Insulin Resistance Flashcards
____ is the most potent anabolic hormone in the body and exerts a multitude of effects on ____.
Insulin
Nitric oxide synthesis (vasodialatior)
Insulin or Glucagon?
Secreted from the beta cells of pancreas
Insulin
Insulin or Glucagon?
Secreted from alpha cells of pancreas
Glucagon
Insulin or Glucagon?
Hyperglycemia
Insulin
Insulin or Glucagon?
Hypoglycemia
Glucagon
Excess blood sugar results in the release of ____
Insulin
Low blood sugar results in the release of ___
Glucagon
Insulin and glucagon have an effect on glycogen synthesis, ____, ____, ____, glucose uptake, ____, and ____.
Gluconeogenesis
Glycolysis
Lipolysis
Glycogenolysis
Fatty acid synthesis
Insulin is also thought of as an abundance of ___
Carbs
Does insulin increase or decrease these:
Gluconeogenesis
Glycogen synthesis
Glucose uptake
Glycolysis
Lipolysis
Glycogenolysis
Fatty acid synthesis
Gluconeogenesis= decrease
Glycogen synthesis= increase
Glucose uptake=increase
Glycolysis=increase
Lipolysis= decrease
Glycogenolysis=decrease
Fatty acid synthesis= increase
Does glucagon increase or decrease these?
Gluconeogenesis
Glycogen syntheses
Glucose uptake
Glycolysis
Lipolysis
Glycogenolysis
Fatty acid synthesis
Gluconeogenesis= increase
Glycogen synthesis= decrease
Glucose uptake=decrease
Glycolysis=decrease
Lipolysis= increase
Glycogenolysis=increase
Fatty acid synthesis= decrease
Glucagon can also be thought of as ____
Glucose gone
Insulin resistance is generally defined as the inability of target tissues to respond to insulin, causing ________
Elevated blood glucose
When is it normal to have insulin resistance?
Puberty
Pregnancy
Lactation
What is the mechanism of insulin resistance?
Reduced function in the insulin receptor 1phosphatidylinositol 3-kinase
Interference with _____ pathway is responsible for most of the metabolic effects of insulin and if interested with it can lead to altered phosphorylation
1phosphatidylinositol 3-kinase
Insulin resistance starts with certain cell types becoming ____ which results in excess ___ in the bloodstream. This can result in ____
Glucose intolerant
Glucose
Hyperinsulinemia
T or F
In insulin resistance, the pancreas will release more insulin to try to increase the hyperglycemia condition
False, it try’s to decrease the condition
Hyperinsulinemia with insulin insensitivity to cells leads to ____ fasting blood glucose and ___ glucose intolerance. This mostly occurs in adipose and muscle cells
Elevated
Increased
T or F
Insulin resistant muscles lose the ability to stimulate glucose uptake
True
T or F
Insulin resistant adipose tissue can no longer inhibit free fatty acid release
True
Vascular ____ cells are likely to be damaged by hyperglycemia stress
Endothelial cells
What three tissues are insulin independent?
Retina
Kidney
Nervous tissues
Where does excess glucose enter?
Polyol pathway
Whydoes the polyol pathway matter?
Important for retina and nervous tissue
Excess sugar in the bloodstream increases ___ production
Sorbitol
Factors that MAY help with maximizing insulin sensitivity are ____, physical activity, stopping ___, healthy microbiome, ____, __, __,__, certain ___, ____, ___, and ___.
Maintaining healthy body weight
Stopping smoking
Gel forming soluble fiber
Zn
Mg
Vitamin D
Certain photo chemicals
Antioxidants
Omega 3
Cr
What is the ADEQUATE INTAKE for Chromium?
25-35 mcg/d
Supplements of chromium picolinate have been linked to ____ with supplements of __-__ mcg.
Organ damage
600-2400 mcg
What are food sources of Cr?
Meats, fish, poultry
Organ meat
Whole grains
Cheese
Dark chocolate
Mushrooms
Green pepper, beans, spinach
Apple, citrus, banana
Use of stainless steel cookware may increase it
_____ is a clinically pre diabetic condition closely associated with an increased state of insulin resistance
Metabolic syndrome
Causes of metabolic syndrome could be because of what?
Inactivity
Genetic predisposition
Insulin resistance
Central adiposity (hypertrophic fat cells)
Inflammation
Metabolic syndrome has gone up in adults 20-39 from ___% to ___%
16.2% to 21.3%
(Shows it’s not just weight or age causing this, happens to everyone)
Approximately ___% of the adult population is at risk of metabolic syndrome globally
25%
What type of activity increases insulin sensitivity?
Both resistance and aerobic exercise
Excess CHO intake is know to ____ serum TAG and ___ HDL
Increase
Lower
What are 5 ways metabolic syndrome can affect the body?
- Dyslipidemia (elevated TG, lowered HDL)
- Elevated waistline/ central obesity
- Elevated fasting glucose
- Insulin resistance
- Hypertension
The categorical cut points for metabolic syndrome is
Waist circumference
M=
F=
Elevated TG=
Reduced HDL
M=
F=
Blood pressure
Systolic=
Diastolic=
Elevated fasting glucose=
Waist circumference
M= > 40 inches
F= > 35 inches
Elevated TG= >150 mg/dL
Reduced HDL
M= < 40 mg/dL
F= < 50 mg/dL
Blood pressure
Systolic= > 130
Diastolic= >85 mm Hg
Elevated fasting glucose= >100mg/dL
What measurement do Americans and WHO differ in categorical cut points?
