36 Questions
What is the location of the pancreas in humans?
Behind the stomach
What type of gland is the pancreas?
Heterocrine gland
What is the function of glucagon?
To elevate glucose levels in the blood
What is the role of somatostatin in the pancreas?
To inhibit the secretion of both insulin and glucagon
What is the effect of insulin on the blood glucose level?
It reduces glucose levels in the blood
What is the precursor molecule for insulin?
Proinsulin
What is the minimum random plasma glucose level required for diagnosing diabetes?
200 mg/dL
What is the primary function of glycosylated hemoglobin (HbA1C)?
To reflect the glycemic state during the preceding 3 months
What is the most common cause of death in diabetics?
Myocardial infarction
What is metabolic syndrome?
A combination of diabetes, high blood pressure, and obesity
What is the damage caused to the blood vessels in diabetic retinopathy?
Damage to the blood vessels in and around the retina
What is the result of hyperinsulinemia?
Maintaining normal glucose levels
What is the term for a combination of diabetic ketoacidosis and hyperglycemic non-ketotic coma?
Acute diabetic comas
What is the normal microalbumin level in a 24-hour period?
30-300mg
What is the primary consequence of insulin resistance?
Resistance of the target cells to respond to insulin
What is the percentage of diabetic patients that develop nephropathy?
20-30%
What is the result of atherosclerotic ischemia of the coronary arteries?
Myocardial infarction
What is the consequence of hyperglycemia-induced vascular complications?
Inflammation, thrombosis, and vasoconstriction
What is the role of glucokinase in the body?
It phosphorylates glucose in the first step of glycolysis
What is the primary cause of hyperglycemia in Type 2 diabetes mellitus?
Resistance of target tissues to insulin
Which of the following is a characteristic of Type 1 diabetes mellitus?
Characterized by autoimmune destruction of β-cells
What is the effect of increased metabolism on the ATP/ADP ratio?
It increases the ATP/ADP ratio
What is the percentage of diabetic population affected by Type 1 diabetes mellitus?
5-10%
What is the usual age of onset for Type 2 diabetes mellitus?
Usually after the age of 40
What stimulates the secretion of insulin?
Parasympathetic M3 stimulation
What is the effect of glucagon on blood glucose level?
It elevates glucose level in the blood
How does insulin reduce glucose level in the blood?
By its anabolic action on liver, muscle, and adipose tissue
What is the function of GLUT2 in insulin action?
Uptake of glucose by facilitated transport
What is the effect of somatostatin on insulin and glucagon secretion?
It inhibits both insulin and glucagon secretion
What is the precursor molecule for mature insulin?
Proinsulin + C-peptide chain
What is a common feature of diabetic polyneuropathy?
Progression of symptoms from distal to proximal over time
What is a potential complication of diabetic polyneuropathy?
Diabetic foot ulcers
What is a characteristic of autonomic neuropathy in diabetes?
Gastroparesis
What is a risk factor for diabetic foot ulcers?
All of the above
What is a symptom of distal polyneuropathy?
Paresthesia
What is a consequence of abnormal cell-mediated immunity in diabetes?
Increased risk of infections
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
Test your knowledge of the pancreas, its location, and its functions in the digestive and endocrine systems. Learn about the roles of glucagon and insulin in regulating blood sugar levels.
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