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What effect will insulin (normal vs. deficiency) have on cellular events -- protein synthesis, fat synthesis, and glycogen storage?
(p.12-13)
- INSULIN (normal) -->
- - synthesis of protein in muscle and other tissue
- - storage of fat as TG in adipose tissue
- - storage of CHO as glycogen in muscle and liver
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Pathogenesis of Type 1 diabetes.
(p.21)
- autoimmunity
- B-cell destruction
- absolute insulin deficiency
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Pathogenesis of Type 2 diabetes.
- insulin resistance (skeletal muscle, adipose tissue, liver)
- relative insulin deficiency
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Etiology of Type 1 diabetes
- B-cell depletion
- marked atrophy and fibrosis
- glucose approximately 600 (DKA)
- plasma osmolality approximately 320
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Etiology of Type 2 diabetes
- mild B-cell depletion
- focal atrophy
- amyloid deposits
- glucose approximately 900-100 (NKH)
- plasma osmolality approximately 400
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What effect would DKA have on intracellular K+ levels and why?
(p.16)
- HYPERkalemia often occurs with DKA initially
- masks true state of K+
- decreased insulin --> decreased K+ entry into cells --> deficiency of intracellular K+
- hypertonic extracellular fluids (high glucose and excess ketones) --> osmotic diuresis --> profound total K+ depletion
- with treatment, hyperkalemia falls predictably
- result = HYPOkalemia due to correction of acidosis (K+ moves back into cells)
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Insulin vs. glucagon
- opposing regulator effects on glucose homeostasis
- during fasting, low insulin and high glucagon facilitates hepatic gluconeogenesis and glycogenolysis
- decreases glycogen synthesis
- prevention of hypoglycemia
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Effect of insulin vs. glycogen on glycogenolysis
- low insulin
- high glucagon
- increases blood glucose
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Effect of insulin vs. glycogen on gluconeogenesis
glucagon increases the rate of amino acids to glucose
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Effect of insulin vs. glycogen on protein synthesis
- insulin necessary for protein synthesis
- insulin accelerates transport of some amino acids into cells --> could be stimulus for protein synthesis
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Effect of insulin vs. glycogen on ketogenesis
conversion of amino acids to ketoacids
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Effect of insulin vs. glycogen on lipolysis
- absence of insulin
- free fatty acid concentration in plasma begins to rise
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Effect of insulin vs. glycogen on lipogenesis
insulin promotes fatty acid synthesis
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