Diabetes And Obesity

Front 1

Glucose homeostastis is determined by the balance of -_____ & _____

Back 1

insulin secretion
insulin sensitivity

Front 2

Blood glucose levels

Back 2

fasting - rarely below 72%
eating- rarely above 140-150 %

Front 3

increase in glucose results in

Back 3

increase in insuln and decrease in glucagon

Front 4

cells that are obligate glycolyzers...

Back 4

they use glucose almost exclusively as their fuel source
RBCs and hypothalamic neurons

Front 5

starvation diabetes

Back 5

B cell function is affected and plasma glucose levels change

Front 6

too much glucose =

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waste of important fuels
glycosylation of protiens
glucose toxicity

Front 7

Long term complications of unregulated glucose are

Back 7

hyperglycemia
microvascular - retinopathy, neuropathy, anc nephropathy
macrovascular- atherosclerosis

Front 8

multiple fates of ingested glucose

Back 8

glycolysis
pentose cycle
glycogen storage

Front 9

proteins can can be utlized as fuels

Back 9

6kg of about 24,000 calories

Front 10

triglycerides

Back 10

glucose stored with excess intake
most important fuel in adipose tissues
15-20 kg (20-25% of body weight)
enough calories to survive 5-60 days
150,000 calories

Front 11

horomones regulate glucose homeostasis

Back 11

glucocorticoids
glucagon
catecholamines
growth hormone

Front 12

An excess of hormones can result in

Back 12

diabetes
for example, peo, acromegaly, and Cushings

Front 13

diabetes by excess hormones is called

Back 13

counterregulatory hormones

Front 14

the only established glucose lowering hormone is

Back 14

insulin

Front 15

Islets of Langerhans

Back 15

pancreas 90 %
1 million
major barrier to transplant

Front 16

What is the relationship between proinsulin, insulin, and c peptide?

Back 16

for every one insulin molecule secreted on C peptide molecule secreted as well
C peptide is thus a surrogate marker for insulin secretion

Front 17

fuels
calorigenic substrates

Back 17

glucose
amino acids

Front 18

Insulin secretion

Back 18

exerts a number of important effects of liver, muscles, and adiposes
supresses HGP and influences other cells as well
anabolic

Front 19

Insulin

Back 19

mediates its effects via the insulin receptors
composed of alpha and beta chains
becomes phosphorylated during activation and a cascade of events follows

Front 20

receptor cycling

Back 20

receptor numbers are regulated by the hormone for the receptor
too much insulin and insulin receptors down regulate- this is a part of insulin resistance

Front 21

pshosphatidylinositol 3 kinase

Back 21

important mediator of insulin action
ph inositol containing phospholipids in cell membrane
increase pip3 content
activated by insulin in vivo and in vitro
activation reduced in obesity and type ii NIDM
insulin resitance correlates with a decrease in p13 kinase activation
inhibited by owrtmannin

Front 22

glucose transport regulated by

Back 22

p13K

Front 23

Ketone Bodies

Back 23

rise in ketones plays a key role in reducing glucose utlization, glucose production, and proteilysis while maintaining cerebral fuel utilization

Front 24

Obesity

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assessed by BMI and waist to hip ratio
BMI of 25 and above 25-30 overwt
30-40 obese
waist to hip ratio is < than .72

Front 25

what causes obesity?

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leptin deficient = morbidly obese
hypothalmic lesions = obese

Front 26

leptin

Back 26

deficiency = obesity
plays an important role in fertility- it regulates teh hypothalamic/pituitary/ and gonadal axis

Front 27

hyperinsulinemia

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contributes to fat accretion and the storage of calories
chronic hyperinsulinemia has adverse effects: insulin resistance, atherogenesis, and syndrome X and metabolic syndrome

Front 28

Starvation

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biochemical event associated with ketogenesis, glucogenesis, lipolysis, glycogenolysis, all set inot motion by a fall in one hormone

Front 29

obesity

Back 29

hyperinsulinemia associated with obesity causing insulin resistance, which in turn requires the Beta cell to work harder, a vicious cycle... If the Beta cell fails or decompensates then diabetes results.

Front 30

type I diabetes

Back 30

autoimmune... target antigens include proinsulin, insulin, GAD. other antigens

Front 31

prodromal period of IDDM

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first phase loss of insulin secretion
the destruction of most beta cells has already occurred

Front 32

antihyperglycemic treatment strategies for type II

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diet and exercise
sulfonlureras
non-SU secretagogues
insulin
exenatide
biguanides
alpha glucosidase inhibitor
thiazolidinedions

Front 33

biguanides

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metaformin
decreases heptic glucose production

Front 34

alpha glucosidease inhibitor

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decrease carboyhydrate absorption

Front 35

thiazolidinediones

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decrease insulin resistance

Front 36

exantide

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increase glucagon, satiety
decrease gastric dumping

Front 37

diabetes and pregnancy

Back 37

dramatic increase in insulin requirements occur
PRL or placental lactogen responsible fo augmenting beta cell secretion