Online module 1 Mrs Greene Flashcards
What saying is used to help remember the signs of hypercalcaemia ?
It can cause increased urination but not as much as in diabetes.
Think Groans (constipation), Moans (depression and fatigue), Bones (sore bones), and (kidney) Stones
When a patient has increased frequency of urination what additional symptoms would indicate a UTI?
If it was painful to pass urine or if it had a foul smell
Define what diabetes insipidus is
Diabetes insipidus can be caused by low or absent secretion of the water-balance hormone vasopressin from the pituitary gland of the brain, or by a poor kidneyresponse to this chemical messenger, which is also called antidiuretic hormone.
If you were worried about the patient having diabetes insipidus and needed to differentiate it from diabetes mellitus what could you do?
Fluid deprivation test in which fluid output would not decrease in a patient
What is specifically damaged in T1DM (hint in terms of the pancreas)?
Destruction of pancreatic beta cells
What is the purpose of urinanalysis in checking for diabetes ?
In a potential diabetic patient they may well have hyperglycaemia which means theres too much glucose in the blood and it leads to glucose being present in the urine which is detected in urinanalysis which calls for further tests to prove or disprove a diagnosis of diabetes
What random bloog glucose level would be indicative of diabetes ?
Blood glucose >11.1 mmol/L
This alone is not diagnostic, needs to have symptoms of diabetes also to diagnose with this, or 2 measurements on separate occasions over this limit would be diagnostic
HbA1c what is this mainly used for in diabetes ?
More commonly used in monitoring glucose control in known diabetics - hence monitoring effectiveness of there treatment. It can be useful in helping diagnose
HbA1c > 48mmol/L is indicative of diabetes
What does the detection of iselt autoantibodies point to?
T1DM rather than T2DM
What is gluconeogenesis ?
Gluconeogenesis is the metabolic process by which organisms produce sugars (namely glucose) for catabolic reactions from non-carbohydrate precursors.
e.g. amino acids to glucose
What is the ideal plasma concentration of glucose ?
3.6 to 5.8 mmol/L
How many different hormones regulate plasma glucose concentrationa and what is different about the action of insulin in this regulation compared to the rest?
5 different hormones - insulin is the only one which by its action decreases plasma glucose concentration
Where is insulin produced ?
In beta cells of the iselts of langerhans in the pancreas
What are the 4 different roles which insulin carries out to encourage storage of carbohydrate as a way of reducing blood glucose ?
- Facilitation of glucose transport into cells (through glucose transporter 4 (GLUT-4) recruitment in insulin-dependant tissues)
- Stimulation og glycogenesis (synthesis of glycogen from glucose)
- Inhibition og glycogenolysis (breakdown of glycogen into glucose)
- Inhibition of gluconeogenesis
Insulin has some addition effects where it works on fatty acids and amino acids - what are these effects ?
Fatty acid effects:
- Encourages entry of fatty acids into adipose tissues
- Promotes chemical reactions that use fatty acids (for triglyceride synthesis)
- Inhibits lypolysis
Amino acid effects:
- Promotes uptake of amino acids into muscles and other tissues
- Stimulates protein synthesis
- Inhibits degradation of protein
Through what mechanism is insulin secretion regulated ?
It is regulated by a feedback loop:
This means the release of insulin is controlled by its own action
- Presence of glucose in pancreatic beta cells stimulates insulin secretion
- Insulin takes affect and decreases blood glucose conc which results in less glucose entering the beta cells.
- This results in less insulin secreted
What are the other additional factors which regulate insulin secretion ?
- Food ingestion
- Blood amino acid levels
- Sympathetic and parasympathetic ANS
How does food ingestion also regulate insulin secretion ?
In the presence of food ingestion a number of GI hormones (most notibly - glucose dependant insulinotropic peptide) stimulate insulin release in a feed-forward way, this means insulin can be synthesised and secreted in anticipation of nutrients being absorbed.
How does blood amino acid levels also regulate insulin secretion?
Elevated blood amino acid levels stimulate insulin secretion as it then decreases amino acid levels (same sort of negative feedback loop as with insulin and blood glucose levels)
How does the sympathetic and parasympathetic ANS also regulate insulin secretion ?
Pancreas is stimulated by both:
Digestive tract is stimulated by parasympathetic nervous system when food is being digested this stimulation as exerts an effect on the pancreas stimulating insulin synthesis and secretion.
Stimulation of the pancreas by the sympathetic nervous system decreases insulin synthesis and secretion. This is cause when exercising (using sympathetics) blood glucose levels arent restricted by insulin at a time when needed.
What are the 4 hormones capable of increasing blood glucose levels ?
- Glucagon
- Adrenaline
- Cortisol
- Growth hormone
What is the function of glucagon and where is it produced ?
Produced in alpha cells in the iselts of langerhans.
Works to prevent hypoglycaemia converting glycogen into glucose. Stimulated by decreased blood glucose conc or increased amino acid levels in the blood.
Where is adrenaline produced and what is its function ?
Released from the adrenal glands (in reposne to sympathetic stimulation ‘‘fight or flight’’) - Its for emergency situations where it inhibits insulin secretion as well as increasing synthesis of glucose and stimulating the actions of glucagon.
What is the function of cortisol and when is it produced ?
It is produced in reponse to stress.
Increases blood glucose conc by inhibiting glucose uptake in the tissues. Also encourages the degradation of proteins.
