Glucose Flashcards
What is postprandial hyperglycaemia?
Glucose absorbed after carbohydrate digestion increases glucose entry into the blood
Amino acids after protein digestion stimulate gluconeogenesis
What proteins does glucose usually enter cells through?
GLUT-1 to GLUT-7
Via what protein does glucose usually enter leukocytes, neurones, hepatoyctes, erythrocytes and platelets?
GLUT-2
What protein does Glucose use to be transported into adipocytes and myocytes?
GLUT-4
What is the primary function of insulin?
To lower blood glucose
What do catecholamines such as epinephrin stimulate?
Hyperglycaemia
How does epinephrin increase glucose levels?
- By inhibiting glucose secretion
- Stimulus of hepatocytes to increase glycogenolysis
- Increase of GH releasing hormones (GH reduces cell glucose uptake)
Why will you have a decrease in glucose in your sample if you leave the sample on the side?
Any contact with teh serum/ cells neutrealises the glucose in the plasma
What is type 1 Diabetes Mellitus?
targeted B cell destruction
causes an absolute insulin deficiency
usually idiopathic and immune mediated
What is type 2 diabetes mellitus
insulin resistance with an inadequate insulin secretory response
* can be caused by pancreatic insular amyloidosis
What are some other forms of Diabetes Mellitus (Not Hyperglycaemia)
Pancreatic DM
Endocrine (non-pancreatic) DM
Drug-Induced DM
What are some common diseases implicated in Insulin Resistance?
- Obesity
- Hypothryoidism
- Dental disease
- Pancreatitis
- Pregnancy/ Diestrus
Why does measurement of ketoamines mean that you may have diabetes mellitus?
You need high levels of glucose present for high lengths of time for ketoamines to form
What is the link between fructoasmine and glucose?
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
What can effect blood glucose curves
additional stress hyperglycaemia
What is glucosuria?
Increased glucose in the urine
What does excess glucose in the urine promote?
Osmotic Diuresis (inhibition of resportion of water) Polydipsia then occurs in response
Name 4 things that can cause hypoglycaemia?
- Increased insulin secretion
- Decreased insulin antagonism
- Decreased gluconeogenesis
- Decreased glycogenolysis
What are the most common pathogenesis’s for hypoglycaemia?
- Pancreatic or B cell neoplasia
- Hypoadrenocorticism
- Hepatic insufficiency
- Decreased glycogenolysis
- lactational hypoglycaemia
- Sepsis
How can you measure the insulin:glucose ratio?
Immunoassays
How does cortisol increase blood glucose?
- Stimulates gluconeogenesis
- Creates a state of insulin resistance
How do catecholamines increase blood glucose?
- inhibit insulin secretoon
- stimulus of hepatocytes increase of glycogenolysis
- adrenergic stimulus- GH which reduces glucose uptake via cells
What is physiologic hyperglycaemia?
- Postprandial
- due to excitement or fright
- steroid associated
- diestrus
What are three ways you can assess for persistent hyperglycaemia?
- Fructosamine- glycosated protein (glycated albumin or igG)
- Glycated haemoglobin
- Measurement of ketoamines
What is osmotic diuresis?
- Increased glucose in the tubular fluid
goes on to cause polyuria
Name four things that can cause hypoglycaemia
- Increased insulin secretion
- Decreased gluconeogenesis
- Decreased glycogenolysis
- Increased glucose utilisation
