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35 Cards in this Set

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What is Diabetes?
A disturbance in the carbohydrate homeostasis regulated by the opposing actions of INSULIN and GLUCAGON
Diabetes definition again?
a state of CHRONIC HYPERGLYCEMIA due to deficiency of INSULIN or a combination of inuslin receptor abnormalities and inadequate insulin secretion to compensate.
What else with Diabetes?
-Accompanying disturbances in carbohydrate, fat and protein metabolism.
-80-90% of pancreatic Beta cells dysfxn is present even with early diagnosis of DM-1
Pancreas?
-Both an endocrine and exocrine gland
Islets of Langerhans?
-Insulin
-Glucagon
What are the 3 types of HORMONE secreting cells?
-Alpha cells = Glucagon
-Beta cells= Insulin
-Delta cells= Gastrin/Somatostatin
What cells secrete Glucagon?
Alpha cells
What cells secrete Insulin?
Beta cells
What cells secrete Gastrin/Somatostatin?
Delta cells
Acinar cells?
-Amylase
-Lipase
What kind of lipase and amalyse levels does a diabetic usually have?
Normal levels
Beta cells?
-Pro-insulin into inuslin via proteolytic enzymes.
-C-peptide is the catalyst that breaks the disufic bonds
see notes ask*
Regulation on Insulin?
Chemcal:
-Insulin (neg feedback)
-Glucose (hyper and hypoglycemia)
-Amino and fatty acids
-Glucagon
Para/sympathetic stim
Hormones:
Proarglandins
Insulin enhances?
Glucose uptake
Without Insulin=
-no glucose=no ATP!
GLUT 4?
Transporter
Glut 4 is transported outside the cell membrane where it connects and transports glucose into the cells of
-Skeletal muscle
-Cardiac muscle
-Liver
-Adipose tissue
*Facilitates intracellualr transport of K+
4 muscles that util. Glucose?
-Sk Muscle
-Cardiac muscle
-Liver
-Adipose tissue
Insulin is a Anabolic Hormone, what the hell does that mean?
Anabolic=Builder
-Stimulates cellular metabolism using glucose as fuel
-SYNTHESIS in liver, muscle, and adipose of:
-Protein
-Carbs
-Lipids
-Nucleic Acids
Where does Insulin metabolism occur?
-Liver and Kindey (enzymatic catabolism of disulfide bonds)
Glucogenisis?
Glucose---Glycogen
Glycolysis?
Glycogen---simple sugars
Sites of Insulin Activity?
-Liver
-Muscle
-Adipose tissue
Insulin metabolism?
-increases cell metabolism
-Decreases overall blood glucose
-facilitates intracellular transport of K+
Glucagon?
-Inverse relationship with Insulin
-Prod in pancreatic alpha cells
-Secretion inhib by high glucose/stim by low glucose.
-Secretion stim by high protein diet
Glucagon in the liver?
-Stim glucoeogenesis and glycogenolysis
-Antagonizes Insulin
-Stim Lipolysis with ketogenic effect
Which is best to treat hypoglycemic state?
Glucagon
Pancreatic Somatostatin and Carbohydrate Metabolism?
-Metabolizes fat, protein, carbs
(homeostasis of ingested nutrients)
-Regulates Pancreatic A and B fxn
-Inhibits insulin and glucagon secretion
-Prevents excess secretion of inuslin
How many in US have diabetes?
-18.2 in US
-5-10%= Type 2
-90-95%=Type I
What group is most suscept to Type I?
AA
Hispanics
Pima Indians
What is DM I?
-Pancreatic Islet Beta cell autoimmune destruction
-pts are Insulin dependant
-Pts are prone to Ketoacidosis
-Usu under 30yo at time of dx
-Peak indicence at school age and adolescence
-Highest incidence in Northern Europe and in the US
Bascially DM I?
-Beta cell failure
What is the most common DM?
DM Type II!
DM II?
-Most common type
-Due to insulin resistance and lack of insulin secreation compensation
-pts may require Insulin
-HTN, Hyperlipidemia, atherosclerosis are usu. present or at hight risk to develop.
Pts usu. greater than 40 yo
Insulin Resistance Syndrome?
AKA Syndrome X/Metabolic syndrome
-Hyperglycemia
-Hyperinsulinemia
-Dyslipidemia
-HTN
-Increased CAD, MI, PVD, Stroke
*25% of the general non obese pop. have insulin resist.
MODY?
Maturity Onset Diabetes of the Young
-Rare form of NIDDM
-six types
-Genetic mutation of Beta cells
-Non-obese