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Flashcards in Test 2 Deck (40):
1

Difference between Hormone Sensitive Lipase and Lipoprotein Lipase

Hormone sensitive lipase--intracellular, stimulated by low intracellular glucose/insulin, conducts the hydrolysis of stored intracellular triglycerides.

Lipoprotein lipase--located on the endothelial lining of the blood vessels, results in hydrolysis of triglycerides in lipoproteins resulting in the movement of triglycerides into cells.

2

How does pyruvate, oxaloacetate and acetyl-CoA all relate to ketoacidosis?

Pyruvate is the precursor of oxaloacetate which is the primer of the TCA or Kreb's cycle. When the TCA or Kreb's cycle is impaired, triglycerides are broken down to provide energy. This results in acetyl-CoA sythesis which results in ketone synthesis.

3

Fasting blood glucose levels

<100 mg/dL

4

Intolerance or pre-diabetic fasting blood glucose

100-126 gm/dL

5

Diabetic fasting blood glucose levels

>126 gm/dL

6

Fight/ flight hormones

cortisol
epinephrine

7

Hormones involved with storing energy

Insulin
glucagon

8

Insulin secretions

secreted by pancreas (beta-cells)
increases when fed
brings glucose into the cell
anabolic hormone

9

Glucagon secretions

released by pancreas (alpha-cells)
increases between meals
drives gluconeogenesis and glycogenolysis

10

Epinephrine

promotes glycogenolysis in muscle

11

Glucocorticoids

enhance gluconeogenesis

12

difference between type I and type II

I - no insulin
II - lots of insulin but it is not being accepted into the cells

13

What does insulin need to bind to in order to be accepted into a cell?

GLUT-4

14

macrophages and fat cells release

resistin

15

resistin causes

insulin resistance

16

hypertrophic cells genes

activated by fat

17

activated fat cells release...

adipokines, resistin, and adiponectin

18

adipokines attract

macrophages

19

macrophages release

TNF, IL, resistin

20

symptoms of metabolic syndrome

Hyperglycemia (fasting glucose 100+)
Abdominal obesity (waist men >40in women >35in)
Hypertriglyceridemia ( 150 mg/dL +)
Reduced HDL (men <40 mg/dL women <50 mg/dL)
Hypertension ( over 130/85 mmHg)
*only need 3*

21

metabolic syndrome effects on insulin action

-rapid triglyceride breakdown in blood increasing fatty acids
-adiponectin secretion decreased
-resistin increased
-elevated levels of c-reactive protein

22

adiponectin

improves insulin sensitivity

23

c-reactive protein

marker for inflammation

24

obesity and hypertension

-insulin resistance interferes with relaxation and dilation of blood vessels
-hyperinsulinemia promotes absorption of Na (less fluid retention and increase blood volume)

25

obesity and hypertriglyceridemia

-higher triglycerides, higher LDLs, and lower HDLs
-Adipose cells are less responsive and less able to store triglycerides
-higher production of VLDLs

26

consequences of metabolic syndrome

-damage to blood vessels
-blood clot formation promoted
-PF1 overproduced

27

Metabolic syndrome treatments -Diet

-reduce weight
-increase whole grains, fruits, veggies, and low fat milk
-reduce added sugar, refined grains, sodium, sat fat, trans fat, and cholesterol

28

Metabolic syndrome treatments -physical activity

minimum 30 mins a day
may improve blood lipids, hypertension, and insulin resistance
helps with weight management

29

Metabolic syndrome treatments -drug therapy

prescriptions to correct hypertriglycemia and hypertension
insulin resistance not routinely treated in non-diabetic patients

30

T or F: type 2 diabetes will go into a ketoacidotic coma

F

31

Symptoms of diabetes

increased urination
high glucose levels in urine
increased thirst
increased appetite

32

Can pregnant women fast?

No

33

Type 1 diabetes

early onset
autoimmune disease
destruction of pancreatic beta cells
always require insulin
5-10% of cases

34

Type 2 diabetes

later onset
aging obesity, ethnicity, and genetics influence
always have insulin resistance
insulin levels may be high or low
oral medications or insulin
90-95% of cases

35

Ketoacidosis

occurs with type 1
no insulin --> breakdown of triglycerides releasing fatty acids resulting in ketone bodies
leads to a diabetic coma

36

Hyperosmolar hyperglycemia state

evolves over days to weeks
usually in elderly, type 2
results in dehydration and e- imbalance
can cause hyperosmolar coma

37

hypoglycemia

overmedicating, inadequate intake, exercise
shakiness, confusion

38

AGEs

Advanced glycation end products
-cause damage to blood vessels (typically affect larger blood vessels)
-causes poor blood flow and damage to the eyes
-neuropathy
-skin disorders can develop

39

Chronic complications of diabetes

macrovascular complications (atherosclerosis)
microvascular complications (retinopathy, nephropathy)
nueropathy (gastroparesis
femoral artery commonly blocked

40

Diabetes treatment

blood glucose control
safe exercise
drug therapy
blood lipid monitoring