Term
| The islets of Langerhans in the pancreas has outer shell of ___ cells that release ___, and inner shell of ___ cells that release ___. Blood supply comes through the middle and leaves through periphery. |
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Definition
- alpha cells> glucagon
- beta cells> insulin |
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Term
| Insulin has a and b chains, and gets cleaved at the 30 and 31 to release the __ __. High levels of this peptide may be indicative of an insulin producing tumor. |
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Definition
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Term
| Insulin gets cleaved at 30 and 31 amino acids b/c there are ___ amino acids at this cleavage point. |
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Definition
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Term
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Definition
- concentration dependent (50-300 mg/dl)
- biphasic
- amino acids (arginine)
- autonomic |
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Term
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Definition
- on liver, kidneys, hypothalmus
- INDPENDENT of insulin
- Dependent on glucose concentration in extracellular space |
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Term
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Definition
- DEPENDENT on insulin
- on skeletal and fat tissue where action of insulin is important |
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Term
| glucose enters pancreatic beta cell via GLUT 2 transporter> glycolysis> ATP > closes potassium channels> potassium stays inside cell> depolarization> opens voltage gated calcium channels> calcium helps vesicular transport of insulin to cell surface so it can diffuse into fenestrated capillaries |
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Definition
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Term
| ____ inhibit K+ channels. What does this do? |
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Definition
- Slufonureas (glyberide)
- By inhibiting the K+ channels, more calcium comes in through voltage gated calcium channels and more insulin is transporter to circulation |
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Term
| Drug helpful for person not making enough insulin? |
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Definition
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Term
| From ___ -___ mg/dl of glucose, insulin release increases. Max insulin release is between 275 and 300 mg/dl, then it levels off. And below 50 you dont releae much insulin, b/c just use that glucose for the brain. |
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Definition
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Term
| Insulin release is biphasic, explain: |
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Definition
- early insulin spike right when glucose raises, spike comes down within 10 minutes
- then slowly rises again for next hour |
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Term
| The spike was already made insulin just sitting in the capillaries ready to go out. The gradual rise is newly synthesized insulin. |
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Definition
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Term
| How is the biphasic insulin response changed in Type II Diabetics? |
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Definition
- early spike is gone
- they have a constant stimulus for insulin production, so always on far right of curve |
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Term
| amino acids can enter into glycolysis or TCA to make energy (arginine) |
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Definition
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Term
| Why do you get a higher insulin release when glucose is given po instead of intravenously? |
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Definition
| - glucose interacts with GI tract to stimulate the release of incretins (GLP-1)> go to pancreas and assist glucose in stimulating release of insulin |
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Term
| Incretins are broken down quickly by ____. So you can prolong life of incretins by administering ____ ___, which can improve insulin secretion in response to glucose. Chances of having a hypoglycemic attack are lower with this drug. |
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Definition
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Term
| GLP-1, which is an ___, increases ___ in the pancreatic beta cell, which makes more voltage calcium channels open upon deopolarization, so more insulin is secreted. |
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Definition
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Term
| Simultaneous Parasympathetics and Sympathetics innervation will have a net affect of ___ insulin release, even though parasympathetics stimulate release. |
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Definition
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Term
| Vagus nerve increases ____ insulin release, but sympathetic will trump it and ___ release. |
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Definition
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Term
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Definition
- anabolism
- glucose transport into muscle and fatty tissues
- glucose utilization
- glycogen, fat, and protein synthesis
- amino acid transport
- fatty acid transport
- potassium transport |
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Term
| High blood glucose without insulin will damage what? |
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Definition
- insulin independent tissues like kidneys, eyes, RBCs, nerves
- since these tissues are independent of insulin, they still get flooded with glucose in the absence of insulin
- muscle and fat tissues won't really be damaged b/c without insulin, sugar isn't entering these tissues |
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Term
| insulin binding to its receptor causes an upregulation of glucose transpoters to the surface of the cell. |
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Definition
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Term
| Insulin's effects on adipose and muscle tissues: |
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Definition
- increases GLUT-4 receptors except on working muscle
- increases glycogen and protein synthesis in muscle
- increases lipogenesis and inhibits lipolysis
- In the liver increases glycogen synthesis and glucokinase, while inhibiting release of fatty acids |
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Term
| Just a little bit of insulin will result in ____ of release of fatty acids from the liver. This is important for people with __ ___ Diabetes b/c this causes ___. |
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Definition
- inhibit
- Type I Diabetes
- ketoacidosis |
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Term
| Insulin independent tissues, aka tissues that do not need insulin to access glucose: |
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Definition
- nervous system
- red blood cells
- renal medulla
- retina
- germinal epithelium |
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Term
| To measure management of Diabetes, what should you measure? |
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Definition
| - glucose attached to Hb aka HbA1c. |
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Term
| Major hormone to prevent hypoglycemia? |
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Definition
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Term
| Triggers for glucagon release? |
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Definition
- falling blood glucose
- rising amino acids
- autonomics |
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Term
| Factor that causes both insulin and glucagon to increase? Explain. |
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Definition
- rising amino acids
- drink protein shake> insulin goes up, but not CHOs in it> glucose levels go down> glucagon released |
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Term
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Definition
- inhibits insulin release
- stimulates glucagon release |
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Term
| Insulin from pancreatic beta cells, acts on alpha receptors, which ___ more insulin secretion, and on beta receptors, which ___ insulin secretion. The ___ receptor wins and secretion is ____. |
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Definition
- inhibit
- stimulate
- alpha
- inhibited |
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Term
| Glucagon from the pancreatic alpha cells acts on alpha receptors which ___ further glucagon secretion and on beta receptors which ___ further glucagon secretion. The ___ receptor wins and glucagon secretion is ___. |
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Definition
- inhibit
- stimulate
- beta
- stimulated |
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Term
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Definition
- glycogenolysis
- gluconeogenesis
- hormone sensitive lipase
- insulin
- positive inotropic effect on heart |
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Term
| role of hormone sensitive lipase: |
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Definition
| spares glucose for brain by supplying fat for fuel for rest of body |
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Term
| So glucagon stimulates insulin and insulin stimulates glucagon, but not sure how. |
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Definition
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Term
| glucagon increases positive inotropic effects on heart. Explain. |
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Definition
| - increased force and speed of heart contractions> increases contractility |
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Term
| During stress, your body wants to ___ ___ ___ so you have ___ insulin, and high ___. |
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Definition
- make fuel available
- low insulin
- high glucagon |
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Term
| A meal of CHOs will cause: |
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Definition
- insulin to increase
- glucagon to decrease |
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Term
| A meal of protein will cause: |
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Definition
- insulin and glucagon to increase
- glucagon protects you from hypoglycemia |
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Term
| Mixed meal of CHOs and protein will cause: |
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Definition
- increased insulin
- CHO tries to decrease glucagon and protein tries to bring it up, so glucagon doesn't change |
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Term
| Diabetes Mellitus causes: |
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Definition
- hyperglycemia
- polydypsia
- polyuria
- ketoacidosis and loss of K+ |
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Term
| diabetes and hyperosmolar coma: |
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Definition
| - happens in nursing home when pt doesn't drink enough> dehydrated and osmolarity gets high |
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Term
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Definition
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