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Fuel Homeostasis 2

Duke PA physiology

What are the insulin target cells? muscle, liver, fat
What does insulin do to its target cells? stimulates uptake of glucose into the cells
What do the islet alpha cells of the pancreas secrete? glucagon
What effect does a rise in glucagon have on insulin? glucagon turns on insulin
Does insulin stimulate or inhibit glucagon? inhibit
What level does plasma glucose need to be maintained at? 80-100 mg/dL
How does glucose enter the cell? through the GLUT2 transporter
what is Glc converted to? Glc6P
What is GLlc6P converted to? ATP
Is the GLUT2 transporter regulated by insulin? NO - these transporters are present on all cells
Why is glucose phosphorylated? traps it in the cell - keeps it from going out
What phosphorylates glucose? a kinase
What effect does rise in ATP have on the cell? closes ATP sensitive K+ channel
What does the closing of the K+ channel have on the cell? depolarizes the beta cell
What does depolarization of the cell cause? opening of Ca voltage channel
What does Ca entry increase? DAG + IP3
What does increase in DAG + IP3 lead to? release of Ca++ from the ER
What does rise in Ca++ lead to? exocytosis of insulin
What does opening of voltage gated K+ channel cause? repolarization of the cell
What is MODY? mature onset diabetes of the young (type 2)
What step doesn't occur correctly in MODY? phosphorylation of glucose in the cell
What does lack of phosphorylation cause in MODY? high circulating levels of glucose in the blood
What do sulphonylnurea drugs do? close potassium channel - resulting in depolarization of the cell
How long do normal individuals take to remove glucose? 2 hours
What does a glucose tolerance test check? see if it takes longer than normal to clear glucose
What does GLP-1 signal? pancreatic islet beta cell to secrete insulin
What does plasma aa signal to the pancreas? turns on the pancreatic islet beta cell
What effect on insulin secretion does the parasympathetic NS activity have? turns it on
What effect does sympathetic NS activity & plasma epi have on insulin? inhibit pancreate islet beta cell
What transporters on the cell surface of muscle, liver and fat are turned on by insulin? GLUT4 - recruited to the cell surface
What is one of the first sign of diabetes type II? In muscle, do not recruit GLUT4 transporters to cell surface in presence of insulin
What is pathology associated with glucose? too little glucose inside cells, too much glucose outside cells
What does glucose outside of the cells cause? problem - bind to proteins. Also, exceed renal threshhold for glucose, and urine will not be as concentrated - causes increases thirst. Starved for fuel, lose weight.
What causes insulin insuffiency in type 1 diabetes (IDDM)? destruction of the pancreatic islets
What is the treatment for type 1 diabetes mellitus? insulin replacement therapy
What causes insulin insuffiency in type 2 diabetes (NIDDM)? altered response of the beta cell to a rise in plasma glucose
Are target cells sensitive to insulin in type 2 diabetes? no - they are less sensitive to insulin - "insulin resistant"
What metabolism prevails in type 1 diabetes? catabolic metabolism
Which type of diabetes does metabolic ketoacidosis occur in? type 1
What can weight loss cause in type 2 diabetes? decrease free fatty acids, make target cells more sensitive to insulin
What test would you do to check for diabetes? fasting overnight glucose tolerance test
What is the difference in the plasma glucose in a diabetic human (type 1)? plasma glucose rises to higher level (>200mg/dL at 2 hr) and remains elevated longer
What type of insulin response is present in type 1 diabetes? no insulin response - no beta cells, so no insulin at all
What is fasting glucose level in type 1 diabetic individual? elevated >126 mg/dL
What happens to receptors in type 2 diabetes? down regulation
What insulin levels occur in anabolic metabolism? high
What senses a decrease in plasma glucose? pancreatic islet alpha cells
What do pancreatic islet alpha cells cause? increase in glucagon secretion
What does glucagon cause? increase in plasma glucagon
What does plasma glucagon cause in the liver? increased glycogenolysis, increase gluconeogensis, increased ketone synthesis
Created by: ges13



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