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78 Cards in this Set
- Front
- Back
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What does Insulin do? What is it used to tell the body?
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-Decreases Blood Glucose
-Tells the Peripheral Tissues if we have lots of Building Blocks |
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What is the Anabolic Action of Insulin?
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Promotes Synthesis of Glycogen, Triglycerides, and Proteins
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Why is Insulin pre-packaged in secretory granules?
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It must be secreted quickly to act quickly
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Insulin has a short half-life in the blood. What does this mean for its effects?
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Acts quickly and over a short time-scale
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What stimulates the release of Insulin?
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-Glucose
-Amino Acids -Secretin |
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What inhibits the release of Insulin?
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-Low Blood Glucose
-Epinephrine |
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What are the specific Metabolic Effects of Insulin in the Liver?
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-Inhibits Gluconeogenesis and Glycogen Breakdown
-Increases Glycogen Synthesis |
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What are the specific Metabolic Effects of Insulin in the Muscles?
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-Increases Glycogen Synthesis
-Restores Depleted Glycogen |
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Which tissues only use Glucose Selectively? What do these tissues do when Insulin is released? How?
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-Muscle and Adipose Tissue
-Increase Glucose Uptake -Increase Number of Glucose Transporters |
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What effects does Insulin have on Lipid Metabolism?
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-Inhibits Hormone-Sensitive Lipase
-Increase TG Synthesis |
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What effects does Insulin have on AA Metabolism?
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-Stimulates Entry of AAs and Protein Synthesis
-Muscles can Recover from Protein Breakdown |
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What type of Receptor is the Insulin Receptor?
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-Tyrosine Kinase
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What type of receptor dose Insulin act on?
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Insulin Receptor involves Tyrosine Kinase Activity
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What happens to Glucose Transporters when Insulin is present?
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-Number is increased
-Move from inside cell to surface in vesicles -Vesicles fuse with Membrane for Delivery |
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What does it mean if a tissue is Insulin-Independent? What are some examples?
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-Always take up Glucose
-Liver, Brain, Cornea, RBCs |
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Which Tissues always take up Glucose? What is this known as?
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-Liver, Brain, Cornea, RBCs
-Insulin-Independent |
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Where does Glucagon Primarily act? How is this different from Insulin?
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-Liver
-Insulin acts on the Liver, Muscles, Adipose Tissue, pretty much everywhere |
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What does Glucagon do? How?
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-Increases Blood Glucose
-Stimulates Glycogen Breakdown and Gluconeogenesis |
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What does Glucagon work with to oppose the action of Insulin?
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-Cortisol
-E -NE |
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Which blood regulatory hormones will Amino Acids stimulate release of?
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Glucagon and Insulin
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What is Glucagon basically telling the body?
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We are fucking starving!!!
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What are the Metabolic Effects of Glucagon?
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-Increasing Blood Glucose
-Increases FA Oxidation and Formation of Ketone Bodies by the Liver -Increases Uptake of AAs by the Liver (for Gluconeogenesis) |
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Describe the Mechanism of Action for Glucagon.
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-Binds to cell surface Receptors
-Works through G Proteins -Activates cAMP Dependent Protein Kinase |
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What type of Kinase does Glucagon work through? Insulin?
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-cAMP Dependent Protein Kinase
-Tyrosine Kinase |
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What are some symptoms of Hypoglycemia?
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-Headache
-Confusion -Slurred Speech -Seizures -Coma -DEATH!!!!! |
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How does the body respond to Hypoglycemia?
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-Islets of Langerhans release Glucagon
-Receptors in the Hypothalamus release E, ACTH, and GH |
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What is the short-term control for Hypoglycemia and Glucose regulation?
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-Glucagon
-E |
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What is the long-term control for Hypoglycemia and Glucose regulation?
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-Cortisol
-Growth Hormone |
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What are the different types of Hypoglycemia?
