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49 Cards in this Set

  • Front
  • Back
Glucose is derived from what 3 sources?
1. Dietary carbs
2. Body carb stores
3. Synthesis from protein/triglycerides
Give examples of:
Mono = glucose
Oligo = maltose/lactose
Poly = Starch
Outline the absorption of carbs:
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
Key hormones that regulate blood glucose:
1. Insulin
2. Counter-regulatory hormones
Where is insulin produced?
pancreatic beta cells of islets of langerhans
What does insulin do?
-Promotes glycogenesis - storage of glucose as glycogen;
-Promotes lipogenesis
What are the counter-regulatory hormones?
Somatostatin, Cortisol, HPL, ACTH, GH, Glucagon, Epinephrine, Thyroxine.
What 2 hormones specifically coutneract insulin?
1. Somatostatin
2. Gastric inhibitory peptide
How do counter-regulatory hormones function? (3 roles)
1. Stimulate glycogenolysis
2. Stimulate glucose conversion to glycerol
3. Stimulate gluconeogenesis to make glucose from protein
Where is Glucagon secreted from?
Alpha cells of pancreatic islets of langerhans
When glucose increases in the body, how do insulin/glucagon respond?
Insulin - released
Glucagon - inhibited.

... Want to store it away.
What is a normal blood sugar level?
80-120 mg/dl
What is considered hypoglycemic blood sugar level?
<70-104 mg/dl
What is considered hyperglycemic blood sugar level?
>200 mg/dl
Waht is considered a hyperglycemic FASTING bl sugar?
>126 mg/dl
what is the renal threshold for glucose?
160-180 mg/dl
How is hypoglycemia diagnosed?
-Physical symptoms
-Insulin levels
-Glucose levels
How would you tell if hypoglycemia is result of administered insulin (treatment) or not?
Measure C-peptide; commercial insulin lacks this.
What would clue you in to adult hypoglycemia?
Hypoglycemic fasting levels - below 50 is uncommon; investigate!
List 6 disorders of hypo and hyper-glycemia:
1. Cushing's
2. Addison's
3. Pheochromocytoma
4. Islet cell tumor
5. Acromegaly
6. Alcoholism
State the defintition of Diabetes Mellitus
An absolute or relative deficiency of insulin, often progressing to hyperglycemia and associated w/ micro/macro-vascular complications and altered immune response.
What are the 2 types of D. mellitus?
1 - insulin dependent
2 - noninsulin dependent
Which type is more common?
Which type is ketosis more common in?
Which type is obesity common in?
Which type has islet cell antibodies?
Which one shows insulin resistance more often?
How is diabetes diagnosed?
By testing fasting glucose levels, and 2-hr post prandial glucose levels
How is the diagnosis confirmed?
By repeating the test on a different day.
What are 3 other types of diabetes, other than mellitus?
1. Pre-diabetes
2. Gestational
3. Other-condition-associated
How is Gestational diabetes tested for?
By doing a glucose tolerance test
How is a glucose tolerance test done?
-Draw fasting blood sugar
-Give 50 g Glucose
-Draw at 3 additional hours, on the hour.
What is the structure of insulin like?
-2 components: A + B
-Disulfide bond holds A/B tite
-C peptide also bonded to both
How is Pro-insulin in the beta cells activated?
by enzymes from the Beta cells
What happens when Proinsulin is cleaved?
C-peptide is released
What is the specific action of insulin?
Increased cell permeability to glucose
The basic problem in Diabetes type 1 is:
decreased insulin production; antibodies to the islet cells
The basic problem in Diabetes type 2 is:
decreased insulin RESPONSE; further problems differentiate type IIA and IIB
What is the problem in Diabetes type IIA?
type IIB?
IIA: decreased insulin receptors
IIB: antibodies to insulin
The 3 targets of Insulin:
1. Muscle
2. Adipose tissue
3. Liver
What 5 factors can decrease insulin receptors?
1. Caloric intake (high)
2. Age
3. Weight
4. Antagonsit hormones
5. Chronic high insulin
What 3 factors can increase insulin receptors?
1. Anorexia
2. Low insulin levels
3. GH/glucocorticoid deficiency
What are 4 factors that affect Insulin's effectiveness?
1. Concentration reaching target
2. Insulin receptors on target
3. Insulin receptor affinity
4. Cell response to insulin
Which type of diabetes has a more genetic disposition?
Type I
What are metabolic complications of diabetes?
1. Ketoacidosis - type 1
2. Hyperglycemic coma (type 2)
What etiologic factors are associated with Type I? (4)
1. Viral
2. Autoimmune
3. Genetics
4. HLA type
What etiologic factors are associated with Type II? (4)
1. Diet
2. Obesity
3. Genetics
4. Post receptor effect
What are the 3 poly's in the pathogenesis of diabetes?
1. Polyuria
2. Polydipsia
3. Polyphagia
List the 3 chronic complications of diabetes:
1. Poor wound healing/infections
2. Microangiopathy
3. Macroangiopathy