Week 2 - Glucose Regulation Flashcards

1
Q

define glucose regulation

A
  • process of maintaining OPTIMAL blood glucose levels
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2
Q

what 3 main factors interact to maintain glucose regulation?

A
  1. caloric intake (ie. food)
  2. hormones
  3. glucose uptake (by the cells for energy)
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3
Q

list 3 examples of hormones that play a role in glucose regulation

A
  1. insulin
  2. cortisol
  3. glucagon
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4
Q

what is euglycemia? what is the value?

A
  • normal conc of glucose in the blood

- 4-7 mmol/L

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5
Q

describe normal glucose homeostasis; what happens when we eat to maintain our BG

A
  • we eat & carbs are broken down into simple sugars called glucose which is absorbed into the blood
  • elevations in blood glucose stimulate pancreatic cells to secrete insulin
  • insulin allows glucose to enter the cell –> BG goes back down
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6
Q

what are 2 ways glucose can be used after insulin release?

A
  1. for energy by cells (ATP)

2. stored in the liver and fat cells as glycogen

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7
Q

what is stored glucose called?

A
  • glycogen
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8
Q

what is glucagon

A
  • hormone released when BG is too low
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9
Q

what does the release of glucagon cause?

A
  • stimulates the liver to breakdown glycogen to glucose (glycogenlysis) = increased BG
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10
Q

what is glycogenolysis

A
  • process by which glycogen is converted to glucose
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11
Q

what is the function of insulin? when is it released?

A
  • released when we have high BG

- responsible for the transport of glucose from the blood into the cells

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12
Q

what happens if aspects of glucose metabolism malfunction or stop working?

A
  • get hyperglycemia or hypoglycemia
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13
Q

what value is considered hyperglycemia

A

at or above 11mmol/L

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14
Q

what are the 3 main biomechanical causes of hyperglycemia

A
  1. insufficient insulin production or secretion from the pancreas
  2. insulin resistance
  3. excess counter regulatory hormone secretion
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15
Q

what can cause insufficient insulin production/secretion?

A
  • damage to the pancreatic beta cells

ex. autoimmune disfunction, from injury or cancer

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16
Q

what is insulin resistance? what does this cause?

A
  • the body cells are not responding to insulin
    = body cannot use glucose for energy
    = BG continues to rise
17
Q

what are counter regulatory hormones

A
  • hormones that work opposite of insulin

- hormones that work to increase BG

18
Q

what are examples of counter regulatory hormones?

A
  • glucagon
  • cortisol
  • epi
  • growth hormone
19
Q

what value is considered hypoglycemia

A
  • <4 mmol/L
20
Q

what are 3 causes of hypoglycemia

A
  1. insufficient nutrient intake
  2. adverse rxn to meds
  3. too much exercise
21
Q

what are 2 examples of adverse rxn to meds that can cause hypoglycemia

A
  • exogenous insulin –> ex. too much insulin = too much uptake
  • oral antihypoglycemics
22
Q

how can too much exercise cause hypoglycemia including both during exercise & post exercise

A
  • work of muscle contraction requires energy which is derived from glucose stored in muscle cells as glycogen
  • as exercise continues, glycogen is deplted & we start to use glucose from the circulation & liver for energy = lowered BG
  • during post exercise, our body tries to restore our glycogen levels by converting glucose from the circulation = lowers BG even more
23
Q

why is insulin so important (2)

A
  1. insulin is the key that unlocks glucose’s potential in the tissues
  2. some cell need insulin to utilize the glucose as fuel ex. the brain which requires a constant stream of glucose
24
Q

how does hyperglycemia related to inflammation

A
  • hyperglycemia is a pro-inflammatory phase (=can cause inflammation)
25
Q

what are the long term consequences of hyperglycemia (5)

A
  1. blood vessel damage (angiopathy, both macro & micro)
  2. neuropathy
  3. fluid & electrolyte imbalances (dehydration)
  4. acid-base disturbances (DKA)
  5. insulin resistance
26
Q

why does peripheral neuropathy occur with hyperglycemia

A
  • elevated blood glucose has a toxic effect on nerves
27
Q

how does hyperglycemia cause fluid & electrolyte imbalances + dehydration?

A
  • high blood glucose causes osmotic diuresis = fluid pulled intro intravascular space & is peed out
    = dehydration & imbalances
28
Q

what are the consequences of insulin resistance (6)

A
  • atherogenesis
  • plaque formation
  • increase CA risk
  • HTN
  • NASH
  • sleep apnea
29
Q

what causes the consequences of insulin resistance?

A
  • both hyperglycemia & insulin resistance are toxic & proinflammatory states
30
Q

what are the longer term consequences of hypoglycemia (4)

A
  • seizures
  • loss of consciousness
  • death
  • hypoglycemia unawareness syndrome
31
Q

why do many of the consequences of hypoglycemia effect the CNS system?

A
  • bc the brain requires a constant stream of glucose
32
Q

what is hypoglycemia unawareness syndrome

A
  • results from a frequent hypoglycemic state

- results in desensitivity to hypoglycemia = does not get warning signs such as shaky, irritable, dizzy, etc.

33
Q

what is a consequence of hypoglycemia unawareness syndrome?

A
  • lack of warning signs = may miss cue to act on the hypoglycemic episode
34
Q

how does adherence r/t glucose regulation?

A
  • important for the regimen for blood glucose control

ex. insulin, self monitoring

35
Q

what are the symptoms of hyperglycemia (6)

A
  • dry mouth
  • increased thirst
  • weakness
  • headache
  • blurred vision
  • frequent urination
36
Q

what are the symptoms of hypoglycemia (6)

A
  • sleepiness
  • sweating
  • pallor
  • lack of coordination
  • irritability
  • hunger