Module 3 Flashcards
What is the main 3 roles of the liver?
Extract glucose, synthesize it into glycogen, and do glycogenolysis when it is time.
The pancreas has 2 functions: exocrine and endocrine - compare those.
Exocrine: releasing things directly into the ducts
Endocrine: releasing insulin directly into the blood stream
Compare alpha and beta cells.
Alpha: secrete glucagon in response to low blood sugar
Beta: produce insulin in response to high blood sugar
What are the 2 roles of insulin?
Stimulates the uptake and utilization of glucose by cells
Stimulates the liver to store glucose as glycogen
What 3 things happen when there isn’t enough insulin?
Decrease glucose uptake, increase proteolysis and increase lipolysis
What are the 3 main metabolic complications from untreated/unmanaged diabetes?
Impaired insulin secretions = beta cell exhaustion
Insulin resistance = visceral fat
Increase glucose production = impaired suppression of the gluconeogenesis within the liver
Onset, peak, and duration of rapid acting insulin:
15 minutes
1 hour
2-4 hours
Onset, peak, and duration of short acting insulin:
30-60 minutes
2-6 hours
3-8 hours
Onset, peak, and duration of intermediate insulin:
2-4 hours
4-10 hours
10-20 hours
Onset, peak, and duration of long acting insulin:
70 minutes
None
24 hours
What is the somogyi effect?
When there is too much insulin (insulin overdose) it causes hypoglycemia and triggers counter-regulatory hormone mechanisms which cause hyperglycemia and ketosis
What is the dawn phenomenon?
Hyperglycemia in the morning due to natural hormonal release
What routes are available for glucagon?
SQ, IM, IV, PO
What is leptin responsible for?
Satiety
What is leptins relationship with obesity?
As fat increases = leptin increases
But can become leptin resistance
What is adiponectins relationship with obesity?
Inverse relationship - as fat increases = adiponectin decreases
What does adiponectin do?
Increase energy expenditure, enhances cells sensitivity to insulin
What is the BMI to be considered obese?
30+
What is the equation for BMI
kg/m2 or lb/in2 (x703)
What are the BMI classifications?
Underweight = < 18.5
Ideal = 18.5-24.9
Overweight = 25 - 29.9
Obese = 30-39.9
Morbidly obese = >40
What does ghrelin do and how do the levels change in obesity?
Stimulates hunger, controls gastric motility and acid secretion
Decreases
What does GLP-1 do and how do the levels change in obesity?
Stimulates insulin secretion, inhibits glucagon release, slows gastric emptying, increases satiety
Decreases
What does peptide YY do and how do the levels change in obesity?
Reduced appetite, inhibits gastric motility, increased energy expenditure
Decreases
What does CCK do and how do the levels change in obesity?
Increases satiety, reduced food intake, slows gastric emptying
Decreases
For drug therapies treating obesity - what BMI do patients have to have?
Greater than 30
Greater than 27 with other risk factors
How many risk factors have to be present to be diagnosed with metabolic syndrome?
3
In metabolic syndrome criteria: What are the waist circumferences?
> 40 for men
35 in females
In metabolic syndrome criteria: What are the TGL levels
> 150 (or medication for high TGL)
In metabolic syndrome criteria: What are the HDL levels
< 40 men
< 50 women
Or medication for high cholesterol
In metabolic syndrome criteria: What are the BP measurements
> 130 SBP and > 85 DBP
Or medication for high BP
