2500 Week 12 - Glucose Regulation

Diabetes Mellitus

• abnormal insulin prod, impaired insulin use, or both

• untreated = sustained hyperglycemia

Hypoglycemia

• tm insulin compared to available glucose

• activate ANS

• cause neurogenic symps

Untreated hypoglycemia symptoms

• LOC

• seizures

• coma

• death

Haemoglobin A1C

• long-term bs control

• average glucose lvls ov 2-3 months

when is glucose tolerance test (GTT) used?

after consuming sugary drink

Alpha cells

pancreas cells secrete glucagon

Glycogenolysis

glycogen break down to glucose

Neurogenic (clinical manifestations)

• ANS response to low BS

• tremors, sweating, palp, hunger, anxiety

Insulin resistance leads to….

• hyperinsulinemia and hyperglycaemia

• T2DM

Type I DM (T1DM)

• autoimmune

• destroys beta cells in pancreas

• needs insulin shots

Type I DM symptoms

• hyperglycemia

• glycosuria

• polydipsia

• polyuria

• polyphasic

• weight loss

• diabetic ketoacidosis (DKA)

insulin

• secreted by beta cells in pancreas

• responds to high BS

• promotoes cell glucose uptake

Diabetic ketoacidosis (DKA)

• severe insulin deficiency

• leads to ketone prod and acidic blood

DKA symps

• fruity breath

• ketonuria

ketosis

body burns fat instead of glucose

Beta cells

• pancreas cells

• secrete insulin

Gluconeogenesis

glucose forms fr non carb sources (aa, fats)

Neuroglycopenic (break down the word)

• brain dysfunc

• confused, blurred vision, slurred speech

Islets of Langerhans

clusters of pancreatic cells that regulate BS

Type II DM (T2DM)

• insulin not used

• insulin resistance/insufficient insulin prod

fasting blood sugar

usually fast after 12

Hyperosmolar Hyperglycemic State (HHS)

• T2DM

• BS greater than 34

HHS treatment

fluid replacement: 0.9 or 0.45 NS

Glucagon

• resp to low BS

• stim glucose release from liver (thats y serum glucose increase)

Hypoglycemic unawareness

autonomic neuropathy that interferes w secretion of counter-regulatory hormones

Cortisol

• stress hormone

• prod by adrenal cortex

• used in metabolism, immune resp

Pituitary

secrete TSH to regulate endocrine func

T3 (triiodothyronine)

more active than T4 and regulates metabolism

TRH (Thyrotropin-Releasing Hormone)

• from hypothal

• stim pituitary to release TSH

Thyroid storm

• severe hyperthyroid

• fever, tachycardia, HTN

Graves’ Disease

• immune sys attacks thyroid

Moon Face

round face bc of fat redistribution in Cushing’s Syndrome

Adrenal Insufficiency

cortisol/aldosterone deficiency

Thyroid hormones

• T3 and T4

Thalamus

• process sensory info

• connects hypothal

T4 (thyroxine)

• converted to T3

• important for metabolism

Hyperthyroidism s/s

• weight loss

• sweating

• tremors

• high met

Myxedema Coma

severe hypothyroidism

goiter

• enlarged thyroid

• hypothyroid

goiter cause

iodine deficience

thyroid dysfunc

Negative feedback loop

hormone regulate their own prod for homeostasis

Buffalo Hump

• fat deposit on upper back

• Cushing’s Syndrome

Hypothalamus

• controls pituitary gland

• regulates hormones via TRH

Adrenal gland

• on top of kidneys

• prod cortisol, aldosterone, adrenaline

TSH

• released by pituitary

Hypothyroidism

Addison’s Disease

Cushing’s Syndrome

Hyperpituitarism

Hashimoto Thyroiditis cause worldwide and Canada

• Iodine worldwide

• Atrophy Canada

Cushing’s Disease