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28 Cards in this Set

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DM I or II with increased insulin/C peptide
DM II
what are clinical finding that are consistant with DM II
increased inhilin
increased glucose in plasma
NO ketones
hwo can hyperinsulinemia be confirmed
C peptide assay (longer 1/2 life than insulin)
are ketones associated with DM II
nope, we have SOME insulin, just enough to inhibit lipolysis and ketone formation
what does untreated DM I look like
high ketones
high FFA
lw insulin
what is the problem

eat drink pee LOTS
increased FFA
low Na/K
HIGH glucagon
C peptide is low
Ketones high
glucose high
DM I
how does an insulin deficit affect plasma and urine glucose levels in DM I
Plasma: increased becuase less GLUT 4 to take glucose into cells, gluconeogenesis als increases plasma glucose levels bc glucagon levels are high

Urine: LOTS of glucse, exceed reabs capacity, so Glucose is lost in urine as acts as osmotic gradient to pull out Na/K and water. Pee LOTS, low Na/K
what happens to plasma FFA in DM I
increased

**no insulin means hormone sensitive lipase goes unregulated. TONS of lipolysis releasing FFA. this is enhanced by glucagon

**the presense of insulin inhibits lipolysis
how does lack of insulin in DM I affect plasma glucagn
HIGH!

no insulin so no inhibitin on glucagon

**increased lipolysis and gluconeogenesis
what happens to ketoens in the plasma nad urine in DM I. this is a result of lack of insulin
increased FFA

**these are then converted to Ketone bodies (acetoacrtic acid and hydroxybutryic acid)

**filtered by kidney adn appear in urine
why are ketones present in the plasma and urine in DM I
there is MASSIVE lipolysis bc of lack in insulin and high glucagn. teh FFA released are converted t ketne bodies that are in plasma and urine

**insulin normally wuld inhibit hormone sensitive lipase form going lipolysis crazy but in DM I we dont have insulin to stop HSL
what happens to C peptice in DM I
decreased, C peptide is a reflectin f plasma levels. in DM I its low
wht happens to BP in DM I
decreased and decreases more when you stand

**low BP is secondary to fluid loss (osmotic diuresis from glucose in urine)
**decrease in ECF, means as you stand decreased venous return to heart, decreased CO and decreased arterial pressure
if yu exercise what happens t FFA with and withut insulin injectins
withut: increase FFA levels

With insuiln: FFA levels are low
what happens to plasma glocose in exercise with and withouth insulin
Without InsulinL decreases

With Insulin: decreases more
what happens to insulin levels during exercise, what happens if we add insulin
w/o insulin: decreases

with insulin: not as much of a decrease
what decreases insulin release in exercise
catecholamines

**greater intensity of exercise greater drop in insulin, more lipolysis
why do we need to account for exersice wehn dosing insulin for DM I
exercise decreases insulin levels so we would need to give them a little more
why do we see a decrease in glucose with exercise, why is there an even greater driop when we exercise with insulin given
exercise increases glucose uptake into the mm

with insulin more glucose is taken up int the tissues and glucose levels drop further

**increased demands for glucose in exercising mm
why do plasma FFA increase in exercise and decrease with exercise and insulin
w/o insulin and exersice: increased FFA bc lipolysis is stim

w/insulin the FFA is low bc insulin is antilipolytic
how is plasma glucose constant throughot exercise with and w/o glucose infusion
gucose utilization is the sme as hepatic glucose production

**countergegulatoy hormones on glycogenolysis nad gluconeogenesis

**even with extra insulin added the hypoglycemia is stronger than the insuin so glucagon is stil released to make sure we have hepatic glocose production
how does the rate of glucose produciton and utilization during exercise compare for men and women
men have higher rates of hepatic glucose production and tissue utilization

**males make and use more glucose during exercise
who has a greater EPI respons to exercise men or women
men

*8the NE response was hte same
what is the effect of exercise on catecholamine release in men and women
NE: same for both

EPI: more released in men than women
how do levels of glucagon release during exercise vary among men nad women
same

**men did have a higher increment from rest to exercise
what happened to the cortisol response in men and women in response to exercise
same increase and hten a decrease
so men use more glucose in exercise than women, what hormone mirrors this result
men also have increased EPI release

**the larger increment in glucagon can also accoudn for the higher amt of glucose men use
what are the 2 possible explainations for increased glucose use in men during exercise as compared to women
1. men also have icnreased EPI release

2. Men have increased glucagon increment

**same NE, cortisol, (gucagon),