerance test

51
Q

type 1 diabetes

A

autoimmune destruction of beta cells

insulin dependant
daily insulin injections

MED 310 (47 decks)

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