Pancreas CIS Flashcards
Insulin increases glycogen storage in the ____ and ____.
Liver and Skeletal mm
Insulin promotes glucose uptake and use by _____ and _____.
skeletal mm and adipose tissue
Insulin ________ output by the liver.
Suppresses glucose
Insulin promotes _____ synthesis and storage in the ____ and ____.
- triglyceride
- liver and adipose tissue
Insulin promotes the clearance of ______ from the _____.
- chylomicrons
- blood
Insulin suppresses lipolysis of ______.
adipose triglyceride stores
GLUT2 is insulin ____.
independent
GLP1 potentiates ____ and is used in ______ to encourage insulin release.
- Insulin release
- Type II Diabetes
4 steps of insulin secretion from beta cells
- Glucose enters the cell via GLUT2
- intracellular K increases
- intracellular Ca increases via voltage sensitive Ca2+ channels
- Insulin in released via secretory granules
After meal ingestion, insulin secretion promotes the movement of ____ into the ____.
- Potassium
- intracellular space
4 actions of GLP-1
- inhibits gastric emptying
- promotes insulin release
- inhibits glucagon release
- Suppresses appetite
What is the role of DPP-IV?
to degrade GLP-1
Two drug types used in DMII to promote/ potentiate insulin release?
- GLP1 agonist
2. DPP-IV inhibitors
What does each peak stand for in a double peak appearing in a CGM reading? What may the patient need?
- double peak indicates a high fat meal
peak 1 = carbs
peak 2 = lipids - a second dose of insulin to accommodate for the second peak of fat
CGM reading: in a pt with impaired glucose tolerance, a peak will ______. In a healthy individual we see an______.
- slowly decrease
- abrupt decrease
Long term complications of DM involve which organ systems? (4)
- nervous
- CV
- renal
- sensory organ
_____ is a group of chronic metabolic disorders characterized by abnormality in ______ or actions ________.
- insulin secretion
- resulting in hyperglycemia
_____ results frm absolute deficiency of insulin secretion due to ______.
- Type I DM
- beta cell destruction
Type I DM patients require _____ and are prone to _____.
- insulin
- ketoacidosis
____ results from a combination of _____ and _____, which is often preceded by a period of abnormal ______.
- Type II DM
- Insulin resistance
- insulin deficiency
- carbohydrate metabolism
DM type II patients are typically ____, may not ______, and are usually not prone to _____.
- over weight
- immediately require insulin
- ketoacidosis
_____ represents diabetes diagnosed during pregnancy.
Gestational DM
Type I DM age of onset
peak in early childhood and adolescence
Pathophysiology of Type I DM
Autoimmune disease
Conditions Associated with Type I Diabetes (3)
- autoimmune thyroid
- celiac disease
- addison’s disease
Type II DM onset
post pubertal
Pathophysiology of Type II DM
insulin resistance
Conditions associated with Type II DM (4)
- obesity
- lipid abnormalities
- PCOS
- NAFLD (non alcoholic fatty liver disease)
_____ + _____ = autoimmunity
genetic predisposition + environmental trigger
GLUT 4 is found in ___ and __ tissues. And are stored in ____ until needed.
- Striated mm and fat
- Intracellular vesicles
GLUT 3 is found in ____.
Neurons
GLUT 2 is found in ____ , _____ , _____, and ____.
- pancreatic beta cells
- liver
- intestine
- kindey
GLUT 1 tissues: (3)
- SKM
- Fat
- endothelial cell lining the blood vessels of the brain
3 causes for obesity induced insulin resistance:
- Lipotoxicity
- Lipotoxicity and inflammation
- development of dyslipidemia
Define Lipotoxicity
Decreased GLUT4 uptake of glucose in response to insulin release
Define Lipotoxicity and Inflammation
Decreased ability of insulin to repress hepatic glucose production
Define the development of dyslipidemia
inability of insulin to repress hormone-sensitive lipase (HSL) or increase lipoprotein lipase (LPL) in adipose tissue
Describe the incretin effect and diabetes
- in a healthy individual, incretin levels increase significantly after blood glucose levels rise; in a diabetic patient we don’t see this large of an incretin release
What is released first in the body, incretin or insulin?
incretin
Obesity BMI criteria
greater than 30
BMI calculation
weight in Kg / (height in Meters)^2
Normal fasting oral glucose tolerance test results
under 100
fasting oral glucose tolerance test results for diabetes
126 or above
Normal non-fasting oral glucose tolerance test results
below 140
non fasting oral glucose tolerance test results for diabetes
200 or above
Hemoglobin A1c levels for diabetes
greater than 6.5
HgV A1C levels asses glucose control over that past ___ months
3 months
Insulin release is different in response to oral glucose compared to IV glucose due to the secretion of _____.
incretin
Incretin is released after ____ glucose consumption.
oral
