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endocrinology > insulin secretion and intermediary metabolism > Flashcards

insulin secretion and intermediary metabolism Flashcards

1
Q

what is insulin

A

The hormone of eating

it stores away food and lowers blood glucose

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2
Q

which hormones act to increase glucose

A

glucagon
catecholamines
somatotrophin
cortisol

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3
Q

what does a diagnosis of diabetes mean to people

A

in pregnancy - tight control of blood sugar

people worried about hypoglycaemia

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4
Q

what is T1DM

A

elevated glucose
insulin required to prevent ketoacidosis
insulin needed to maintain life and prevent high sugar affecting kidney function

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5
Q

what is T2DM

A

more common
health burden
glucose
hypertension and dyslipidaemia

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6
Q

dyslipidaemia and diabetes

A

major risk factor for CVD
elevated LDL and TG conc
decreased HDL and cholesterol

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7
Q

describe the prevalence of diabetes

A

T1 11%
T2 85-95%
MODY 3%
obesity can trigger T2DM - not the cause

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8
Q

how is diabetes treated or monitored

A

diet - alter nutrition
insulin - physiologically - match to meal, complex protein that gastric acid breaks down - injection not tablet
capillary glucose monitoring
insulin pump - doesn’t complete homeostatic loop - still need to measure insulin and carbs

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9
Q

when does hypoglycaemia occur

A

imbalance between diet, insulin and exercise
out of blue
cause accident

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10
Q

why is glucose important

A

respiratory substrate - esp CNS
<4-5mM - hypoglycaemia - brain function impaired
<2mM coma
variable between individual and ability to use other substrates

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11
Q

describe the action of insulin on the B cell

A

stimulates glucose transporter Glut 2
freely allow glucose into the cell so can see glucose conc
glucokinase - rate limiting step - glucose-6-phosphate - met pathways - insulin secretion amount appropriate to ambient glucose concentration

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12
Q

describe insulin synthesis

A

proinsulin - big hormone a and B chain made as 1 chain joined by C(connecting)-peptide
C-peptide cleaved
a and B chain joined by disulphide bridges
C-peptide longer half life than insulin - measure to see if pancreas is working

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13
Q

describe the secretion of insulin

A 
glucose enter Glut 2 
g-6-p 
ATP
block ATP sensitive K+ channel 
cause Ca2+ in through voltage dependant Ca channel
insulin released from B cell
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14
Q

comparison of oral or Iv glucose

A

oral higher insulin release - incretin affect

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15
Q

describe glucagon like peptide 1 (GLP-1)

A

gut hormone - secreted in response to nutrients in gut
transcription product of proglucagon gene - mostly from L cell
stimulates insulin, suppresses glucagon
increase satiety (feeling full)
short half life - rapid degradation from dipeptidyl peptidase-4 (DPPG-4 inhibitor)
treatment of T2 - injection because big hormone

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16
Q

describe the islets of Langerhans

A

2% pancreas
a - glucagon
B - insulin
d - somatostatin
gap junctions - small molecules pass between cells
tight juctions form small intercellular spaces where hormones are held and have paracrine effects

17
Q

relationship between insulin, somatostatin, glucagon

A

somatostatin inhibits insulin and glucagon
insulin stim growth and development - intermediary metabolism, decrease blood glucose
glucagon - increase blood glucose, liberate glucose from liver maintain 3.5mML

18
Q

what stimulates insulin production

A 
certain AA
increase blood glucose
B receptors - parasympathetic activity 
GLP1 - therapeutic target 
glucagon
19
Q

what inhibits insulin production

A

a-receptors - parasympathetic activity

somatostatin

20
Q

effect of insulin

A

increased AA transport and protein synthesis, lipogenesis

decreased lipolysis, gluconeogenesis, glycolysis, glucose into cell by Glut 4 - decreased blood glucose

21
Q

what stimulates glucagon production

A

certain AA
sympathetic and parasympathetic activity
certain GI hormones

22
Q

what inhibits glucagon production

A

insulin

somatostatin

23
Q

effect of glucagon

A

increased: lipolysis, gluconeogenesis, AA to liver, gluconeogenesis, hepatic glycogenolysis, blood glucose, increase hepatic glucose output (HGO)

24
Q

describe 1st phase insulin release

A

insulin is stored then make insulin to cope

diabetes - chronically stressed don’t have 1st release

25
Q

Describe the insulin receptor

A

deterioration doesn’t cause t2DM
on muscle and liver
recognise 3D structure
transmembrane pass message onto cytoplasm
phosphorylation of cell protein substrates
tyrosine kinase domains
cause mitogenic growth effects

26
Q

where is leptin produced

A

white fatty deposits

27
Q

is glucosuria diagnostic of DM

A

no

28
Q

Do increased plasma non-esterified fatty acid concentrations stimulate insulin secretion

A

no

endocrinology (12 decks)

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