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Y2 Endocrine Block > Insulin Production and action > Flashcards

Insulin Production and action Flashcards

1
Q

what should the plasma glucose concentration be after a meal?

A

8-12 mM

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2
Q

what should the plasma glucose concentration be in fasting conditions?

A

4-5 mM

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3
Q

why does the hormone glucagon NOT have an effect on glycogen breakdown in muscle?

A

because there are no glucagon receptors in muscle

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4
Q

describe the functions fo glycogen in liver and the muscle

A

In liver: storage for blood glucose maintenance

In muscle: storage for local energy production (only used by muscle itself)

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5
Q

Describe the effect of insulin on glycogen metabolism in the LIVER during FED state

A

LIVER:
Insulin increases Glucokinase and inhibits Glucose-6-phosphatase
Insulin increases activity of glycogen synthase and inhibits glycogen phosphorylase

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6
Q

Describe the effect of insulin on glycogen metabolism in the MUSCLE during FED state

A

MUSCLE:
Insulin increases activity of GLUT-4 transporters (increases glucose uptake into cell)
Insulin increases activity of glycogen synthase and inhibits glycogen phosphorylase

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7
Q

which hormones affect glycogen metabolism IN THE LIVER during the fasting state?

A

Glucagon and Noradrenaline

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8
Q

how do glucagon/noradrenaline affect glycogen metabolism during the FASTINg state?

A

they have the opposite affect of insulin
(INHIBITS Glucokinase and increases Glucose-6-phosphatase)
(INHIBITS activity of glycogen synthase and INCREASES glycogen phosphorylase )
stimulates gluconeogenesis

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9
Q

which hormones affect glycogen metabolism IN MUSCLES during the fasting state?

A

Noradrenaline

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10
Q

which 3 reactions in liver glycolysis are not reversible and why?

A

glucokinase (GK)
Phosphofructokinase (PFK)
pyruvate kinase (PK)

they all involve use of ATP

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11
Q

What is used to bypass glucokinase?

A

glucose 6 phosphatase

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12
Q

What is used to bypass Phosphofructokinase?

A

fructose-1,6-bisphosphatase

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13
Q

What is used to bypass pyruvate kinase?

Describe when they come into play

A 
Pyruvate carboxylase (PCOX)
phosphoenolpyruvate carboxykinase (PEPCK)

Pyruvate —(PCOX)—>oxaloacetate
oxaloacetate —(PEPCK)—-> phosphoenolpyruvate

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14
Q

which hormone/s increase gluconeogenesis

A

glucagon and noradrenaline

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15
Q

which hormone/s inhibits gluconeogenesis

A

insulin

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16
Q

what happens to glucose in adipose tissue during FED state ?

A

glucose is converted into triglycerides

17
Q

What are the 2 ways in which triglycerides can be made?

A

make yourself using fatty acid synthase

Make from fatty acids in diet

18
Q

What does HSL break down TGs into? where do the products go?

A

Into fatty acids (goes to muscle to be used as fuel) and glycerol (goes to liver to be used to make glucose)

19
Q

Which hormone stimulates HSL and how does it do this?

A

Adrenaline

It increases adenylyl cyclase activity which increases cAMP and PKA production which in turn increases HSL activity

20
Q

what effect does insulin have on adipose lipolysis ?

A

It inhibits it

21
Q

which hypoglycaemic drugs increase insulin secretion?

A

S -sulphonylureas
I - incretin mimetics
D - DPP-4 inhibitors

22
Q

which hypoglycaemic drugs increase insulin sensitivity?

A

biguanides and thiazolidinediones

23
Q

which hypoglycaemic drugs increase glucose excretion?

A

SGLT2 inhibitors

24
Q

How do sulphonylureas work?

A

they inhibit ATP sensitive K channels which increase Ca influx into beta cells and recruits insulin filled vesicles

25
Q

How does metformin work?

A

acts as a weak poison, it inhibits liver mitochondrial function which represses ATP so cells which use ATP stress and shut down ATP-using processes so reduces HEPATIC GLUCONEOGENESIS

26
Q

which 2 enzymes does insulin inhibit in order to inhibit gluconeogenesis ?

A

PEPCK and G6Pase

27
Q

How does thiazolidinedione work?

A

it stops the inappropriate deposition of lipid in non-adipose tissues by making more adipocytes so more fat can be stored in adipose tissue

28
Q

what are incretins?

A

gastrointestinal hormones which potentiate (increase power of) insulin secretion

29
Q

give examples of 2 incretins and why do these not last long?

A

Glucagon like peptide (GLP-1)
Gastric inhibitory peptide (GIP)

short lived because they are rapidly inactivated by the enzyme DPP-4

30
Q

how do SGLT2 inhibitors work?

A

inhibits renal reuptake of of glucose and let it be peed out in urine (reduces hyperglycaemia)

Y2 Endocrine Block (21 decks)

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