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Organisation of the Body

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Question
Answer
Regulation of blood glucose levels   show
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Anatomy of the pancreas   show
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Innervation   show
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show Clusters of 1000 endocrine cells 1 million islets in a human Different islet endocrine types; alpha (glucagon), beta (insulin), delta (somatostatin), PP-cells (pancreatic polypeptide) and epsilon (Ghrelin)  
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show Gene located on chromosome 11 Expressed as preproinsulin and processed to make mature insulin Cleavage of C-peptide occurs in the golgi Mature insulin stored in secretory vesicles - 8fg per granule 10000 granules per beta cell  
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show Increase in glucose moving in through GLUT1/2 Converted to ATP through oxidative metabolism ATP blocks potassium ATP channels Cell depolarises opening CVGGs Leads to exocytosis of vesicles  
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show Initial rapid rise in insulin conc following glucose consumption Continues to increase over the next 2 hours as glucose moves into cells  
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show Stimulated by increased blood glucose Inhibits release of glucose from the liver Promotes uptake of glucose into muscle and fat  
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show Increased blood glucose PSNS Amino acids Fatty acids Glucagon Gastrointestinal hormones SNS and Somatostatin inhibit  
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show Tyrosine kinase Dimerises on activation and auto phosphorylates Inserts GLUT4 into membrane Enzymes involved in metabolic pathways are activated or inactivated  
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show Carbohydrate metabolism - GLUT4, glycolysis, glycogenesis, inhibits gluconeogenesis and glycogenolysis Protein metabolism - stimulates AA uptake and protein synthesis Lipid metabolism - Stimulates lipogenesis and inhibits lioplysis  
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Action of insulin on K   show
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show GLUT1 - plasma membrane of all cells - glucose, galactose and mannose GLUT2 - intestine, kidney etc - glucose and fructose GLUT3 - everywhere - glucose GLUT4 - muscle - glucose GLUT5 - gut - fructose  
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show SGLT1 - intestine and kidneys = (2 NA for 1 glucose) SGLT2 kidney - (1 Na for 1 glucose)  
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Incretin hormones   show
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show Healthy - incretin hormones are responsible for glucose secretion Diseased - K atp channels responsible for glucose secretion GIP pathway not active in diabetics - explains why metformin has no effect on healthy cells  
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Release of incretin hormones   show
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show Inhibits glucagon secretion Stimulates insulin secretion Decreases appetite Inhibits gastric emptying  
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show Glucagon - pro-glucagon - GLP1 by prohormone convertase 1/3 secreted GLP1 - small peptides - amino acids by dipeptidyl peptidase IV  
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Alpha cells and glucagon   show
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show Decreased blood glucose SNS AAs GI hormones inhibited by somatostatin and insulin  
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Glucagon receptors   show
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show Inhibitory polypeptide found in brain, GI tract and islets Cleaved from prosomatostatin - 14aas in brain and 28 aa in islets Pancreatic inhibitor of insulin and glucagon secretion - brake on islet cell activity Inhibitory Gas GPCR  
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show Urine output increases Urine contains raised amounts of glucose Caused by lack of glucose Type 1 - lack of insulin Type 2 - resistance to insulin and collapsing b cell function More than one cause of type 2  
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show Normal fasting plasma glucose - 3.5-5.5 mM Considered hypoglycaemic if <4 mM Diagnosis of diabetes if > 7 mM Normal individuals clear glucose in 2 hours diabetic >11.1 mM after 2 hours  
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show Type 1 - immune destruction of B cells Neonatal - mutations in K atp channels Type 2 - impaired b cell function and defective insulin signalling in metabolic syndrome Gestational diabetes Maturity onset diabetes of young people - mutations in 6 genes  
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show Insulin dependent Immune destruction of beta cells Complete lack of insulin signals starvation increasing gluconeogenesis and glycolysis Ketogenesis is upregulated Peak incidence 12-14 Genetic and environment play a role  
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Type 2 diabetes   show
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show Gangrenous foot - poor blood and nerve supply Neuropathy in retina leading to blindness Kidney damage - primary cause of death Albumin detected in urine due to podocyte damage Results from glycosylation of proteins in high plasma glucose  
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Glycosylated haemoglobin   show
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Glycation   show
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