Lec 15 - Glucose homeostasis Flashcards

1
Q

why is glucose delivery to CNS vital

A

outside of neonatal period, CNS cant substitute glucose

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2
Q

what enzyme catalyses glucose to glycogen

A

glycogen synthase

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3
Q

what is the stored resovoir of glucose

A

glycogen

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4
Q

normoglycaemia

A

4-6mmol/L

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5
Q

gluconeogenesis: what and where

A

in liver
conversion of fat and protein derivatives to glucose

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6
Q

hyperglycaemia

A

> 10mmol/L (sustained)

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7
Q

what type of action does insulin

A

hyperglycaemic towards normal glycaemic range

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8
Q

why might some tissues be more sensitive to insulin (and which)

A

liver
muscle
adipocytes
(more insulin receptors)

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9
Q

how is glucose controlled when there are no inslin receptors

A

glucose transporters in cell membrane

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10
Q

two main hormones in glucose

A

insulin and glucagon

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11
Q

what cells is insulin released from

A

beta cells in islets

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12
Q

what does low blood sugar trigger

A

release of glucagon

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13
Q

what cells secrete glucagon

A

alpha cell in islets

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14
Q

what is EGP

A

endogenous glucose production
which increases blood sugar levels
triggered by glucagon
and braked by insulin

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15
Q

what are incretins

A

hormones that work to increase insluin secretion and switch off glucagon

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16
Q

2 main incretin hormones

A

GIP
GLP-1

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17
Q

2 types of diabetes mellitus

A

1 = autoimmune destruction of beta cells
2 = defects in insluin release, sensing and/or signalling

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18
Q

where are the islets of langerhans

A

in pancreas
close to blood vessels (highly vascularised AND richly innervated)
1% of pancreatic tissue

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19
Q

what do delta cells in islets of langerhans release

A

somatostatin

20
Q

what do epsilon cells release in islets

A

ghrelin

21
Q

what do pp cells in islets make hehe

A

pancreatic plypeptide

22
Q

insulin precursor

A

proinsulin

23
Q

what type of bonds between the 2 chains of insulin

A

disulphide

24
Q

what is the linker peptide in insulin

A

C peptide

25
Q

what enxyme converts proinsulin into insluin and c peptide

A

proenzyme convertase (PC)

26
Q

why is c peptide good to use clinically

A

has a longer half life than insulin

27
Q

what is insulin complexed with in secretory vesicles

A

zinc
forms multimeric crystals in the vesicles

28
Q

how many grnaules does each beta cell hold

A

~ 10,000 granules

29
Q

half life of insulin

A

3-5 mins

30
Q

where is inslouin metabolised

A

liver

31
Q

what pathways does insulin stimulate

A

glycolysis
glycogen synthase
glucose uptake
protein synth
gene expression

32
Q

what pathways does insulin inhibit

A

gluconeogenesis
lipolysis

33
Q

what type of receptor is insluin receptor

A

intrinsic tyrosine kinase

34
Q

what proteins does activation of insulin receptor activate

A

IRS and SH2 activation
activation of IRS-1

35
Q

what pathway does insluin binding activate

A

pi3 kinase pathway
and Ras/ref pathway

36
Q

what signalling molecule coordinates phosphorylation of downstream proteins in insulin signalling

A

AKT

37
Q

what gene synthesises glucagon

A

pre-proglucagon gene

38
Q

if pro-enzyme convertase 1 acts of pre-proglucagon, then what is it converted to

A

GLP-1

39
Q

what receptor is glucagon rec

A

GPRC
adenylate cyclase pathway
increase cAMP

40
Q

what is glucagon release stimulated by

A
  • low glucose duh
  • adrenaline
  • amino acids
  • acetylcholine
  • GIP at low glucose conc
41
Q

what is glucagon inhibited by

A
  • raised glucose
  • somatostatin
  • insulin, GABA, the zinc from beta cells
  • GLP-1
  • GIP at high glucose conc.
42
Q

EGP effects

A
  • glycogenolysis (glycogen ->glucose)
  • lipolysis (to increase circulating glycerol and fatty acids)
  • gluconeogenesis (amino acids and glycerol -> glucose)
43
Q

how does insulin switch off glucagon production

A

inhibits alpha cells

44
Q

what else do beta cells secrete that suppress alpha cells

A

GABA

45
Q

effects of somatostatin

A
  • inhibits insulin and glucagon by inhibiting alpha and beta cells
  • acts locally, doesnt leave islet
46
Q

why do alpha cells also need to switch on the beta cells and delta cells

A

if goes unchecked, these cellls can raise blood sugar too much
acts as negactive feedback

47
Q
A