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What effect does insulin have on endothelial tissue? Regulation of the secretion of the vasodilator nitric oxide and the vasoconstrictor Endothelin-1. Nitric oxide stimulates vasodilation and increased blood flow to the target tissues. It also inhibits pathways in the inflammation cascade
What effect does insulin have on the liver? It increases uptake of amino acid, activates glycogen synthase, inhibits GNG enzymes and decreases uptake of substrates. (Insulin also has no effect on the GLUT transporters in the liver)
What effect does insulin have on adipose tissue? It promotes leptin secretion, translocates GLUT 4, activates lipoprotein lipase, stores excess glucose as fat and inhibits lipolysis.
What effect does insulin have on muscle tissue? Activates glycogen synthase, increases uptake of BCAA, stimulates protein synthesis, translocates GLUT 4 and reduces loss of amino acids from muscle
What happens in the endothelium without insulin? Less vasodilation and slower movement of glucose to target tissues. CRP and the inflammation pathways both increase too
What happens in the liver without insulin? Amini acid uptake is decreased, glycogen is broken down (& glycogen synthase isn't activated), glucagon elevates and PEPCK expression is increased. GNG occurs.
What happens in the adipose tissue without insulin? Leptin is not secreted, GLUT 4 isn't translocated therefore glucose uptake & storage doesn't occur. LPL is not activated (lipoproteins are not broken down). There is also increased lipolysis and no lipogenesis.
What happens in the muscle tissue without insulin? Glycogen synthase is not activated (&and glycogen is not made). There is decreased uptake of BCAA, decreased protein synthesis, increased loss of amino acids and GLUT 4 is not translocated (Glucose is not take up)
What are some factors that lead to insulin resistance? Inflammatory mediators, overabundance of adipose tissue, lipid deposits in non-adipose tissue
What is the effect of insulin resistance on the pancreas? Hyperglycaemia is constantly stimulating cells to produce more insulin; this results in hyperinsulinaemia followed by insulin deficiency (as a result of beta-cell exhaustion)
What are incretins? Proteins/hormones released into circulation after minutes of eating and may continue to be released for up to 3 hours. They stimulate a decrease in blood glucose, slow the gastric emptying and inhibit glucagon release.
What are the three stages of insulin release? Cephalic, secretion 1 and secretion 2.
What stage of insulin release is often inhibited in T2DM? Secretion 2
Created by: KatApple