Pancreas And Diabetes Flashcards
What functions does oancreas have
Exocrine and endocrine
Where is the pancreas located
Retro perutoneal, 2nd lumbar vertebral level
What two innervations does pancreas have
Sympathetic and parasympathetic
What are the three aprts of pancreas
Head (linked to bile ducts) body and tail
What are the exocrine parts of pancreas
Acinar cells
Whats the function of pancreatic islet
Endocrine part
What are the nests of cells called
Islets of langerhans
What are three major cell types and function
Alpha secrete glucagon
Bete secrete insulin
Delta secrete somatostatin
Where are delta nad alpha cells located
Periphery
What is pancreatic polypeptide
Released internally to self regulate pancreas activities
What us amylin
Released with insulin
Describe insulin
Polypeptide linked by disulfude binds
Why is insulin injected
Its a polypeptide and would be broken down in stomach
How is insulin made
Pro insulin forms c peptide then insulin
Why is it hard to measure insulin
Short half life so measure c peptide instead
What stimulate leoduction of insulin
Glucose
What is an inhibitor for insulin
Somanostatin
What feedback is glucose control
Negative
Blood glucose increase
Increase insulin
Glucose used by tissue
Inculin decreased in blood
Why is calcium important
Muscle contraction
Precursor for insulin production
Where is sodium levels higher in inside or outside of cells
Outside of cells
What type of channel is the calcium channel
Voltage gated ion channel
What happens during stimulatory blood glucose
More atp produced
Whats the function if GLUT4
Insulin stimulated glucose transport
Where is GLUT4 found
Skeletal and cardiac muscle
Name an important receptor in the insulin intracellular effect
Tyrosine kinase
Whats the function of tyrosine kinase
Add’s phosphate
What are insulin effects on glucose metabolism
Stimulates glycogen synthesis in liver and muscle and glycolysis in most cells
In liver insulin inhibits gluconeogenesis
What effect does insulin have on adipose fat tissue
Converted into fatty acids in form of triacylglycerols
What effect does insulin have on lrotein metabolism
Stimulates amino acid uptake and protein synthesis in muscle inhibiting proteolysis
Where is glucagon located
Alpha cells
Whats the main physio roles of glucagon
Increase blood sugar levels through stinukation if glycogenolysis and gluconeogenesis
What effect does glucagon have on insulin
Antagonist
What does the opening of k channel then cause
Opens the sodium voltage gated channels
What effects does glucagon have on liver
Opposite effects from insulin, works via cAMP increasing blood glucose
What does glucagon stimulate
Breakdown if triacylglycerol
Stimulates liver lipolysis and ketogenesis
What organs use ketones
Heart and muscle
What does glucagon stimulate
Stimulate Liver proteolysis gluconeogenesis and urea cycle
Where is somatostatin released
Delta cells of the islets of langerhans
What doe’s somatostatin inhibit
Release of growth hormone
Release of almost all peptide hormones
What happens when we have high insulin and low glucagon
Insulin stimulates conversion of amino acids to protein
Insulin stimulates the conversion of fatty acids to triacylglycerol
What happens when glucagon is high and insulin is low
Liver and muscle glucagon and muscle converted to glucose
Lipolysis
Ketones formed
What type of diabetes are there
Diabetes insipidus- not to do with bood sugar
Diabetes mellitus t1/t2
Gestational diabetes - transient and occurs in pregnancy
Tell me
More about diabetes insipidus
Polydipsia thirst
Polyuria increased urination
Due to lack of production of Anti Dieuretic hormone
Kidney cannot make enough concentrated urine and too much water is passed from body
Where is adh formed
Posterior pituitary
Talk more about gestational diabetes
Hyperglycaemia in pregnancy
Develops in third trimester
Risk factors
High BMi
And if had diabetes in lrevious pregnancies
Tell me more about diabetes mellitus
Affect ability to produce or repsones to insulin
Body has trouble moving glucose from body into cells
Leads to:
Abnormal metabolism of carbs
More glucose in urine
What is type 1 diabetes
Auto imuune disease where body destroys b cells
This affects ability of pancreas to release insulin
What are the symptoms of type 1 diabetes
Polyuria
Polydispsia
Polyphagia
Weight loss
Stunted growth children
Ketoacidosis
List major complications of diabetes
Renal damage nephropathy
Neuropathy leading to gangrene
Cardiovascular high BP heart disease
Retinopathy cataracts glaucoma
Brain damage
Extremities
What two tests are there for diabetes
Glucose tolerance test
Glycated haemoglobin Hb A1c
What does glucose tolernace test test for
Measure blood glucose levels at given time points following ingestion of glucose
What does Hb A1c test for
Chrronic measurement of glucose levels
What is the only treatment for T1 diabetes and why
Subcutaneous injection or via pump and that is because insulin is a polypeptide and will be digested in body and not absorbed
What are the three types of insulin
Short
Intermediate
Long acting
What is the cause of type two diabetes
Insulin resistance
What are risk factors for type two diabetes
Obesity
Hypertension
Lack of exercise
Genetics
What are the theories to why people develop diabetes
Perpetual feeding state- cells constantly exposed to insulin
Cells stop responding to insulin
Pancreas increases insulin release
Pancreas burns out
Pro Inflammatory cytokines released from adipose tissue cause inflammation which stoo normal insulin signalling pathway
What are the two types of treatment for diabetes
Lifestyle changes such as increae in exercise
Pharmacological treatment
What are the different types of treatment for diabetes
Insulin sensitivers
Insulin secretagogues
Drugs which slow reabsorption of glucose
Incretins- stimulate insulin release
What are example of insulin sensitivers
Biguanides - metformin
Examples of Insulin secretagogues
Sulphyonlureas- gluclazide
What are examples of slow reabsorptions of glucose
SGLT 2 inhibitors
How does metformin work
Increase glucose uptake into cells and improves sensitivity of insulin receptor
Decreases both hepatic glucose production and intestinal absorption of glucose
What is the typical reduction in HbA1C values for metformin
1.5-2.0%
How do sulfonylureas work
Stimulate release of insulin, bind to SUR 1 on pancreatic beta cells closing ATP channels
How do SGLT inhibitors work eg dapagliflozin canagliflozin
Inhibit renal reabsorption of glucose
What do SGLT inhibitors can alsi be used to treat
Prognosis of Cardiovascular diseases such as heart failure
How do incretins DPP4 inhibitors and GLP 1 analogues work
Incretins decrease blood glucose by stimulating insulin release
DPP4 breaks down incretins
