The Pancreas and Its Functions

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Questions and Answers

What is the location of the pancreas in humans?

Behind the kidneys
Behind the small intestine
Behind the stomach (correct)
Behind the liver

What type of gland is the pancreas?

Endocrine gland
Heterocrine gland (correct)
Exocrine gland
Mixed gland

What is the function of glucagon?

To stimulate insulin secretion
To reduce glucose levels in the blood
To regulate digestion
To elevate glucose levels in the blood (correct)

What is the role of somatostatin in the pancreas?

To inhibit the secretion of both insulin and glucagon (C) Signup and view all the answers

What is the effect of insulin on the blood glucose level?

It reduces glucose levels in the blood (B) Signup and view all the answers

What is the precursor molecule for insulin?

Proinsulin (C) Signup and view all the answers

What is the minimum random plasma glucose level required for diagnosing diabetes?

200 mg/dL (C) Signup and view all the answers

What is the primary function of glycosylated hemoglobin (HbA1C)?

To reflect the glycemic state during the preceding 3 months (D) Signup and view all the answers

What is the most common cause of death in diabetics?

Myocardial infarction (C) Signup and view all the answers

What is metabolic syndrome?

A combination of diabetes, high blood pressure, and obesity (B) Signup and view all the answers

What is the damage caused to the blood vessels in diabetic retinopathy?

Damage to the blood vessels in and around the retina (C) Signup and view all the answers

What is the result of hyperinsulinemia?

Maintaining normal glucose levels (B) Signup and view all the answers

What is the term for a combination of diabetic ketoacidosis and hyperglycemic non-ketotic coma?

Acute diabetic comas (A) Signup and view all the answers

What is the normal microalbumin level in a 24-hour period?

30-300mg (C) Signup and view all the answers

What is the primary consequence of insulin resistance?

Resistance of the target cells to respond to insulin (D) Signup and view all the answers

What is the percentage of diabetic patients that develop nephropathy?

20-30% (B) Signup and view all the answers

What is the result of atherosclerotic ischemia of the coronary arteries?

Myocardial infarction (B) Signup and view all the answers

What is the consequence of hyperglycemia-induced vascular complications?

Inflammation, thrombosis, and vasoconstriction (D) Signup and view all the answers

What is the role of glucokinase in the body?

It phosphorylates glucose in the first step of glycolysis (D) Signup and view all the answers

What is the primary cause of hyperglycemia in Type 2 diabetes mellitus?

Resistance of target tissues to insulin (B) Signup and view all the answers

Which of the following is a characteristic of Type 1 diabetes mellitus?

Characterized by autoimmune destruction of β-cells (B) Signup and view all the answers

What is the effect of increased metabolism on the ATP/ADP ratio?

It increases the ATP/ADP ratio (B) Signup and view all the answers

What is the percentage of diabetic population affected by Type 1 diabetes mellitus?

5-10% (D) Signup and view all the answers

What is the usual age of onset for Type 2 diabetes mellitus?

Usually after the age of 40 (A) Signup and view all the answers

What stimulates the secretion of insulin?

Parasympathetic M3 stimulation (A) Signup and view all the answers

What is the effect of glucagon on blood glucose level?

It elevates glucose level in the blood (A) Signup and view all the answers

How does insulin reduce glucose level in the blood?

By its anabolic action on liver, muscle, and adipose tissue (C) Signup and view all the answers

What is the function of GLUT2 in insulin action?

Uptake of glucose by facilitated transport (C) Signup and view all the answers

What is the effect of somatostatin on insulin and glucagon secretion?

It inhibits both insulin and glucagon secretion (B) Signup and view all the answers

What is the precursor molecule for mature insulin?

Proinsulin + C-peptide chain (C) Signup and view all the answers

What is a common feature of diabetic polyneuropathy?

Progression of symptoms from distal to proximal over time (D) Signup and view all the answers

What is a potential complication of diabetic polyneuropathy?

Diabetic foot ulcers (A) Signup and view all the answers

What is a characteristic of autonomic neuropathy in diabetes?

Gastroparesis (B) Signup and view all the answers

What is a risk factor for diabetic foot ulcers?

All of the above (D) Signup and view all the answers

What is a symptom of distal polyneuropathy?

Paresthesia (D) Signup and view all the answers

What is a consequence of abnormal cell-mediated immunity in diabetes?

Increased risk of infections (D) Signup and view all the answers

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Study Notes

The Pancreas

Location: abdomen behind the stomach
Functions as a gland
Mixed/heterocrine gland: both endocrine and digestive exocrine functions

Glucagon and Insulin

Glucagon (α cells of pancreas):
- Elevates glucose level in blood by promoting gluconeogenesis, glycogenolysis, and lipolysis
Insulin (β cells of pancreas):
- A protein hormone produced as Proinsulin + C-peptide chain → mature Insulin
- Reduces glucose level in blood by anabolic action on liver, muscle, and adipose tissue
- Secretion controlled by:
  - Glucose level
  - Autonomic stimulation (sympathetic α2 inhibit insulin secretion, parasympathetic M3 & sympathetic β2 stimulate)
  - Somatostatin hormone (inhibitory hormone)

Somatostatin

“Inhibitory peptide” (δ cells of pancreas)
Can act in a paracrine manner to inhibit secretion of both insulin & glucagon from nearby cells

Diabetes Complications

Macrovascular Complications:
- Atherosclerotic macrovascular disease
- Increased incidence of:
  - Hypertension
  - Angina
  - Myocardial infarction
  - Gangrene of the lower extremities
Microvascular Complications:
- Retinopathy
- Neuropathy
- Nephropathy
- Diabetic Retinopathy
  - Damage to blood vessels in and around the retina
  - Diabetes is the most common cause of blindness
- Diabetic Nephropathy:
  - 20-30% of patients with DM develop nephropathy
  - Membranes of glomerular capillaries are thickened and damaged
  - Macroalbuminuria (proteinuria)
  - Normal microalbumin level is 30-300mg/24 hours
- Diabetic Neuropathy
  - Pathophysiology of DM and metabolic syndrome

Diabetes Mellitus (DM)

Chronic metabolic disorder characterized by chronic hyperglycemia
Lack of insulin or insulin resistance
Type 1 DM (IDDM): autoimmune destruction of β cells; severe insulin deficiency
Type 2 DM (NIDDM): defect in insulin secretion, tissue resistance to insulin, obesity
Characteristics:
- Age of onset
- Pancreatic function
- Genetic component
- Signs and symptoms
- Treatment
Diagnostic Criteria:
- Symptoms of diabetes (3Ps: Polyuria, Polydipsia, Polyphagia) plus
- Laboratory Tests:
  - Random plasma glucose ≥ 200 mg/dL
  - Fasting Plasma Glucose (FPG)
  - Glycosylated hemoglobin (HbA1C)

Etiology and Progression of DM

Obesity
Impaired Insulin Secretion (exhausted β cells)
Insulin Resistance (high glucose and Insulin together)
Metabolic Syndrome (Syndrome X):
- Diabetes, high blood pressure, and obesity
- Increased risk of coronary heart disease, stroke, and other conditions affecting blood vessels

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