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35 Cards in this Set
- Front
- Back
What is Diabetes?
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A disturbance in the carbohydrate homeostasis regulated by the opposing actions of INSULIN and GLUCAGON
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Diabetes definition again?
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a state of CHRONIC HYPERGLYCEMIA due to deficiency of INSULIN or a combination of inuslin receptor abnormalities and inadequate insulin secretion to compensate.
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What else with Diabetes?
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-Accompanying disturbances in carbohydrate, fat and protein metabolism.
-80-90% of pancreatic Beta cells dysfxn is present even with early diagnosis of DM-1 |
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Pancreas?
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-Both an endocrine and exocrine gland
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Islets of Langerhans?
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-Insulin
-Glucagon |
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What are the 3 types of HORMONE secreting cells?
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-Alpha cells = Glucagon
-Beta cells= Insulin -Delta cells= Gastrin/Somatostatin |
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What cells secrete Glucagon?
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Alpha cells
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What cells secrete Insulin?
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Beta cells
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What cells secrete Gastrin/Somatostatin?
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Delta cells
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Acinar cells?
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-Amylase
-Lipase |
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What kind of lipase and amalyse levels does a diabetic usually have?
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Normal levels
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Beta cells?
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-Pro-insulin into inuslin via proteolytic enzymes.
-C-peptide is the catalyst that breaks the disufic bonds see notes ask* |
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Regulation on Insulin?
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Chemcal:
-Insulin (neg feedback) -Glucose (hyper and hypoglycemia) -Amino and fatty acids -Glucagon Para/sympathetic stim Hormones: Proarglandins |
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Insulin enhances?
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Glucose uptake
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Without Insulin=
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-no glucose=no ATP!
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GLUT 4?
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Transporter
Glut 4 is transported outside the cell membrane where it connects and transports glucose into the cells of -Skeletal muscle -Cardiac muscle -Liver -Adipose tissue *Facilitates intracellualr transport of K+ |
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4 muscles that util. Glucose?
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-Sk Muscle
-Cardiac muscle -Liver -Adipose tissue |
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Insulin is a Anabolic Hormone, what the hell does that mean?
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Anabolic=Builder
-Stimulates cellular metabolism using glucose as fuel -SYNTHESIS in liver, muscle, and adipose of: -Protein -Carbs -Lipids -Nucleic Acids |
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Where does Insulin metabolism occur?
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-Liver and Kindey (enzymatic catabolism of disulfide bonds)
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Glucogenisis?
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Glucose---Glycogen
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Glycolysis?
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Glycogen---simple sugars
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Sites of Insulin Activity?
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-Liver
-Muscle -Adipose tissue |
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Insulin metabolism?
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-increases cell metabolism
-Decreases overall blood glucose -facilitates intracellular transport of K+ |
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Glucagon?
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-Inverse relationship with Insulin
-Prod in pancreatic alpha cells -Secretion inhib by high glucose/stim by low glucose. -Secretion stim by high protein diet |
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Glucagon in the liver?
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-Stim glucoeogenesis and glycogenolysis
-Antagonizes Insulin -Stim Lipolysis with ketogenic effect |
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Which is best to treat hypoglycemic state?
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Glucagon
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Pancreatic Somatostatin and Carbohydrate Metabolism?
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-Metabolizes fat, protein, carbs
(homeostasis of ingested nutrients) -Regulates Pancreatic A and B fxn -Inhibits insulin and glucagon secretion -Prevents excess secretion of inuslin |
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How many in US have diabetes?
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-18.2 in US
-5-10%= Type 2 -90-95%=Type I |
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What group is most suscept to Type I?
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AA
Hispanics Pima Indians |
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What is DM I?
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-Pancreatic Islet Beta cell autoimmune destruction
-pts are Insulin dependant -Pts are prone to Ketoacidosis -Usu under 30yo at time of dx -Peak indicence at school age and adolescence -Highest incidence in Northern Europe and in the US |
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Bascially DM I?
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-Beta cell failure
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What is the most common DM?
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DM Type II!
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DM II?
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-Most common type
-Due to insulin resistance and lack of insulin secreation compensation -pts may require Insulin -HTN, Hyperlipidemia, atherosclerosis are usu. present or at hight risk to develop. Pts usu. greater than 40 yo |
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Insulin Resistance Syndrome?
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AKA Syndrome X/Metabolic syndrome
-Hyperglycemia -Hyperinsulinemia -Dyslipidemia -HTN -Increased CAD, MI, PVD, Stroke *25% of the general non obese pop. have insulin resist. |
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MODY?
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Maturity Onset Diabetes of the Young
-Rare form of NIDDM -six types -Genetic mutation of Beta cells -Non-obese |