[FMS] NAM - integration of metabolism (fasting state)

Question 1

Describe the fasting (post-absorptive) state.

Answer 1

• Blood glucose concentrations peak an hour after eating
• They return to normal by two hours after a meal
• Blood glucose is removed for oxidation or storage
• Concentration of insulin drops and glucagon rises

Question 2

what happens to glucose, ketone bodies, and fatty acids during prolonged fasting (for days)

Answer 2

increase ketone bodies and fatty acids, decrease glucose

As starvation continues:

• More KB are recovered from the kidney
• Muscle uses FA rather than KB
• FA concentrations plateau and KB rise
• The brain can use more KB and less glucose
• The need for gluconeogenesis is reduced and muscle protein breakdown decreases
• Urea production decreases

Question 3

What are the chronic complications of diabetes mellitus?

Answer 3

• Microangiopathy
  
  • changes in walls of small blood vessels seen as thickening of basement membrane
• Retinopathy
  
  • blindness is 25x more common in the diabetic patient
• Nephropathy
  
  • renal failure 17x more common
• Neuropathy
  
  • postural hypotension, impotence, foot ulcers

Question 4

fatty acids are transported to the liver bound to

Answer 4

albumin