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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
- 1. Insulin
- 2. Glucagon
- 3. Somatostatin
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?
- Increases glycogenolysis
- Stimulates gluconeogenesis
- 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
- Diabetic nephropathy
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
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