Glucose, Ketamine, and Related Regulatory Hormones

Question 1

What does insulin do?

Answer 1

Decreases blood glucose concentration

Promotes uptake by hepatocytes, myocytes, and adipocytes

Question 2

How does glucose enter cells?

Answer 2

Via receptors GLUT1 to GLUT7

Question 3

Which glucose receptor is insulin dependent? Where is it?

Answer 3

GLUT4

Present in myocytes and adipocytes

Question 4

How does glucagon increase [glucose]?

Answer 4

Gluconeogenesis

Glycogenolysis

Question 5

What do catecholamines do?

Answer 5

Primarily decreased insulin release
Increases glycogenolysis
Leads to GH release –> increases [glucose] by decreasing uptake by hepatocytes and myocytes
Cortisol increases [glucose] by gluconeogenesis and insulin resistance

Question 6

What sample is needed to analyze glucose?

Answer 6

Serum or heparanized plasma

Question 7

What are the physiologic causes of hyperglycemia?

Answer 7

Postprandial
Excitement or fright
Steroid associated hyperlgycemia
DIestrus

Question 8

What are the pathologic cause of hyperglycemia?

Answer 8

Type 1 diabetes mellitus
Type 2 DM
Pancreatic DM
Endocrine DM
Infetious (BVD, Sepsis)
Hyperammonemia
Pharmacologic

Question 9

What is the most common canine DM?

Answer 9

Type 1 DM

Question 10

What is the most common cat DM?

Answer 10

Type 2 DM

Question 11

What does type 1 DM do?

Answer 11

β-cell destruction

Question 12

What does type 2 DM do?

Answer 12

Insulin resistance with inadequate compensatory insulin secretory response

Question 13

What does pancreatic DM do?

Answer 13

Any pancreatic disease that damages high numbers of β-cells

Question 14

What is hypoglycemia caused by?

Answer 14

Increased glucose use, decreased glucose production, or both

Question 15

What are the pathologic causes of hypoglycemia?

Answer 15

Increased insulin secretion 
Decreased insulin antagonism
Decreased gluconeogenesis
Decreased glycogenolysis
Increased glucose utilization
Sepsis
Pharmacologic or toxicologic

Question 16

What are causes of increased insulin secretion?

Answer 16

Functional pancreatic β-cell neoplasia

Xylitol toxicosis

Question 17

What are causes of decreased insulin antagonism?

Answer 17

Hypoadrenocoritcism
GH deficiency
Hypopituitarism

Question 18

What is a cause of decreased gluconeogenesis?

Answer 18

Hepatic insufficiency

Question 19

What is a cause of increased glucose utilization?

Answer 19

Lactational hypoglycemia

Question 20

What is fructosamine?

Answer 20

Ketoamines formed by irreversibly linking of glucose to albumin or other plasma proteins (mostly IgG)

Question 21

What is glycated Hgb?

Answer 21

Ketoamine formed by the addition of glucose to Hgb

Question 22

What is the half-life of fructosamine?

Answer 22

2-3 weeks, but variable between species

Question 23

What is the half-life of glycated Hgb?

Answer 23

2-3 months

Question 24

What are causes of increased fructosamine and glycated Hgb?

Answer 24

DM
Hypothyroidism
Hyperproteinemia

Question 25

What are causes of decreased fructosamine and glycated Hgb?

Answer 25

Insulinoma in dogs
Hypoproteinemia and hypoalbuminemia
Cats with hyperthyroidism
Anemia