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W/Physiology > Topic 7.4 > Flashcards

Topic 7.4 Flashcards

1
Q

“type” of molecule that insulin is

A

antidiabetic / antiketogenic

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2
Q

2 steps of insulin synthesis

A
  • pre-pro-insulin
  • pro-insulin
  • insulin + c peptide
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3
Q

How is insulin stored?

A

complexed with Zn2+ in granules (180 units in pancreas)

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4
Q

2 stages of electrical activity of beta cells

A
  • early peak phase

- sustained phase

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5
Q

Difference between EPP and SP?

A

EPP : the readily releasable pool of granules is released, SP has more granules not near the membrane released

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6
Q

What does glucose induce? (2)

A
  • Exocytosis of insulin

- Transcription of insulin (if long exposure)

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7
Q

What is the incretin effect?

A

feed forward mechanism that increases insulin secretion

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8
Q

Which molecules contribute to incretin effect?

A
  • GLP and GIP (enterohormones)
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9
Q

What do GLP and GIP bind to?

A

Gs coupled receptor

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10
Q

Which molecules can decrease glucagon secretion?

A

GLP-1

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11
Q

7 activators of insulin secretion

A
  1. Glucose
  2. AA (K, R, L)
  3. Enterohormones (GLP, GIP)
  4. Glucagon
  5. B adrenergic R
    6 Vagus stimulation via M1R
  6. FFA
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12
Q

4 inactivators of insulin secretion

A
  1. Hypoglycaemia
  2. SST
  3. Leptin
  4. Alpha2R
    (Gi receptors)
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13
Q

Where can we find K-ATP

A
  • beta cells of pancreas
  • in SA node
  • in vascular smooth muscle
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14
Q

What is K-ATP?

A

ATP regulated K+ channel

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15
Q

7 steps of release of insulin by beta cells

A
  1. Glucose enters through glut2
  2. Glycolysis
  3. ATP inhibits K-ATPase : K+ trapped in
  4. Depolarization
  5. VDCC open
  6. Release of insulin granules
  7. VDK+ channels drive repolarization
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16
Q

Pharmacological inhibition of insulin secretion

A

diazoxid

17
Q

Pharmacological stimulation of insulin secretion

A

sulphonyl urea (binds to K-ATP SU)

18
Q

What does the insulin receptor recruit after autophosphorylation?

A

IRS-1

19
Q

What 2 pathways can IRS1 activate?

A
  • MAP kinase pathway

- PI3K pathway

20
Q

What does the map kinase pathway result in?

A

mitogenic signals

21
Q

What does PI3K pathway result in?

A

activation of PKB and PKC

22
Q

What do PKB and PKC do?

A

phosphorylate rab4

23
Q

What does rab4 do? (2)

A
  • release GLUT4 vesicles

- increase glycolysis

24
Q

Effect of insulin on intermediary metabolism in liver (4)

A
  • increase glycolysis
  • increase glycogenesis
  • decrease glycogenolysis
  • decrease gluconeogenesis
25
Q

Effect of insulin on skeletal muscle IM (4)

A
  • increase glycolysis
  • increase protein anabolic effect
  • increase glycogenesis
  • decrease FFA and ketone bodies use
26
Q

Effect of insulin on adipose tissue (3)

A
  • clears lipids from plasma
  • lipoprotein lipase increases breakdown of FFA
  • decreases breakdown of TG
27
Q

Overall anabolic effect of insulin (4)

A
  • increase protein synthesis
  • increase lipogenesis
  • increase glycogenesis
  • decrease gluconeogenesis
28
Q

2 types of diabetes

A

type 1 : insulin dependant

type 2 : insulin independant

29
Q

What is type 1 diabetes due to?

A

autoimmune destruction of beta cells

30
Q

3 effects of type 1 diabets

A
  • excessive glucose : osmotic diuresis

- ketone bodies : ketoacidosis, vomiting

31
Q

What is type 2 diabetes due to?

A
  • limitation of ability to produce enough insulin

- resistance to insulin

32
Q

Treatment of type 2 diabetes?

A
  • change diet
  • exercise (glut4)
  • sulfonylurea
  • TZD (tiazolidin-dion drugs)
33
Q

What does TZD do?

A
  • decrease resistin secretion

- increase adiponectin secretion (decrease resistance)

34
Q

3 diagnostic tests for diabetes

A
  1. Glucose tolerance test (fasting and 2 hours after ingesting glucose)
  2. Glycated Hb
  3. C peptide

W/Physiology (31 decks)

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