Week 2 - Glucose Regulation

Question 1

define glucose regulation

Answer 1

• process of maintaining OPTIMAL blood glucose levels

Question 2

what 3 main factors interact to maintain glucose regulation?

Answer 2

1. caloric intake (ie. food)
2. hormones
3. glucose uptake (by the cells for energy)

Question 3

list 3 examples of hormones that play a role in glucose regulation

Answer 3

1. insulin
2. cortisol
3. glucagon

Question 4

what is euglycemia? what is the value?

Answer 4

• normal conc of glucose in the blood

- 4-7 mmol/L

Question 5

describe normal glucose homeostasis; what happens when we eat to maintain our BG

Answer 5

• we eat & carbs are broken down into simple sugars called glucose which is absorbed into the blood
• elevations in blood glucose stimulate pancreatic cells to secrete insulin
• insulin allows glucose to enter the cell –> BG goes back down

Question 6

what are 2 ways glucose can be used after insulin release?

Answer 6

1. for energy by cells (ATP)

2. stored in the liver and fat cells as glycogen

Question 7

what is stored glucose called?

Answer 7

• glycogen

Question 8

what is glucagon

Answer 8

• hormone released when BG is too low

Question 9

what does the release of glucagon cause?

Answer 9

• stimulates the liver to breakdown glycogen to glucose (glycogenlysis) = increased BG

Question 10

what is glycogenolysis

Answer 10

• process by which glycogen is converted to glucose

Question 11

what is the function of insulin? when is it released?

Answer 11

• released when we have high BG

- responsible for the transport of glucose from the blood into the cells

Question 12

what happens if aspects of glucose metabolism malfunction or stop working?

Answer 12

• get hyperglycemia or hypoglycemia

Question 13

what value is considered hyperglycemia

Answer 13

at or above 11mmol/L

Question 14

what are the 3 main biomechanical causes of hyperglycemia

Answer 14

1. insufficient insulin production or secretion from the pancreas
2. insulin resistance
3. excess counter regulatory hormone secretion

Question 15

what can cause insufficient insulin production/secretion?

Answer 15

• damage to the pancreatic beta cells

ex. autoimmune disfunction, from injury or cancer

Question 16

what is insulin resistance? what does this cause?

Answer 16

• the body cells are not responding to insulin
  = body cannot use glucose for energy
  = BG continues to rise

Question 17

what are counter regulatory hormones

Answer 17

• hormones that work opposite of insulin

- hormones that work to increase BG

Question 18

what are examples of counter regulatory hormones?

Answer 18

• glucagon
• cortisol
• epi
• growth hormone

Question 19

what value is considered hypoglycemia

Answer 19

• <4 mmol/L

Question 20

what are 3 causes of hypoglycemia

Answer 20

1. insufficient nutrient intake
2. adverse rxn to meds
3. too much exercise

Question 21

what are 2 examples of adverse rxn to meds that can cause hypoglycemia

Answer 21

• exogenous insulin –> ex. too much insulin = too much uptake
• oral antihypoglycemics

Question 22

how can too much exercise cause hypoglycemia including both during exercise & post exercise

Answer 22

• work of muscle contraction requires energy which is derived from glucose stored in muscle cells as glycogen
• as exercise continues, glycogen is deplted & we start to use glucose from the circulation & liver for energy = lowered BG
• during post exercise, our body tries to restore our glycogen levels by converting glucose from the circulation = lowers BG even more

Question 23

why is insulin so important (2)

Answer 23

1. insulin is the key that unlocks glucose’s potential in the tissues
2. some cell need insulin to utilize the glucose as fuel ex. the brain which requires a constant stream of glucose

Question 24

how does hyperglycemia related to inflammation

Answer 24

• hyperglycemia is a pro-inflammatory phase (=can cause inflammation)

Question 25

what are the long term consequences of hyperglycemia (5)

Answer 25

1. blood vessel damage (angiopathy, both macro & micro) 2. neuropathy 3. fluid & electrolyte imbalances (dehydration) 4. acid-base disturbances (DKA) 5. insulin resistance

Question 26

why does peripheral neuropathy occur with hyperglycemia

Answer 26

- elevated blood glucose has a toxic effect on nerves

Question 27

how does hyperglycemia cause fluid & electrolyte imbalances + dehydration?

Answer 27

- high blood glucose causes osmotic diuresis = fluid pulled intro intravascular space & is peed out = dehydration & imbalances

Question 28

what are the consequences of insulin resistance (6)

Answer 28

- atherogenesis - plaque formation - increase CA risk - HTN - NASH - sleep apnea

Question 29

what causes the consequences of insulin resistance?

Answer 29

- both hyperglycemia & insulin resistance are toxic & proinflammatory states

Question 30

what are the longer term consequences of hypoglycemia (4)

Answer 30

- seizures - loss of consciousness - death - hypoglycemia unawareness syndrome

Question 31

why do many of the consequences of hypoglycemia effect the CNS system?

Answer 31

- bc the brain requires a constant stream of glucose

Question 32

what is hypoglycemia unawareness syndrome

Answer 32

- results from a frequent hypoglycemic state | - results in desensitivity to hypoglycemia = does not get warning signs such as shaky, irritable, dizzy, etc.

Question 33

what is a consequence of hypoglycemia unawareness syndrome?

Answer 33

- lack of warning signs = may miss cue to act on the hypoglycemic episode

Question 34

how does adherence r/t glucose regulation?

Answer 34

- important for the regimen for blood glucose control | ex. insulin, self monitoring

Question 35

what are the symptoms of hyperglycemia (6)

Answer 35

- dry mouth - increased thirst - weakness - headache - blurred vision - frequent urination

Question 36

what are the symptoms of hypoglycemia (6)

Answer 36

- sleepiness - sweating - pallor - lack of coordination - irritability - hunger