W14D2P3-altered metabolic states

psychological
environmental
physiological

what types of factors affect food (energy) intake

energy intake > energy expenditure

increase fat deposition in adipose tissue

increase leptin secretion by adipose tissue

increase plasma leptin concentration (increase BMR)

altered activity of integrating centers in the hypothalamus

decrease energy intake, increase metabolic rate

what happens when energy intake is greater than energy expenditure

decrease metabolic rate

in general, what happens when you decrease energy stores

need to provide glucose to body in large quantities without food

exercise state is similar to the fasted state... why

bc there is increased sympathetic input

why does insulin go down during the exercise state

internal glucose transporters

why does a drop in insulin not affect muscle glucose uptake

diabetes mellitus type 1

lack of insulin production (genetics)

diabetes mellitus type II, target, beta

-lack of insulin sensitivity at _____ cells
-lack of insulin secretion from ____ cells

1. decrease glucose uptake by cells, increase glycogenolysis, increase gluconeogenesis so increase plasma glucose

2. increase lipolysis, increase plasma free fatty acids, increase ketone synthesis, increase plasma ketones, increase plasma H+

increase renal filtration of glucose and ketones

osmotic diuresis

increase Na+ and water excretion

decrease plasma volume

decrease arterial BP

decrease blood flow to brain

impaired brain function, coma, death

explain what happens when there is an insulin deficiency

diabetic ketoacidosis

most often occurs with untreated type I diabetes

increase glucose in filtrate disrupts osmotic gradient

How does diabetic ketoacidosis affect renal function

decrease insulin = increase triglyceride breakdown

leads to large quantities of acidic ketones

How does diabetic ketoacidosis affect pH balancing