Lecture 1/31

Cards (58)

  • Everything except lipids are shuttled to the liver
  • glucose is either used for energy or converted to glycogen
  • glucose's energy uses include
    • being used by cells
    • conversion to cholesterol or triglycerides
  • the goal of glucose regulation is to keep plasma glucose at regular levels
  • glands for glucose regulation release either hypoglycemic or hyperglycemic agents
  • hypoglycemic agents lower blood glucose levels
  • hyperglycemic agents increase glucose levels when it gets low
  • islets of langerhans are clusters of 3 cell types: alpha, beta, delta
  • glucagon - most antagonist hormone to insulin
  • glucose cannot be obtained from lipiids
  • epinephrine is released in response to stress
    • part of sympathetic nervous system, or "flight or flight" response
  • the sympathetic and parasympathetic nervous system is controlled by the vagus nerve
  • epinephrine gets as much sugar to the skeletal muscles as possible in as little time as possible
  • cortisol increases liver glycogenesis
  • cortisol is also called the stress hormone
    secreted during stress, not flight or fight
  • diabetes resulting from hyperthyroidism or being extremely stressed is called secondary diabetes melitus
  • cortisol suppresses the immune system
  • diabetes insipidus - lack of ADH causes reabsorption of water in kidneys
  • hyperglycemia
    • excess glucose in plasma
    • caused by imbalance of regulatory hormones
    • diabetes mellitus is defined as consistent hyperglycemia
  • diabetes means opens faucet, refers to polyuria
  • mellitus refers to the sweet, honey like taste in the urine of diabetic patients
  • hypoglycemia
    • low plasma glucose levels
    • sometimes transient (until hyperglycemic agents kick in), sometimes permanent
    • can be wide ranging
  • see decrease in mental cognition at glucose levels ~50 mg/dl
  • Of the disease states involving blood sugar, hypoglycemia is a more urgent matter, as is can cause the central nervous system to shut down
  • chronic hyperglycemia has more long term effects
  • type 1 diabetes is insuline dependent diabetes melitus
  • type 1 diabetes is called juvenile diabetes since most patients are diagnoses as children or teens
  • the incidence of type 1 diabetes is lower than type ii
  • type type 1 diabetes defining characteristic is the lack of insulin secretion
  • type 1 diabetes is an autoimmune disease
  • the antibodies destroying the beta cells are cross- reactive, may have originally been created against antigen similar to beta cells
  • type 1 Diabetes
    • genetics - is family related, exact gene unknown
    • onset - sudden, acute; often when younger
    • signs and symptoms
    • 3 "polys" - polyuria, polydypsia, polyphagia
    • progression - see rapid weight loss; if glucose low enough, exhibit mental confusion
    • it not resolved, patient can go into a coma and die
  • resolution of type 1 diabetes
    endocrinologist gives insulin, proper diet, consistent glucose testing; once insulin levels satisfactory, prescribed insulin and given direction to follow
  • polyuria - pee alot
  • polydypsia - constant thirs
  • polyphagia - constant hunger
  • type 1 diabetes
    • long term complications
    • nephropathy - kidney disease
    • protein (albumin smallest protein) seeps into urine because glomerular pores become bigger
  • type 1
    • in beginning stages, the dipstick is not sensitive enough to pick up protein
    • more sensitive test called microalbumin is one of the earliest indicators of renal disease in diabetes
  • neuropathy - irritation of sensory peripheral nerves
    • patient feels constant pain of the extremeties
  • retinopathy - vasculature in retina of eye is affected