Metabolic and endocrine control during special circumstances Flashcards
During the latter portion of pregnancy, processes become catabolic. Why?
Maternal insulin is dominated by anti-insulin hormones secreted by the placenta such as corticotrophin releasing hormones. This decreases the mother’s insulin sensitivity.
Why is it advantageous for the fetus for a catabolic phase of pregnancy?
It allows for greater substrate availability for fetal growth
What does the fetal placental unit consist of?
It consists of the placenta, fetal adrenal glands and the fetal liver
Give the names of the two important steroid hormones secreted by the fetal placental unit.
Oestriol and progesterone
What is the effect of the anti-insulin hormones secreted by the placenta?
They cause impaired glucose uptake in adipose and muscle tissue
Due to the increased appetite in pregnancy there is increased blood glucose levels. How do the B cells respond?
B cell hypertrophy and hyperplasia
What is the main cause of gestational diabetes?
B-cell dysfunction in the setting of obesity and chronic insulin resistance
What are the clinical implication of gestational diabetes? (4)
1) Increased chance of miscarriage 2) Increased chance of congenital malformation 3) Fetal macrosomia =large body 4) Shoulder dystocia= Shoulders stuck
What are the risk factors of gestational diabetes? (3)
- > 25years
- > 25kg/m^2
- History of diabetes or macrosmia
How do you manage gestational diabetes?
- Dietary modification (low caloric intake)
- Insulin for persistent hyperglycaemia
- Ultrasound to check on the baby
What pathway in the liver is used to recycle lactate?
The Cori cycle
Fatty acids are only used as fuel in ……. conditions
Aerobic
Increased AMP concentration causes decreased Glut 4 translocation in muscle tissue. True or false?
True
Which hormones increase over a marathon? (4)
Glucagon, adrenaline, GH and cortisol
How is energy used in exercise as time goes on?
1) ATP and creatine phosphate is used first 2) Anaerobic glycolysis and muscle glycogen are then used 3) Aerobic oxidation of muscle and liver glycogen and plasma glucose 4) Then FFA’s from adipose tissue is aerobically oxidised
