Pancreas Flashcards

1
Q

Define glycolysis

A

Breakdown of glucose into smaller compounds which generates energy

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2
Q

Define glycogenesis

A

The formation of glycogen from glucose

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3
Q

Define glycogen

A

Glucose polymer

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4
Q

Define glycogenolysis

A

Glycogen breakdown to glucose

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5
Q

At what concentration is hyperglycaemia defined?

A

Above 30 mM

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6
Q

Explain osmotic diuresis

A

Occurs with high blood glucose. Lots of pee as the body tries to excrete glucose. Can also lead to excessive thirst

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7
Q

Define gluconeogenesis

A

The formation of glucose from non-carbohydrates substrates like lactate and amino acids

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8
Q

Explain 2 mechanisms of hepatic glucose production

A

Glycogenolysis

Gluconeogenesis

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9
Q

What concentration of blood glucose defines hypoglycaemia

A

2-3 mM

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10
Q

Name 3 factors that lower blood glucose levels

A

Transport of glucose into cells for energy production
Transport of glucose into cells for storage as glycogen
Urinary excretion of glucose

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11
Q

Define an islet of langerhan

A

The secretory cells of the pancreas

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12
Q

Name the 2 hormones that are secreted by the islets of langerhans and the related cells

A

Alpha cells - glucagon

Beta cells - insulin

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13
Q

Which hormone secreted by the pancreas is catabolic?

A

Glucagon

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14
Q

Glucose is hydrophilic. How does it enter the cell?

A

Through a transport protein

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15
Q

What is a GLUT

A

Glucose transporter

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16
Q

Location of GLUT 1?

A

Blood brain barrier

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17
Q

Which glucose transporter starts to work at higher concentrations of glucose? 15-20 mM

A

GLUT 2

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18
Q

Activation of GLUT 2 (found on the liver and pancreas) initiates what events?

A

Pancreas - insulin secretion

Liver - removal of glucose from the blood

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19
Q

Which GLUT is found in all tissues?

A

GLUT 3

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20
Q

Which GLUT, found on muscle and fat cells, can be increased in expression with resistance training?

A

GLUT 4

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21
Q

Which 2 glucose transports are the most sensitive to glucose?

A

1 and 3

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22
Q

What effect does insulin have on GLUT4

A

Stimulates glucose uptake by GLUT4 by promoting exocytosis, causing the vesicles to deposit the transporter into the cell membrane of myocytes and adipocytes

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23
Q

Does insulin promote the synthesis or breakdown of proteins and fats?

A

Synthesis

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24
Q

What acts on the pancreas to get it to start secreting insulin?

A

GLP (a gastrointestinal hormone).

GLP is released on food intake

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25
Q

Other than high blood glucose and food intake, what 2 other factors can stimulate insulin secretion?

A

High blood amino acid concentration

Parasympathetic stimulation

26
Q

Name the 2 main sites of action of glucagon?

A

Liver and adipose tissue

27
Q

Is glucagon catabolic or anabolic?

A

Catabolic

28
Q

Low blood glucose levels stimulate the pancreatic alpha cells to secrete what?

A

Glucagon

29
Q

Which hormone stimulates gluconeogenesis?

A

Glucagon

30
Q

To mobilise glucose from its storage form, glucagon promotes which process?

A

Glycogenolysis

31
Q

Other than glucagon and adrenaline, which other 2 molecules increase blood glucose levels?

A

Glucocorticoids

Growth hormone

32
Q

Explain type 1 diabetes

A

It is an autoimmune condition that causes the destruction of the beta cells of the pancreas, inhibiting insulin secretion

33
Q

What treatment option is used for gestational diabetes?

A

Recombinant human insulin injections. (Same as for type 1)

34
Q

Explain 2 non-pharmacological treatment option for diabetes?

A
  • exercise (increases GLUT4 expression)
  • diet (limiting sugary foods, non processed, vegetables, lean meat)
  • weight loss
35
Q

Explain the use of a biguanide

A

It is an oral hypoglycaemic

Inhibits glucose output from the liver and increases glucose uptake by the muscles

36
Q

Name a biguanide

A

Metformin

37
Q

What is an advantage of using a biguanide? Give 1 drug example.

A

Does not cause hypoglycaemia

Example= metformin

38
Q

Which oral hypoglycaemic drug class requires functioning beta cells?

A

Sulfonylureas

39
Q

Explain the MOA of sulfonylureas

A

Stimulates insulin secretion

40
Q

Gliclazide and tolbutamide are examples of which drug class?

A

Sulfonylureas

41
Q

Potential problem with sulfonylureas?

A

Can cause hypoglycaemia. Can also stimulate appetite and weight gain

42
Q

Explain how thiazolidinediones reduce insulin resistance

A

It is an agonist for a nuclear insulin receptor. It enhances the uptake of fatty acids which lowers blood glucose

  • since free fatty acids increase gluconeogenesis
43
Q

Give an example of a thiazolidinedione

A

Rosiglitazone

44
Q

Give the MOA of Byetta

A

It is a venom derived peptide that is a GLP agonist. Used in T2DM

45
Q

Name 2 mechanisms that the body can use to decrease blood glucose levels

A
  • transport of glucose from the blood into cells

- urinary excretion

46
Q

How does insulin affect GLUT 4 expression

A

In the presence of insulin, vesicles containing GLUT 4 move to the cell membrane and deposit / undergo exocytosis and the transporter is inserted into the membrane of adipose and muscle cells

47
Q

Name the two actions of GLUT 4 (one on fat and one on muscles)

A

Muscles - glut 4 activation increases glycogen synthesis and also increase glucose use in the muscles
Fat - promotes lipogenesis (building of new fat)

48
Q

What 3 actions does insulin stimulate in the liver

A
  • glycogen synthesis

- inhibits gluconeogenesis and glycogenolysis

49
Q

Is insulin secreted in the fed or fasted state

A

Fed

50
Q

Explain the action of GLP

A

GLP is a hormone secreted by the hormone in response to food intake. It acts on the pancreas to stimulate the beginning of insulin secretion

51
Q

Does the parasympathetic system increase or decrease insulin secretion?

A

Increase

52
Q

When is glucagon secreted

A

In fasting state

53
Q

Which hormone, glucagon or insulin, increases glycogenolysis ang gluconeogenesis?

A

Glucagon

54
Q

Which drug class requires functioning beta cells?

A

Sulfonylureas (e.g. gliclazide)

55
Q

What affect does insulin have on fatty acids and amino acids?

A

Promotes their cellular uptake and conversion into storage forms (triglycerides and protein)

56
Q

Define gluconeogenesis

A

Conversion of amino acids into glucose in the liver

57
Q

True or false. Insulin promotes protein synthesis

A

True

58
Q

Explain how glucose and amino acids act on the pancreatic beta cell to stimulate insulin secretion.

A

Glucose and amino acids enter the cell via GLUT 2. They are converted to ATP
ATP closes K channel which depolarises the cell.
Depolarisation opens Calcium channel. Calcium facilitates the exocytosis of insulin vesicles.

59
Q

What happens after a high protein meal?

A

Amino acids act on beta cells to stimulate insulin secretion. Insulin then lowers blood amino acid levels by promoting protein synthesis

60
Q

Does the brain need insulin to access glucose?

A

No

61
Q

How can hyperglycaemia be aggravated by protein degradation in diabetic patients?

A

Due to reduced insulin, protein metabolism becomes catabolic. This increases blood amino acid concentration. These amino acids can then be used by the liver for gluconeogenesis, producing even more glucose and raising BG levels