Intermediary metabolism

Question 1

How does ↑epinephrine affect intermediary metabolism?

Answer 1

1) ↑Glycogenolysis in liver and muscle
2) ↑Gluconeogenesis in liver
3) ↑Lipolysis in adipocytes

Question 2

How does ↑growth hormone affect intermediary metabolism?

Answer 2

1) ↑Lipolysis in adipocytes

Question 3

How does ↑cortisol affect intermediary metabolism?

Answer 3

1) ↑Lipolysis in adipocytes
2) ↑Proteolysis in muscles
3) ↑Gluconeogenesis in liver
4) ↑Ketogenesis in liver

Question 3

What are the normal glucose concentration ranges of:
i) Random
ii) Fasting
iii) Post prandial

Answer 3

i) Random: 4 - 7.8mmol/L
ii) Fasting: 4 - 6mmol/L
iii) Post prandial: 4 - 7.7mmol/L

Question 4

What are 5 risk factors for developing T2DM?

Answer 4

Metabolic syndrome (3 or more)
1) Waist circumference >90(M) or >80(F)

2) High TG >1.7mmol/L

3) High fasting glucose >6.1mmol/L

4) High BP >130/85mmHg

5) Low HDL <1 (M) or <1.3mmol/L

Question 5

What is IFG in diabetes testing?

Answer 5

Impaired fasting glucose:
6< Fasting glucose <7mmol/L

Question 6

What is IGT in diabetes testing?

Answer 6

Impaired glucose tolerance:
7.7< plasma glucose < 11.1mmol/L

Question 7

How is OGTT related to GH?

Answer 7

Can be used to having GH excess
- if GH is not suppressed by ↑glucose/glucose challenge → malignancy

Question 8

What are 4 secondary causes of diabetes?

Answer 8

1) Monogenic diabetes
2) Pancreatic disorders (eg. pancreatic disorders)
3) Endocrine disorders (eg. Cushing’s, Growth hormone excess)
4) Drug-induced diabetes (eg. Corticosteroids)
5) Immune-mediated diabetes
6) Genetic syndromes
7) Gestational diabetes

Question 9

What is the clinical definition of hypoglycemia?

Answer 9

<4.0mM

3.0 - 3.9mM → mild
2.2 - 2.9 mM → moderate
< 2.2mM → severe

Question 10

What are the physiological defences against hypoglycemia?

Answer 10

Detected by CNS → ↓insulin, ↑glucagon, ↑adrenaline, ↑cortisol, ↑GH
1) Glycogenolysis
2) Gluconeogenesis
3) Ketogenesis

Question 11

What are 4 causes of hypoglycemia?

Answer 11

1) Insulin excess
2) Deficiency of counter-regulatory hormones
3) Impaired glucose generation (liver, kidney failure)
4) Others (eg. SUs, insulin autoimmune hypoglycemia insulinoma, alcohol, etc.)