Growth and Diabetes Flashcards
T/F: The endocrine system is the principle factor controlling growth.
FALSE
Genetics
What determines final height?
Rate of bone growth
Various factors effecting growth include…
- Genetics
- Nutrition
- Freedom from disease
- Endocrine
What are the hormones in the growth axis?
GHRH -> GH -> IGF-1
____ is necessary for fetal growth, while ____ becomes important later in development.
IGF-1; GH
_______ is required for synthesis of GH and manifestation of GH effects.
Thyroid hormone
Which glucose-regulating hormones help control growth?
- Glucocorticoids: inhibit GHRH
2. Insulin: oppose GH and IGF-1
T/F: Gonadal steroids (T and E2) have a role in growth.
True
At puberty, the epiphyseal plates ossify due to actions of which hormone?
E2
To promote GH secretion the hypothalamus will _______ GHRH secretion and ________ SS secretion.
increase; decrease
What are the effects of GH?
- Stimulates cell division
- Stimulates protein synthesis
- Acts in opposition to insulin
What is the principle indirect effect of GH on growth?
Stimulate secretion of IGF-1 from the liver and other tissues
What is the short-loop feedback effect on GH?
IGF-1 inhibits GH secretion
What is the long-loop feedback effect on GH?
IGF-1 inhibits GHRH and stimulates SS
_____ is elevated during sleep, while _____ is elevated during the day.
GHRH; SS
How can malnutrition impede growth?
Impairs IGF-1 synthesis independent of GH
What is the result of sex steroids on GH and IGF-1?
Sex steroids stimulate GH and IGF-1, but ultimately cause the fusion of epiphyseal plates
What effects do cortisol/glucocorticoids have on growth?
Inhibit growth
What is the key determinant of the effects of GH?
AGE
Effective early on; negligent or maybe detrimental later in life
______ results from prepubertal onset of excess GH; _______ results from postpubertal onset of excess GH.
Gigantism; Acromegaly
What dental effects can excess GH have?
Macroglossia, increased spacing and tilting, enlarged salivary glands, excess cementum
How can you treat someone with GH insensitivity/Dwarfism?
Exogenous IGF-1
What are some considerations for dental patients with GH insufficiency?
Delayed tooth shedding and replacement, decreased salivary function leading to more caries and perio problems
T/F: Insulin is an anabolic hormone that acts to store nutrients.
True
What causes insulin to be released in normal patients?
Increase in blood glucose and signals from parasympathetics
What inhibits insulin secretion?
Sympathetic nervous system
Which diabetes is an autoimmune disorder where pancreatic beta cells are destroyed resulting in reduced production of insulin?
Type I
What is Type II diabetes?
Combination of insulin resistance and deficiency
What are some common symptoms of diabetes?
- Elevated glucose concentrations
- Polyuria
- Fatigue
- Blurred vision
What are some common complications with diabetes?
- Kidney failure
- Vascular disease
- Blindness
- Skin and mucosal infections
- Perio disease
What might help Type I diabetics during long procedures?
Snacks
