blood glucose Flashcards

(54 cards)

1
Q

how does the pancreas deal with a hyper

A
  1. pancreas produces and secretes insulin
  2. glucose moves from liver into cells
  3. liver and muscle cells convert glucose to glycogen
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2
Q

how does the pancreas deal with a hypo

A
  1. pancreas produces and secretes glucagon
  2. glucose moved from blood into liver
  3. liver and muscle cells convert glycogen to glucose
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3
Q

what is glucose needed for in the body

A
  • energy for basic functions
  • neurones rely only on glucose so need for nervous system function
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4
Q

which organs are involved in glucose regulation

A
  • pancreas
  • liver
  • adrenal gland
  • thyroid gland
  • anterior pituitary gland
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5
Q

which pancreatic cells are needed in glucose regulation

A
  • alpha = glucagon
  • beta = insulin
  • delta = somatosatin
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6
Q

what is the function of insulin

A
  • decreases blood glucose through GLUT4
  • increased expression of glycogen synthase
  • inactivation of phosphorylase, decreasing gluconeogenesis
  • decrease expression of rate-limiting enzymes
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7
Q

what is the function of somatostatin

A
  • decrease blood glucose by supressing glucagon release
  • suppresses gastrin and pituitary tropic hormones
  • decreases insulin release
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8
Q

which hormones are involved in insluin regulation

A
  • insulin
  • somatostatin
  • glucagon
  • cortisol
  • adrenaline
  • thyroxine
  • growth hormone
  • adrenocorticotropic hormone
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9
Q

what does glucagon do

A

increase blood glucose through increased glycogenolysis and gluconeogenesis

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10
Q

what does cortisol do

A

increase blood glucose levels via stimulation of glucogenesis by antagonism of insulin

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11
Q

what does adrenaline do

A
  • increase glucose by glycogenolysis
  • increase fatty acids from adipose tissue
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12
Q

what does thyroxine do

A

increase glucose through glycogenolysis and increase absorption in the intestine

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13
Q

what does growth hormone do

A
  • promotes gluconeogenesis
  • inhibits liver uptake
  • stimulates thyroid
  • inhibits insulin
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14
Q

what does adrenocorticotropic hormone do

A
  • stimulates cortisol release
  • stimulate fatty acid release
  • feeds into gluconeogenesis
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15
Q

how is insulin regulated in beta cells

A
  • GLUT2 cells transport glucose and glucokinase
  • convert glucose into glucose-6-phosphate
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16
Q

what is glycolosis

A

the conversion of glucose to pyruvate creating free ATP

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17
Q

how is insulin move out of beta cells

A
  1. negative feedback on ATP sensitive K channels close
  2. Ca in through voltage gated channel
  3. activates calcium-calmodulin dependent protein kinase
  4. insulin secreted through exocytosis
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18
Q

what inhibits insulin release

A
  • adrenaline
  • galanin
  • somatostatin
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19
Q

what stimulates insulin release

A
  • acetylcholine
  • bombesin
  • glucagon like peptide 1
  • glucagon
  • cholecystokinin
  • glucose dependent insulinotropic peptide
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20
Q

why are KATP channels open in low metabolism

A
  • low ATP and elevated MgADP
  • activity generates hyperpolarised membrane potential preventing electrical activity
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21
Q

what does insulin uptake promote

A
  • increased glucose uptake
  • increased glycogen storage
  • promotes protein production
  • promotes glycolysis
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22
Q

how does glucose enter into cells

A

through insulin activation of the GLUT 4 receptors

23
Q

how does insulin affect glucose metabolism in the muscle and adipose

A
  • increase glucose uptake
  • increase glycogen synthesis
  • inhibits glycogen breakdown
24
Q

how does insulin affect glucose metabolism in the liver

A
  • increases glycogen formation
  • inhibits glycogen breakdown
  • inhibits gluconeogenesis
25
how does insulin affect protein metabolism in the muscle and adipose
- increase amino acid uptake - promotes protein synthesis - inhibits degradation
26
how does insulin affect protein metabolism in the liver
- inhibits breakdown of amino acids - decreases urea formation
27
how does insulin affect fat metabolism in adipose
- increased storage of triglycerides - increased storage of fatty acids
28
how does insulin affect fat metabolism in the liver
- inhibits breakdown of fatty acids to ketones
29
what happens in the liver when there is high blood glucose
- increase glycogen storage - decrease gluconeogenesis - decrease glycogenolysis
30
what happens in the liver when there is a low blood glucose
- increase glycogenolysis - increase gluconeogenesis - decrease glycogen storage
31
what is glycogenolysis
glycogen to glucose
32
when is gluconeogenesis
amino acids, waste products and fats into glucose
33
what is ketosis
alternative fuel source by converting fast in starvation state
34
what are the different types of ketones
- acetoacetate - beta hydroxybutyrate - acetone
35
how is ketone formed
free fatty acids undergo hydrolysis to Acetly CO converted into acetoacetate and other ketone bodies
36
how is acetone formed
from the breakdown of the other ketone bodies
37
what is type I diabetes
- autoimmune reaction - destruction of B cell by cytotoxic T-lymphocytes
38
what are symptoms of type I diabetes
- thirsty - increased urination - tired - losing weight without trying - thrush - blurred vision - cuts and grazes not healing - fruity smelling breath
39
what is type II diabetes
- normal or raise insulin secretion - insulin receptor insensitivity - liver does not react to signals of insulin
40
what are the symptoms of type II diabetes
- peeing more - thirsty - tired - losing weight without trying - itching around penis or vagina - cuts take longer to heal - blurred vision
41
what are symptoms of hypoglycaemia
- sweating - tingling lips - shaking or trembling - dizziness - tiredness - palpitation - irritibility
42
what are hyperglycaemia symptoms
- increased thirst - dry mouth - frequent urination - tiredness - blurred vision - weight loss - recurrent infections
43
what is DKA
absence of insulin and maintained glucagon causes a release in fatty acids which are rapidly converted to ketones which build up
44
what are symptoms of DKA
- fast/ deep breathing - dry skin - flushed face - fruity breath - headache - stiffness - vomiting
45
what is hyperosmolar hyperglycaemic state
severe dehydration caused by the body trying to get rid of excess sugar
46
what are the symptoms of hyperosmolar hyperglycaemic state
- urination - thirst - nausea - dry skin - disorientation
47
what is hypovolemia
- reduction of fluid volume - changes to balance of electrolytes
48
what is grade 1 hypovolaemic shock
- 15% loss - normal BP, and resps
49
what is grade 2 hypovolaemic shock
- 15-30% loss - increase resps - normal bp narrowing pulse pressure
50
what is grade 3 hypovolaemic shock
- 30-40% loss - systolic falls to 100 - tachycardic and tachypnoea
51
what is grade 4 hypovolaemic shock
- 40% loss - tachy with weak pulse - significant decreased systolic
52
what occurs in gestational diabetes
- oestrogen, cortisol and human placental lactogen have blocking effect on insulin - 20-24 weeks pregnant
53
what is the target BM levels
- normal = 4-7 - diabetic = 4-9
54
how to manage diabetes
- focused history - oxygen if needed - take a BM - give oral glucose, IV glucose or IM glucagon