6. Carbohydrates

Front 1

Glucose is derived from what 3 sources?

Back 1

1. Dietary carbs
2. Body carb stores
3. Synthesis from protein/triglycerides

Front 2

Give examples of:
-Monosacch's
-Oligosacc's
-Polysacc's

Back 2

Mono = glucose
Oligo = maltose/lactose
Poly = Starch

Front 3

Outline the absorption of carbs:

Back 3

1. Eat complex carbs
2. Salivary amylase breaks down
3. From stomach to sm intestine
4. Small intestine to portal vein, pancreatic amylase
5. To liver

Front 4

Key hormones that regulate blood glucose:

Back 4

1. Insulin
2. Counter-regulatory hormones

Front 5

Where is insulin produced?

Back 5

pancreatic beta cells of islets of langerhans

Front 6

What does insulin do?

Back 6

-Promotes glycogenesis - storage of glucose as glycogen;
-Promotes lipogenesis

Front 7

What are the counter-regulatory hormones?

Back 7

SCHAGGET
Somatostatin, Cortisol, HPL, ACTH, GH, Glucagon, Epinephrine, Thyroxine.

Front 8

What 2 hormones specifically coutneract insulin?

Back 8

1. Somatostatin
2. Gastric inhibitory peptide

Front 9

How do counter-regulatory hormones function? (3 roles)

Back 9

1. Stimulate glycogenolysis
2. Stimulate glucose conversion to glycerol
3. Stimulate gluconeogenesis to make glucose from protein

Front 10

Where is Glucagon secreted from?

Back 10

Alpha cells of pancreatic islets of langerhans

Front 11

When glucose increases in the body, how do insulin/glucagon respond?

Back 11

Insulin - released
Glucagon - inhibited.

... Want to store it away.

Front 12

What is a normal blood sugar level?

Back 12

80-120 mg/dl

Front 13

What is considered hypoglycemic blood sugar level?

Back 13

<70-104 mg/dl

Front 14

What is considered hyperglycemic blood sugar level?

Back 14

>200 mg/dl

Front 15

Waht is considered a hyperglycemic FASTING bl sugar?

Back 15

>126 mg/dl

Front 16

what is the renal threshold for glucose?

Back 16

160-180 mg/dl

Front 17

How is hypoglycemia diagnosed?

Back 17

-Physical symptoms
-Insulin levels
-Glucose levels

Front 18

How would you tell if hypoglycemia is result of administered insulin (treatment) or not?

Back 18

Measure C-peptide; commercial insulin lacks this.

Front 19

What would clue you in to adult hypoglycemia?

Back 19

Hypoglycemic fasting levels - below 50 is uncommon; investigate!

Front 20

List 6 disorders of hypo and hyper-glycemia:

Back 20

1. Cushing's
2. Addison's
3. Pheochromocytoma
4. Islet cell tumor
5. Acromegaly
6. Alcoholism

Front 21

State the defintition of Diabetes Mellitus

Back 21

An absolute or relative deficiency of insulin, often progressing to hyperglycemia and associated w/ micro/macro-vascular complications and altered immune response.

Front 22

What are the 2 types of D. mellitus?

Back 22

1 - insulin dependent
2 - noninsulin dependent

Front 23

Which type is more common?

Back 23

2

Front 24

Which type is ketosis more common in?

Back 24

1

Front 25

Which type is obesity common in?

Back 25

2

Front 26

Which type has islet cell antibodies?

Back 26

1

Front 27

Which one shows insulin resistance more often?

Back 27

2

Front 28

How is diabetes diagnosed?

Back 28

By testing fasting glucose levels, and 2-hr post prandial glucose levels

Front 29

How is the diagnosis confirmed?

Back 29

By repeating the test on a different day.

Front 30

What are 3 other types of diabetes, other than mellitus?

Back 30

1. Pre-diabetes
2. Gestational
3. Other-condition-associated

Front 31

How is Gestational diabetes tested for?

Back 31

By doing a glucose tolerance test

Front 32

How is a glucose tolerance test done?

Back 32

-Draw fasting blood sugar
-Give 50 g Glucose
-Draw at 3 additional hours, on the hour.

Front 33

What is the structure of insulin like?

Back 33

-2 components: A + B
-Disulfide bond holds A/B tite
-C peptide also bonded to both

Front 34

How is Pro-insulin in the beta cells activated?

Back 34

by enzymes from the Beta cells

Front 35

What happens when Proinsulin is cleaved?

Back 35

C-peptide is released

Front 36

What is the specific action of insulin?

Back 36

Increased cell permeability to glucose

Front 37

The basic problem in Diabetes type 1 is:

Back 37

decreased insulin production; antibodies to the islet cells

Front 38

The basic problem in Diabetes type 2 is:

Back 38

decreased insulin RESPONSE; further problems differentiate type IIA and IIB

Front 39

What is the problem in Diabetes type IIA?
type IIB?

Back 39

IIA: decreased insulin receptors
IIB: antibodies to insulin

Front 40

The 3 targets of Insulin:

Back 40

1. Muscle
2. Adipose tissue
3. Liver

Front 41

What 5 factors can decrease insulin receptors?

Back 41

1. Caloric intake (high)
2. Age
3. Weight
4. Antagonsit hormones
5. Chronic high insulin

Front 42

What 3 factors can increase insulin receptors?

Back 42

1. Anorexia
2. Low insulin levels
3. GH/glucocorticoid deficiency

Front 43

What are 4 factors that affect Insulin's effectiveness?

Back 43

1. Concentration reaching target
2. Insulin receptors on target
3. Insulin receptor affinity
4. Cell response to insulin

Front 44

Which type of diabetes has a more genetic disposition?

Back 44

Type I

Front 45

What are metabolic complications of diabetes?

Back 45

1. Ketoacidosis - type 1
2. Hyperglycemic coma (type 2)

Front 46

What etiologic factors are associated with Type I? (4)

Back 46

1. Viral
2. Autoimmune
3. Genetics
4. HLA type

Front 47

What etiologic factors are associated with Type II? (4)

Back 47

1. Diet
2. Obesity
3. Genetics
4. Post receptor effect

Front 48

What are the 3 poly's in the pathogenesis of diabetes?

Back 48

1. Polyuria
2. Polydipsia
3. Polyphagia

Front 49

List the 3 chronic complications of diabetes:

Back 49

1. Poor wound healing/infections
2. Microangiopathy
3. Macroangiopathy