Phys Hormone Iii

Front 1

Cortisol as a glucose counter regulatory hormone

Back 1

under normal conc. cortisol effects carb metabolism but barely. It helps adjustment to fasting.

cortisol maintains enzymes required for gluconeogenisis and lipolysis

Front 2

Glucose counter reulatory hormones

Back 2

glucagon (main one)
symp system
cortisol
GH

Front 3

GH primary responsiblity

Back 3

stimulates protein synthesis and bone growth

Front 4

GH affects on carb and lipid metabolism

Back 4

GH has minor effects on carb and lipid metabolsim. GH affects carbs and lipid metabolism when plasma levels are hi or lo. At hi levels GH has anti insulin effects and it makes adipocyes for sensitive to lipolytic stimuli and increases gluconeogenisis by liver and decreases muslce and adipocytes sensitivy to insulin.

it overall decreases glucose uptake by cells

Front 5

hormone levels during fasting

Back 5

insulin is lo (decreases)
glucagon hi (increase)
GH hi (increase)
cortisol normal

Front 6

what happens to glycogen during fasting

Back 6

glycogen stores in liver and muscle are depleted so plasma glucose declines

Front 7

during fasting what do metabolic substrate shift to?

Back 7

lipolysis products
fa
glycerol
ketones

Front 8

describe glucose uptake by liver, adipocytes, muscle, and brain during fasting

Back 8

glucose uptake by liver, adipocytes, and skeltal m. decreases

glucose uptake by brain remains normal

Front 9

what happens during fasting

5 main things

Back 9

1. glucose uptake by liver, adipocytes, muscle decreases but brain glucose uptake remains constant

2. glycolysis is decreased in liver and skeletal m.

3. lipolysis increases. tissue shift to use fa for metabolism

4. breakdown protein

5. glycerol from lipolysis and aa (alanine) from protein catabolism undergo gluconeogenisis

Front 10

what happens after 3days of fasting?

Back 10

1. decrease in insulin MORE

2. use more fa

3. increase ketone conc. for brain bc no more glucose left. increase ketones decrease protein catabolism bc now brain is using ketones.

Front 11

Problem with ketone synthesis

Back 11

can cause metabolic acidosis

Front 12

how long can fat stores provide body with metabolic substrate

Back 12

60 days then death occurs

Front 13

hypoglycemia

Back 13

lo blood sugar in postabsorptive state

Front 14

sympotoms of hypoglycemia

Back 14

due to lack of glucose in brain

headaches
confusion
dizziness
incoordination
slurred speech
convulsions
coma if below 40 mg/dL

Front 15

effects of symp stimulation due to lo blood glucose (hypoglycemia)

Back 15

tachycardia
trembling
nervousness
sweating
anxiety

Front 16

2 things that can cause hypoglycemia

Back 16

increased blood insulin

defect in glucose counter regulatory systems

Front 17

how can blood insulin be increased to cause hypoglycemia

Back 17

insulin secreting tumors

drugs causing insulin secretion

overdose of insulin

drugs (beta adrenergic, ethanol)

Front 18

how can pt get a defect in glucose counter regulatory systems to cause hypoglycemia

Back 18

inadequate glycogenolysis or gluconeogenisis due to liver disease

glucagon defiency

cortisol defiency

Front 19

criteria for diagnosis of diabetes

Back 19

fasting plasma glucose of more than 140 mg/dL or plasma glucose over 200 mg/dl 2 hrs after glucose meal

Front 20

% of people with Type I diabets

Back 20

9%

Front 21

2 peaks of incidence for diabetes I

Back 21

first at puberty

second peak around 40

Front 22

Type I diabetes

Back 22

lack of insulin due to destruction of pancreatic beta cells

autoimmune disease

Front 23

plasma glucose with type I diabetes

Back 23

plasma glucose is 300-400 mg/dl but could be up to 1000 mg/dl. since glucose does not enter the cell, the cell thinks its starving so it increases lipolysis, making fa, glycerol and ketones

ketones cause diabetic ketoacidosis with leads to problems w/ neural function

Front 24

what is seen with type I diabetes pts.

Back 24

see hi glucose levels, hi triacylglyceride levels due to lipolysis and lo insulin

Front 25

what is in Type I diabetes pts urine?

Back 25

glucose and ketones bc saturation of renal transporters

glycosurea

Front 26

polyuria

Back 26

seen with type I and II diabetes

when osmotic diuresis and loss of electrolytes and nutrients cause dehydration

Front 27

polydipsia

Back 27

seen mainly with type I diabetes

it is excessive thirst bc increase urine flow and lossof water

Front 28

why do you see wieght loss in people with Type I diabetes although polyphagia is occuring?

Back 28

due to loss of glucose and nutrients in the urine

Front 29

therapy for type I diabetes

Back 29

insulin injection
insulin pump
insulin pump/glucoe monitor
insulin inhalation

Front 30

who are main pts who get diabetes type II

Back 30

90% are overwieght and 80% are obese

Front 31

type II diabetes

Back 31

insulin is made BUT target tissue is unresponsive to insulin. cells decrease glucose uptake and decrease glycogen synthesis. This is due to obesity

some loss of insulin occurs bc beta cells are not as sensitive to glucose

Front 32

why do pts w/type II diabetes not lose wieght?

Back 32

bc not enough glucose is excreted in urine

Front 33

only time ketosis occurs in type II diabetes

Back 33

stress or trauma from infections

Front 34

symptoms of type II diabetes

Back 34

polyuria,thirst,blurred vision, parethsis, and fatigue

Front 35

therapy for type II diabete

Back 35

excercise
drugs

Front 36

how does excersice help type II diabetes pts?

Back 36

weight reduction w/excercise. insulin responsiveness increases w/ excercise. excercise increases the number of glucose transporters in skeletal m.

Front 37

non insulin dep. diabetes

Back 37

Type II

Front 38

drugs to treat type II diabetes

Back 38

sulfonylureas

biguanides

GLP-1 agonist

amylin agonist

Front 39

how does sulfonylureas help Type II diabetes

Back 39

stimulates secretion of insulin from pancrease by closing K channel

Front 40

how does biguanides help type II diabetes pts?

Back 40

inhibits hepatic gluconeogenisis so more glucose wont be released

Front 41

how does GLP-1 agonist help diabetes II pt?

Back 41

enhances glucose stimulated insulin release and decrease release of nutrients from tummy

Front 42

symptoms of type I diabetes

Back 42

polydipsia
weightloss
polyphagia
blurred vision
polyuria

Front 43

effects of chronic elevated glucsoe levels

Back 43

atherosclerosis bc lipid circulation

kidney failure

peripherial vascualr disease

neuropathies

infection

retinopathies cause blindness

Front 44

what causes chronic abnormalities of diabetes mellitus

Back 44

due to non enzymatic glycoslyation of proteins caused by chronic elevated gllusoe levels

mainly due to damage to vasculature and narrowing of caps