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 symos

Untreated hypoglycemia symptoms

• loss of consciousness

• seizures

• coma

• death

Haemoglobin A1C

• long-term blood sugar control

• average glucose lvls over 2-3 months

when is glucose tolerance test (GTT) used?

after sugary drink consumption

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….

• high insulin prod 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

• N/V

• fruity breath

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

• indadequate insulin prod

fasting blood sugar

usually fast after 12

Hyperosmolar Hyperglycemic State (HHS)

• T2DM

• BS greater than 34

• 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

• can’t feel warning signs of hypoglycaemia

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

• stimulates 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

• reg metabolism, immune resp, stress

Thalamus

• process sensory info

• connects hypothal

T4 (thyroxine)

• converted to T3

• important for metabolism

Hyperthyroidism

• overactive prod = excess T3 and T4

Hyperthyroidism

• weight loss

• sweating

• tremors

• high met

Myxedema Coma

severe hypothyroidism

Goiter

enlargement of thyroid gland

goiter

• enlarged thyroid

• hypothy

goiter cause

iodine deficience

thyroid dysfunc

Negative feedback loop

hormone regulate their own prod for homeostasis

Buffalo Hump

Target tissue

Hypothalamus

Adrenal gland

TSH

Hypothyroidism

Addison’s Disease

Cushing’s Syndrome

Hyperpituitarism

Hashimoto Thyroiditis cause worldwide and Canada

• Iodine worldwide

• Atrophy Canada

Cushing’s Disease