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-Insulin-Induced
-Postprandial - After Eating a Meal -Fasting -Alcohol Intoxication |
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How can Alcohol Intoxication lead to Hypoglycemia?
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-Coupled with not eating other stuff
-Large Increase in NADH -Diversion of Gluconeogenesis Intermediates (Pyruvate and Oxaloacetate) -Can Cause Hypoglycemia |
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What happens to Carbohydrate Metabolism in the Liver during WFS?
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-Glycolysis and Glycogen Synthesis is Increased
-Gluconeogenesis and Glycogenolysis is Decreased |
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What happens to Fat Metabolism in the Liver during WFS?
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-FA Synthesis
-TG Synthesis |
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What happens to AA Metabolism in the Liver during WFS?
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-Protein Synthesis and Export to Other Tissues
-Deaminated and Carbon Skeletons are Degraded |
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How are TGs exported from the Liver?
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VLDLs
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What happens to Carbohydrate Metabolism in Adipose Tissue during WFS?
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-Increased Insulin Promotes Glucose Uptake
-Increased Glycolysis yields Glycerol Phosphate for TG Synthesis |
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What happens to Fat Metabolism in Adipose Tissue during WFS?
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-Increased TG Synthesis (due to Increased Glycerol Availability) and Decreased TG Degradation
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What happens to Carbohydrate Metabolism in Skeletal Muscle during WFS?
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-Increased Insulin Promotes Glucose Uptake
-Glycolysis and Glycogen Synthesis are Increased |
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What happens to Fat Metabolism in Skeletal Muscle during WFS?
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-FA from Chylomicrons and VLDL are used for Energy but are Secondary to Glucose
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What happens to AA Metabolism in Skeletal Muscle during WFS?
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-Protein Synthesis
-Rebuild Muscle Proteins |
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How much of your bodies Oxygen does the Brain Consume? What happens if you are thinking really hard?
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-20%
-You might get hurt (still about 20%) |
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What are the main priorities for the body during the fasting state?
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-Supply Glucose for the Brain and other tissues that require it
-Mobilize Fatty Acids and Ketone Bodies to fuel other tissues |
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What substance that will be mobilized during fasting do we have the Smallest store of? Largest?
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-Glycogen
-Triacylglycerides |
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How long will our Glycogen Stores last during fasting?
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1 day
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What does our body switch to after Glycogen stores are used up?
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Gluconeogensis in the Liver
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As we fast for prolonged periods of time, what becomes increasingly important?
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Ketone Bodies
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What substrates are used for Gluconeogensis?
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-AAs
-Glycerol -Lactate |
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What does Adipose Tissue do during Fasting?
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-Not taking up Glucose anymore
-Starts to degrade Fatty Acids -Glycerol (goes to the Liver for Gluconeogenesis) and Fatty Acids (used by Tissues) are released |
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What happens to Skeletal Muscle during Fasting?
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-Switches Away from Using Glucose so other tissues can
-Degradation of Muscle Results so proteins can be used by the Liver for Gluconeogenesis |
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What does Skeletal Muscle use as fuels during fasting?
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Fatty Acids and Ketone Bodies
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What happens to Brain Metabolism during Fasting?
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-Ketone Bodies are upregulated
-Brain will use a mixture of Ketone Bodies and Glucose -Decreases Demand on the Liver for Glucose, thus sparing Breakdown of Muscle Protein to some extend |
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What is Diabetes Mellitus?
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Collection of Diseases characterized by elevated Blood Glucose
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How is Diabetes Mellitus diagnosed?
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-Fasting Blood Glucose > or = 126 Twice
-Blood Glucose >200 at any time |
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What causes Diabetes Mellitus?
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Absolute or Relative Deficiency of Insulin
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What are some long-term consequences of Diabetes Mellitus?
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-Blindness
-Amputation -Stroke -MI -Renal Failure |
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What are the 3 Main Types of Diabetes Mellitus?
