L17: Absorptive Post State Diabetes

Question 1

What is the absorptive state

Answer 1

Food in gut

Question 2

What is the post absorptive state

Answer 2

Fasting state where nutrients aren’t being absorbed

Question 3

How is insulin secreted in the absorptive state

Answer 3

1) insulin is released by beta cells
2) glucose enters by GLUT-2 into beta cells
3) glucose is metabolised and produces ATP
4) calcium influx occurs
5) calcium causes exocytosis of more insulin

Question 4

When insulin is secreted how does glucose concentration fall

Answer 4

Glucose is taken into cells by GLUT-4

Question 5

Which cells taken in glucose

Answer 5

Adipose
Liver
Muscle
Other

Question 6

What type of a transporter is GLUT4

Answer 6

Insulin sensitive transporter

Question 7

Which cells use GLUT4 for glucose entry

Answer 7

Adipose

Muscle

Question 8

How is glucose taken up into the liver/hepatocytes in the fed state

Answer 8

Glucose enters hepatocytes by GLUT-2 (non-insulin dependent)

Question 9

What is the role of insulin in hepatocytes in the fed state

Answer 9

Insulin converts glucose to glycogen (glycogen synthesis)
Insulin inhibits the breakdown of glycogen
Promotes protein synthesis
Promotes lipogenesis

Question 10

How is glucose taken up into muscle in the fed state

Answer 10

By GLUT4 (insulin sensitive transporter)

Question 11

What is the role of insulin in muscle in the fed state

Answer 11

Stimulate glycogen synthesis
Stimulate lipogenesis
Stimulate Protein synthesis

Question 12

How does glucose enter adipocytes in the fed state

Answer 12

GLUT4

Question 13

What is the role of insulin in adipocytes in the fed state

Answer 13

Stimulate glycolysis

Stimulate lipogenesis

Question 14

What process does insulin inhibit in adipocytes in the fed state

Answer 14

Lipolysis (breakdown of fat)

Question 15

How does insulin enter hepatocytes, muscle, adipocytes in the fed state

Answer 15

Via insulin receptor

Question 16

What is lipogenesis

Answer 16

Fat synthesis

Question 17

What reactions occur in the post absorptive state

Answer 17

Glycogenolysis
Gluconeogenesis
Beta oxidation

Question 18

What is gluconeogenesis

Answer 18

Make glucose from amino acids, lactate and glycerol

Question 19

Which organ carries out glycogenolysis and gluconeogenesis

Answer 19

Liver

Question 20

Where does amino acids and lactate come from for gluconeogenesis

Answer 20

Muscle

Question 21

Where does glycerol come from for glucoeneogenesis

Answer 21

Adipose tissue

Question 22

What is the main aim of beta oxidation

Answer 22

Breakdown fat into ketone bodies and convert ketone bodies to acetyl CoA for the krebs cycle

Question 23

What is type 1 diabetes

Answer 23

Young onset

Beta cell destruction

Question 24

What is type 2 diabetes

Answer 24

Insulin resistance

Insulin levels are high/normal but activity is low

Question 25

What happens in hepatocytes for diabetics

Answer 25

No insulin means Decreased glycogen synthesis Increased glycogenolysis Because you are no longer inhibiting or promoting so activity inside is the opposite

Question 26

What happens in adipocytes for diabetics

Answer 26

Decreased glucose uptake | Increased lipolysis

Question 27

Why is there decreased glucose uptakes

Answer 27

GLUT4 is insulin sensitive and insulin in not present for glucose uptake

Question 28

What happens in muscle cells for diabetics

Answer 28

Decreased glucose uptake | Breakdown of protein

Question 29

What state does the body think you are in during diabetics

Answer 29

Fasted state because there is no insulin so it breaks down stores resulting in serum glucose levels to increase

Question 30

What happens to increased fatty acids in diabetics

Answer 30

Enter beta oxidation to give acetly coA Increased acetly coa inhibits Krebs cycle and instead undergoes ketogeneiss (production of ketone bodies) Ketone bodies are taken up by extrahepatic tissues to become broken down and converted back to acetly coa for Krebs cycle

Question 31

What does the breakdown of ketone bodies in extra hepatic tissues lead to

Answer 31

Smell in breath

Question 32

What is the clinical features of uncontrolled diabetes

Answer 32

``` Dehydration Polyuria Infections Weight loss Kerosine ```

Question 33

What is the treatment of diabetes

Answer 33

Rehydration Insulin Treat infections

Question 34

What happens to haemoglobin in diabetes

Answer 34

Becomes glycated (HBA1C)

Question 35

What are the long term consequences of diabetes

Answer 35

Retinopathy Nephropathy Neuropathy

Question 36

What is retinopathy

Answer 36

Poor quality blood vessels in the Reina that lead to vision loss

Question 37

What is nephropahty

Answer 37

Damage to the kidney which leads to chronic renal failure

Question 38

What is neuropathy

Answer 38

Abnormal and decreased sensation with feet hands and fingers

Question 39

What are the macro vascular consequences of diabetes

Answer 39

``` Atherosclerotic Strokes Heart attacks Peripheral vascular disease Hyperlipidemia ```

Question 40

What is the long term treatment of diabetes

Answer 40

``` Lipid lowering drugs Reduced blood pressure Avoid smoking Diet Home monitoring Tablets/insulin ```