Signs and symptoms of diabetes
- polyuria, polydipsia, polyphagia, unexplained weight loss
Fed State Hormone vs Fasting State Hormone
- Fed State: Insulin is apeptide hormoneproduced bybeta cellsof thepancreatic islets; it is considered to be the mainanabolichormoneof thebody. It regulates themetabolismofcarbohydrates,fatsandproteinby promoting the absorption of carbohydrates, especiallyglucosefrom the blood intoliver,fatandskeletal musclecells. Glucoseproduction andsecretionby the liver is strongly inhibited by high concentrations of insulin in the blood.
- Fasting State: Glucagonis apeptide hormone, produced byalpha cellsof thepancreas. It works to raise the concentration ofglucoseandfatty acidsin the bloodstream, and is considered to be the maincatabolichormone of the body.
insulin resistance or absence of cellular response to insulin can lead to dysregulated glucose metabolism in type 2 diabetes.
- Insulin resistance, which is the inability ofcells to respond adequately to normal levels of insulin, occurs primarily within the muscles,liver, and fat tissue.
- insulin normally suppressesglucoserelease.
Define hemoglobin A1c and determine the optimal/target levels
Hemoglobin A1c: ishemoglobinwith glucose attached. TheA1ctest evaluates the average amount of glucose in the blood over the last 2 to 3 months by measuring the percentage of glycated (glycosylated)hemoglobin.
diagnostic criteria for obesity and metabolic syndrome.
- Large waist: waistline that measures at least 35 inches for women and 40 inches for men
- High triglyceride level
- Increased blood pressure
- Elevated fasting blood sugar
benefits and potential side effects associated with the use of metformin.
- Benefits: decreases gluconeogenesis and has an insulin-sensitizing effect
- Side effects: gastrointestinal irritation, includingdiarrhea, cramps, nausea, vomiting, and increasedflatulence; The most serious potential side effect of metformin use islactic acidosis
types of insulin
- rapid acting: onset is less than 15 minutes and lasts up to 5 hrs
- short acting: onset is less than 1 hr, lasts up to 8 hrs
- intermediate acting: onset is less than 2 hrs, and lasts up to 18 hrs
- long acting: onset is less than 2 hrs and lasts up to 24 hrs
MOA of chromium
- dentified as regulating insulin by increasing the sensitivity of theinsulin receptor
MOA of magensium
important role in carbohydrate metabolism and its deficiency may worseninsulin resistance
MOA of psyllium
owering of blood cholesterol levels in people with elevated cholesterol,[1]and lowering of blood glucose levels in people with type 2 diabetes.
MOA of ceylon cinnamon
improves blood glucose and cholesterol levels
hepatic fatty acid metabolism
- synthesis
- oxidation:
- deposition: turned into triglycerides and then taken with lipoprotein to tissues
Correlate hyperglycemia to the development of hypertriglyceridemia
- Elevated levels of triglycerides lead to elevated levels of free fatty acids
risk factors and clinical presentation of hyperlipidemia.
- Risk factors: Genetic predisposition; Diet/other lifestyle factor;Pregnancy; male
- Clinical presentation: Most patients have no signs/symptoms
- PE findings occur in patients w/ sever elevated lipids: Usually familial syndrome, Xanthomas, Corneal arcus
pathogenesis of hyperlipidemia
- insulin resistance leads to lipids being released into the blood and too many lipids not being cleared would lead to hyperlipidemia
Explain the role of beta-oxidation of fatty aids and fatty acid synthesis in weight loss
Because peroxisomal beta oxidation produces less ATP than does beta oxidation in mitochondria, a relative increase in peroxisomal fatty acid beta oxidation can lead to a reduction in lipid mass and to weight loss. The hydrogen peroxide generated by this pathway can be used by catalase for the oxidation of substrates such as ethanol.
Describe the lifestyle changes recommended to manage hyperlipidemia
- limit intake of lipids
Characterize herbs and supplements
- Red yeast rice: most effective over-the-counter therapy for the treatment of elevated LDL
- Berberine: increases hepatic LDL-R and suppresses PCSK9 expression
- Spirulina: results in reductions in body fat percentage, serum total cholesterol, and fasting glucose levels; Comes from algae
- Extended release niacin: reducing total cholesterol, LDL, TG, and VLDL and increasing HDL a
- High dose omega 3 fatty acids: significant reductions in serum TG, VLDL, decreased LDL-P, increased LDL and HDL particle size, as well as major reductions in all CVD events
