Week 7 the diabetic pandemic

Question 1

what are the roles of the pancreas?

Answer 1

Acini- secrete digestive enzymes into duodenum

Islets of langerhans- secrete horomones into blood

Question 2

what hormones are produced in the pancreas?

Answer 2

Glucagon- from alpha cells
insulin from beta cells
Somatostatin from delta cells

Question 3

what does somatostatin do?

Answer 3

inhibits insulin and glucagon secreation

Question 4

what is the function of insulin?

Answer 4

small protein that helps in carbohydrate, fat and protein metabolisim

Question 5

what are the effects of insulin on adipose tissue?

Answer 5

increase glucose uptake
increase lipogenesis
decrease lipolysis

Question 6

what are the effects of insulin on muscle tissue?

Answer 6

increase glucose uptake
increase glucagon synthesis
increase protien synthesisi

Question 7

what are the effects of inslulin on the liver?

Answer 7

decrease gluconeogenisis
increase glycogen synthesis
increase lipogenisis

Question 8

what are the effects of inslulin on the liver?

Answer 8

decrease gluconeogenisis
increase glycogen synthesis
increase lipogenisis

Question 9

what triggers the realse of insulin?

Answer 9

stimulated by increase in blood glucose lvels

Question 10

what is the half life of insulin?

Answer 10

15 minutes in unbound form in the circulating blood

Question 11

what is insulins effects of excess carbohydrates?

Answer 11

storage un liver and skeletal mucles as glycogen

Question 12

if glycogen stores are exceeded what is insulins effects of excess carbohydrates?

Answer 12

converted to fat - lipogenesis and stored in adipose tissue

Question 13

what effect does insulin have on amino acids?

Answer 13

promotes uptake for converson into protiens

Question 14

what effect does insulin have on glucogenesis? why?

Answer 14

it decreases as this is the creation of glucose from other sources and is not needed if blood sugars are high enough

Question 15

how is insulin metabolised?

Answer 15

by insuliase in the liver

Question 16

how does insulin work to lower blood sugar?

Answer 16

insulin activates membrane receptors on target cells which then become highly permiable to glucose

Question 17

how much glycogen is stored in the liver?

Answer 17

up to 6% of the entire liver mass is glycogen

Question 18

what is the mechanism of action of insulin on the cells uptake of glucose?

Answer 18

insulin receptors bind insulin and activate
causes gene expression and growth regulation
signals transduction to GLUT4 carrier protiens
glucose uptake - use or store as glycogen

Question 19

what effects does isnulin have on fat metabolisim?

Answer 19

decreased fat metabolisim

Question 20

what occurs to fat metabolisim in the absense of insulin?

Answer 20

hydolysis of storde tryglycerides realsing free fatty acids

Question 21

what effects does insulin have on protein metabolisim?

Answer 21

cause proteins to be stored by increasing uptake of amino acids
promotes pretien synthesis by increasing the translation of messanger RNA

Question 22

what is the function of glucagon?

Answer 22

relased in response to low blood sugar
rapidly converts glycogen to glycose
increased glugogenoneisis- through transport of amino acids to liver

Question 23

what is the definition of diabetes mellitus?

Answer 23

a deficency of insulin production or nsulin action resulting in hyperglycemia

Question 24

what causes type one diabetes?

Answer 24

autoimmune destruction of pan creatic beta cells producing a deficency in insulin production

Question 25

what is the peak incidence of type one dabetes?

Answer 25

9 months to 14 years

Question 26

what is type 2 diabetes?

Answer 26

associated with insulin resistance
may initally have increased palsma insulin levles to compensate
commonly assocaited with obesity as it reduces the relative number of insulin receptors on target cells

Question 27

what are the autonomic symptoms of hypoglyecemia?

Answer 27

hynger, trmor, anxiety, nervousness, palpitations, tachycardia, sweating, pallor, pupil dilation

Question 28

what are the CNS symptoms of hypoglycemia?

Answer 28

headache

irratability, confucsion, stupor, dysphonia, diplopia, sezires, hemiparesis, seizures, coma

Question 29

what is hypoglycemic-associated autonomic failure?

Answer 29

condition that may develop in T1 or T2 diabetes - decreases adrenaline release and sympathatic response

Question 30

what are the risk factors for gestational diabetes?

Answer 30

> 30 years ol
histroy type 2 diabetes
overweight
previous gestational diabetes

Question 31

what is diabetic ketoacidosis?

Answer 31

lack of insulin resulting in high BGL
fatty acids used
production of ketones by liver

combination of three states
high blood sugar, ketosis and metabolic acidosis

Question 32

learn diabetic ketoacidosis pathphysiology

Answer 32

learnt it

Question 33

what are the symptoms of diabetic ketoacidosis?

Answer 33

tachycardia, hypotension, hyperventilation, frequent vommiting, polyuria, polydipsia (thirst), fatigue, abdominal pain/tenderness

Question 34

what is HHS?

Answer 34

hyperosmolar hyperglycemic state

no hyperventialtion, significal dehydration

Question 35

what are the clinical signs and symtpms of HHS?

Answer 35

dehydration, thirst, seizures, hemiparesis, muscle twitcing, hyperthermia and hallucinations

Question 36

what are some complications of diabetes?

Answer 36

ateriols- hardening
cappilari - basment memrabe thickens harder for difusion
arteris- athersclarosis- increase stroke and MI
Diabetic retinopathy0 blindness
kidney damapre
perihperarl nuropathy - numbness of hands and feet