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How does the body use fuel in fasting/starvation?
Insulin drops → glycogen breakdown and gluconeogenesis both begin rising in parallel from the start
Glycogen depletes within 12–24 hours; gluconeogenesis takes over progressively, using amino acids (muscle) and glycerol (fat)
Lipolysis also begins rising within the first few hours as falling insulin relieves suppression of hormone-sensitive lipase
By days 2–3, ketone production is high enough to partially substitute for glucose in the brain → reduces (but never eliminates) demand on gluconeogenesis
Metabolic rate declines gradually throughout — not a discrete step — driven by falling thyroid hormone activity
All processes overlap and run concurrently; no single process fully stops before the next begins
Compare what happens to albumin in a patient undergoing starvation-related malnutrition and disease-related malnutrition, and why?
Albumin will stay around the same for a long time in a starvation-related malnutrition patient, while someone with a disease will have decreased albumin. This is because inflammatory cytokines(IL 1, 6, TNF-alpha) inhibits albumin synthesis to create other disease fighting proteins, while leaky vessels due to inflammation will also allow more albumin leak
What are acute phase reactants, and when are they secreted?
When there is detection of tissue damage or infection, proteins produced by the liver will go up or down(acute phase reactants), with some going up(positive) and some going down(negative), in order to redirect resources to deal with threats
What is one positive acute phase reactant and one negative acute phase reactant?
Positive: C reactive protein
Negative: Albumin
Who secretes insulin?
Beta cells in the islets of langerhans
Is insulin a catabolic or anabolic hormone?
Anabolic
What triggers insulin resistance, and why?
Inflammation: inflammatory cytokines like TNF-alpha interfere with insulin signaling pathway
How can insulin resistance impact lean body mass recovery in a patient w starvation vs disease related malnutrition?
Patients w/o insulin resistance can still recover fully due to insulins anabolic state promotion, while insulin resistance will obviously make that much more difficult despite refeeding