Glucose

Question 1

What is postprandial hyperglycaemia?

Answer 1

Glucose absorbed after carbohydrate digestion increases glucose entry into the blood
Amino acids after protein digestion stimulate gluconeogenesis

Question 2

What proteins does glucose usually enter cells through?

Answer 2

GLUT-1 to GLUT-7

Question 3

Via what protein does glucose usually enter leukocytes, neurones, hepatoyctes, erythrocytes and platelets?

Answer 3

GLUT-2

Question 4

What protein does Glucose use to be transported into adipocytes and myocytes?

Answer 4

GLUT-4

Question 5

What is the primary function of insulin?

Answer 5

To lower blood glucose

Question 6

What do catecholamines such as epinephrin stimulate?

Answer 6

Hyperglycaemia

Question 7

How does epinephrin increase glucose levels?

Answer 7

• By inhibiting glucose secretion
• Stimulus of hepatocytes to increase glycogenolysis
• Increase of GH releasing hormones (GH reduces cell glucose uptake)

Question 8

Why will you have a decrease in glucose in your sample if you leave the sample on the side?

Answer 8

Any contact with teh serum/ cells neutrealises the glucose in the plasma

Question 9

What is type 1 Diabetes Mellitus?

Answer 9

targeted B cell destruction
causes an absolute insulin deficiency
usually idiopathic and immune mediated

Question 10

What is type 2 diabetes mellitus

Answer 10

insulin resistance with an inadequate insulin secretory response
* can be caused by pancreatic insular amyloidosis

Question 11

What are some other forms of Diabetes Mellitus (Not Hyperglycaemia)

Answer 11

Pancreatic DM
Endocrine (non-pancreatic) DM
Drug-Induced DM

Question 12

What are some common diseases implicated in Insulin Resistance?

Answer 12

• Obesity
• Hypothryoidism
• Dental disease
• Pancreatitis
• Pregnancy/ Diestrus

Question 13

Why does measurement of ketoamines mean that you may have diabetes mellitus?

Answer 13

You need high levels of glucose present for high lengths of time for ketoamines to form

Question 14

What is the link between fructoasmine and glucose?

Answer 14

If high levels of glucose are present for weeks on end then the proteins bind with the glucose
- you can use a serum sample to measure

Question 15

What can effect blood glucose curves

Answer 15

additional stress hyperglycaemia

Question 16

What is glucosuria?

Answer 16

Increased glucose in the urine

Question 17

What does excess glucose in the urine promote?

Answer 17

Osmotic Diuresis (inhibition of resportion of water) Polydipsia then occurs in response

Question 18

Name 4 things that can cause hypoglycaemia?

Answer 18

• Increased insulin secretion
• Decreased insulin antagonism
• Decreased gluconeogenesis
• Decreased glycogenolysis

Question 19

What are the most common pathogenesis’s for hypoglycaemia?

Answer 19

• Pancreatic or B cell neoplasia
• Hypoadrenocorticism
• Hepatic insufficiency
• Decreased glycogenolysis
• lactational hypoglycaemia
• Sepsis

Question 20

How can you measure the insulin:glucose ratio?

Answer 20

Immunoassays

Question 21

How does cortisol increase blood glucose?

Answer 21

• Stimulates gluconeogenesis
• Creates a state of insulin resistance

Question 22

How do catecholamines increase blood glucose?

Answer 22

• inhibit insulin secretoon
• stimulus of hepatocytes increase of glycogenolysis
• adrenergic stimulus- GH which reduces glucose uptake via cells

Question 23

What is physiologic hyperglycaemia?

Answer 23

• Postprandial
• due to excitement or fright
• steroid associated
• diestrus

Question 24

What are three ways you can assess for persistent hyperglycaemia?

Answer 24

• Fructosamine- glycosated protein (glycated albumin or igG)
• Glycated haemoglobin
• Measurement of ketoamines

Question 25

What is osmotic diuresis?

Answer 25

• Increased glucose in the tubular fluid
  goes on to cause polyuria

Question 26

Name four things that can cause hypoglycaemia

Answer 26

1. Increased insulin secretion
2. Decreased gluconeogenesis
3. Decreased glycogenolysis
4. Increased glucose utilisation