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What is the normal range of blood glucose?
60 - 160 mg/dL
What are the advantages to prolonged high glucogon/low insulin?
Increased use of ketones by brain (saves glucose)
Prolongs survival by sparing proteins as fuel for gluconeogenesis
Stress response of rise in glucagon
Increased glucose delivery to underperfused brain
What are the products of the following:
1. Beta cells
2. Alpha cells
3. Delta cells
What is the role of somatostatin?
Inhibits secretion of both insulin and glucagon
What is the role of insulin?
Stimulate glucose and amino acid uptake
Stimulate glycogen synthesis
Stimulates fatty acid synthesis
Stimulates protein synthesis
What is the role of glucagon?
Enhances ketoacid production
What are the 5 catabolic hormones?
How do cortisol and GH affect metabolism?
Adapt the body to sustained periods of limited food intake
Promote use of fat as energy source
Facilitate conversion of protein to hepatic glycogen
What is Diabetes Mellitus?
Relative or absolute deficiency of insulin
What causes gestational diabetes?
Sustained insulin antagonism by placental hormones
Insulin degradation by placenta
Types of spontaneous diabetes mellitus
Type I - insulin dependent (juvenile)
Type II - insulin independent (mature)
How does obesity cause Type II diabetes?
Obesity causes slight systemic inflammation
Leads to proinflammatory cytokine synthesis
Cytokines down regulate insulin receptors
Complications of diabetes mellitus
Glycation of proteins
Accumulation of sorbitol
Angiopathies (vascular lesions) - diabetic retinopathy, ischemic attacks
What is diabetic ketoacidosis?
Hyperglycemia and accumulation of ketoacids
Results from increased mobilizaion of lipid stores due to relatively high glucagon
Why do patients with diabetic ketoacidosis require fluid/Na replacement?
Increased blood glucose induces osmotic diuresis