Waist circumference
Associated risks with hypertension are ___ and ___, as well as damaged to the microvasculature of what?
CVD and stroke
Retina (visual impairment)
Brain (dementia)
Kidney (renal failure)
What is an ideal systolic and diastolic blood pressure?
S= <120
D= <80
What is considered stage 1 hypertension blood pressure?
S=
D=
S= 130-139
D= 80-89
Smoking, _____, exercise, ___, central adiposity, and ___ are all factors that affect blood pressure
High alcohol intake
High blood cholesterol
Diabetes
What factors affect hypertension?
Stress
Age
Sex
Diet
Looking at hypertension through a dietary lens, what factors would help decrease hypertension?
Mg
Ca
K
Dairy products
Vitamin D
Fruits and vegetables
Lycopene
Fiber
Looking at hypertension through a dietary lens, what factors would increase the risk of hypertension?
Na
Cl
Lipids
Caffeine
Diabetes mellitus is a leading cause of new cases of visual impairment, ____, heart disease, and ____.
___, ___, and ___ are also related to uncontrolled DM2
Painful neuropathy
Kidney failure
NAFLD
cancer
Sleep apnea
The polyol pathway is also known as the ____ pathway
Sorbitol
(Sugar alcohol)
T or F
The polyol pathway is also known as the sorbitol-aldose reductase pathway or the sorbitol pathway
True
The microvasulature of retina, kidneys, and nerves can become damaged if the ____ pathway is implicated
Polyol/ sorbitol pathway
glucose can either get converted to ____ or fructose. It becomes fructose by glucose getting converted into ___ by Aldose reductase with the help of NADPH. Then the sorbitol uses sorbitol dehydrogenase to be converted to ___
Pyruvate
Sorbitol
Fructose
The fructose is important for the function of what?
Various organs
The fructose made can be used by the ___ to be used as an energy source for ___, the PNS which is ____, and the lens and retina
Liver
Glycolysis
Peripheral nervous system
Under normal glycemic conditions, most glucose is converted to ____ through the glycolytic pathway. Less than ___% of glucose enters the polyol pathway
Pyruvate
3%
What increases or decrease by result if hyperglycemia in cells using the polyol pathway?
High blood glucose
Sorbitol=
Fructose production=
NADPH=
NADH=
Myo-inositol=
Taurine=
High blood glucose
Sorbitol= increase
Fructose production= increase
NADPH= decrease
NADH= increase
Myo-inositol= decrease
Taurine= decrease
Decreased NADPH leads to a reduction in the synthesis of ____, glutathione reductase, ___, and ____
Nitric oxide synthase
Myo-inositol
Taurine
____ are vasodialatiors in blood vessels so a decrease in them can diminish ____ blood flow
Nitric oxide
Nerve cell
T or F
Nitric oxide increases with age
False
Glutathione is a ____ that maintains the vitamin __and __
Antioxidant
Vitamin C and E
(Decrease leads to free radicals)
Proper levels of ____ May prevent reactive oxygen species from accumulating and damaging nerve cells
NADPH
Which of the following may help with maximizing insulin sensitivity?
A. Sufficient vitamin D uptake
B. Physical activity
C. Intake of certain micronutrients like Zinc
D. Two correct
E. All correct
E
Which of the following can result from unmanaged/ uncontrolled type 2 diabetes?
A. Sleep apnea
B. NAFLD
C. Visual impairment
D. Two correct
E. All correct
E
T or F
A function if insulin is to increase glycogen synthesis
True
Which are factors that affect hypertension?
A. Stress
B. Exercise
C. Eating potassium rich foods
D. Two correct
E. All correct
E
Which of the following are true regarding the sorbitol aldose reducatse pathway?
A. Sorbitol is a sugar alcohol
B. Sorbitol reductase converts sorbitol to fructose
C. This pathway converts glucose to fructose which is needed for certain cells
D. Two correct
E. All correct
D
T or F
One of the functions of taurine is that it’s an antioxidant
True
T or F
Increased sorbitol dehydrogenase activity is associated with an increase in superoxide radical and methylglyoxal
True
Which of the following are problems associated with increased activity of the polyol pathway in a fasting hyperglycemic state?
A. Decreased NADH levels
B. Increased myo-inositol
C. Decreased vitamin E status
D. Two correct
E. All correct
C
Which of the following are actions of glucagon?
A. Decrease gluconeogenesis
B. Increase glycogenolysis
C. Decrease fatty acid release
D. Two correct
E. All correct
B
T or F
The proposed mechanism for type 2 diabetes deals with the reduced expression in the IRS-1/PI 3 kinase pathway
True
T or F
Insulin is a potent anabolic hormone in the body and it interacts with carbs, protein, and lipids
True
Which of the following are sources of chrominum?
A. Cheese
B. Cooking w stainless steel
C. Banana
D. Two correct
E. All correct
E
T or F
Fructose can be used by the Schwann cells for an energy source
True
Glycogen is stored in the ___, while insulin is released from the ____
Liver
Pancreas
T or F
Niacin is a coenzyme important for the polyol pathway
True
T or F
When an individual has insulin resistance they cannot lose weight due to the hyperinsulinemia
False
Which of the following do not put you at risk for metabolic syndrome?
A. Blood pressure if 135/83
B. TAG of 100 mg/dL
C. Fasting blood glucose of 159 mg/dL
D. Two correct
E. None correct
B