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-Type 1
-Type 2 -Gestational |
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What happens in Type 1 Diabetes?
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-Was Called Insulin-Dependent Diabetes
-Autoimmune Destruction of Beta Cell of the Pancreas -Can't Produce Insulin |
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What happens in Type 2 Diabetes?
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-More Common
-Was Called Non-Insulin Dependent -Peripheral Tissues Become Resistant to Insulin |
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What is Gestational What happens in Type 1 Diabetes?
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Temporary Condition during Pregnancy
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Patient comes in with Blood Glucose of 210. What do they have?
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Diabetes
-Blood Glucose >200 at any time |
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Patient comes in with Fasting Blood Glucose of 115. What do they have?
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Prediabetes
Fasting plasma glucose levels of 101-125 mg/dL indicates pre-diabetes |
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What are the Metabolic Changes associated with Type 1 Diabetes?
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-Hyperglycemia
-Ketoacidosis due to excessive FA Mobilization and Ketone Bodies -High FA leads to high VLDL and Hypertriglyceridemia -Lipoprotein Lipase Decreased -Effects of Glucagon are Unopposed by Insulin |
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How can we measure Blood Glucose regulation over longer periods of time?
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Look at HbA1C Levels
-Covalently modified by Glucose -Integrates Exposure of RBCs to High Blood Glucose -Tells us how well Glucose Levels have been Regulated over a Longer Term |
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What is Metabolic Syndrome? What does it predispose a person to?
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-Group of Related Abnormalities that Increase an Individuals Probability for Developing CV Disease and Diabetes
-Type 2 Diabetes |
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Approximately what percentage of adults are thought to have Metabolic Syndrome?
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1/4
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How is Metabolic Syndrome Diagnosed?
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If a person has 3 or more Risk Factors
-Large Waist -High Levels of TGs -High HDL Cholesterol -High BP -High Fasting Glucose |
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What are some Common Factors involved in Metabolic Syndrome?
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-Impaired Glucose Tolerance
-Dyslipidemia -Abdominal Obesity |
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What is unique about Visceral Fat? What does this seem to lead to?
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-It doesn't respond well to Insulin
-Leads to Obesity, Insuling resistance, Compensatory Hyperinsulinemia, Inability to Control Plasma Glucose |
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Adipocytes are not just Inert Storage Depots for Fat
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They may play a role in the Pathophysiology of Insulin Disorders
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How do the Metabolic Alterations in Type 1 Diabetes compare with Type 2?
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Milder
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What will you initially see in a patient with Type 2 Diabetes? Why?
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-Hyperinsulinemia
-Body is trying to compensate for the lack of reaction from Insulin |
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What are some risk factors for Type 2 Diabetes?
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-Genetics
-Obesity -Lifestyle |
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How is Type 2 Diabetes Treated?
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-Diet
-Weigh Reduction (Has cured people in some cases) -Exercise -Various Drugs -Insulin (1/3 of patients end up needing it) |
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What are Sulfonylureas used for? How do they work?
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-Type 2 Diabetes Treatment
-Make Beta Cells Secrete Insulin Faster and to Higher Levels |
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What are some Effects of Hyperglycemia from Type 2 Diabetes?
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-Accelerated Atherosclerosis
-Retinopathy -Neuropathy -Peripheral Neuropathy - Can lead to Amputation |
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What is the leading cause of new blindness?
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Type 2 Diabetes
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Why does Gestational Diabetes occur?
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-Because they bitch got pregnant!!!!
-Certain Placental Horomones Oppose the Action of Insulin -May Develop Type 2 Diabetes (40-60%) |
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What levels of Blood Glucose are considered Hypoglycemic?
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<40
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What is the Clinical Triad? What does this triad diagnose?
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-Polyuria - Urinating a lot
-Polydipsia - Thirsty, Drink a lot -Polyphagia - Hungry, Eat a lot -Diabetes |
