L8 Plasma Glucose Flashcards

1
Q

What should fasting glucose levels be?

A

70-100mg glucose/100cm^3

3.9-5.5mmol/L

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2
Q

How is glucose stored?

A

As glyocgen

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3
Q

What is glycogenesis?

A

The conversion of glucose to glycogen in the liver.

Stored in skeletal muscle and liver.

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4
Q

What is glycogenolysis?

A

The breakdown of glycogen into glucose.

The liver and kidneys can release glucose into circulation in response to low plasma glucose.

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5
Q

What is gluconeogenesis?

A

Production of glucose from a non-carbohydrate source e.g. proteins and lipids

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6
Q

How is glucose stored if glycogen stores are fully saturated?

A

Glucose is converted to free fatty acids and stored in adipocytes in the form of triglycerides.

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7
Q

What is classed as hypoglycaemia?

A

BGL < 3.9mmol/L

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8
Q

What is classed as hyperglycaemia?

A

BGL > 7mmol/L

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9
Q

What factors influence blood glucose levels?

A
  • How much and what type of food is eaten
  • Amount of physical and mental activity
  • Hormones
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10
Q

What is the function of the exocrine pancreas?

A

Production of pancreatic enzymes.

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11
Q

Describe the cellular composition of the endocrine pancreas.

A

Islets of Langherhans (highly vascularised and innervated) 3 types:

  • Alpha cells: secrete glucagon
  • Beta cells: secrete insulin
  • Delta cells: secrete somatostatin
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12
Q

What type of hormones are secreted from the alpha, beta and delta cells?

A

Peptide hormones (fast acting)

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13
Q

When is insluin secreted from beta cells?

A
  • When plasma glucose is high the beta cells are depolarised

- Causes opening of Ca volatge gated channels, influx of calcium and release of insulin by exocytosis

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14
Q

What are the principle actions of insulin?

A
  • Stimulates liver to convert glucose to glycogen (glycogenesis)
  • Stimulates excess glucose to be converted to fat
  • Activates glycolysis
  • Inhibits gluconeogenesis and glycogenlysis
  • Binds to insulin dependent receptors and forces fat and muscle cells to take up glucose from the blood through the GLUT4 transporter

Lowers BGL

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15
Q

What are incretins?

A

Hormones which enhance the beta cell response to glucose, allows cells to respond better to insulin.

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16
Q

What are the principle actions of glucagon?

A
  • Promotes glycogenolysis
  • Inhibits glycogenesis
  • Activates amino acid uptake and stimulates gluconeogenesis
  • Lipolytic effect- triglycerides broken down to fatty acids

Raises BGL

17
Q

What is the function of somatostatin?

A

Inhibits insulin and glucagon release.

18
Q

Which other hormones have a role in regulating plama glucose levels?

A
  • Adrenal glucocorticoids
  • Growth hormone
  • Catecholamies
  • Thyroxine

All raise BGL, insulin is the only hormone which lowers.

19
Q

What are the symptoms of diabetes mellitus?

A
  • Fatigue
  • Thirst
  • Blurred vision
  • Poor wound healing
  • Freqeunt urination
  • Weight loss
  • Numb/tingling hands and feet
20
Q

Outline type I diabetes.

A
  • Autoimmune disorder
  • Pancreatic beta cells attacked
  • Unable to produce insulin
  • Unknown cause
21
Q

Outline type II diabetes.

A
  • Increasing failure of cells to respond to insulin
  • Insulin resistance
  • Preventable
  • Genetic and environmental risk factors (and ethnicity)
22
Q

What are the 3 main consequences of hyperglycaemia?

A
  • Polyphagia: frequent hunger, especially pronounced hunger
  • Polydipsia: frequent thirst, especially excessive thirst
  • Polyuria: frequent urination, especially excessive urination
23
Q

What is chronic hypoglycaemia?

A

Low BGL for prolonged time periods, causes:

  • increased gluconeogenesis = weight loss
  • increased lipolysis = ketoacidosis
  • increased glycogenlysis
24
Q

What are the long term complications of chronic hyperglycaemia?

A
  • Kidney damage
  • Neurological damage
  • Cardiovascular damage
  • Retinal damage
25
Q

Give examples of dental complications associated with diabetes.

A
  • Early tooth loss
  • Gingivitis
  • Periodontitis
  • Dental caries
  • Xerostomia
  • Oral burning sensation
  • Taste disturbances
  • Fungal infection
  • Lichen planus