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Questions and Answers
What is the location of the pancreas in humans?
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?
What type of gland is the pancreas?
- Endocrine gland
- Heterocrine gland (correct)
- Exocrine gland
- Mixed gland
What is the function of glucagon?
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?
What is the role of somatostatin in the pancreas?
What is the effect of insulin on the blood glucose level?
What is the effect of insulin on the blood glucose level?
What is the precursor molecule for insulin?
What is the precursor molecule for insulin?
What is the minimum random plasma glucose level required for diagnosing diabetes?
What is the minimum random plasma glucose level required for diagnosing diabetes?
What is the primary function of glycosylated hemoglobin (HbA1C)?
What is the primary function of glycosylated hemoglobin (HbA1C)?
What is the most common cause of death in diabetics?
What is the most common cause of death in diabetics?
What is metabolic syndrome?
What is metabolic syndrome?
What is the damage caused to the blood vessels in diabetic retinopathy?
What is the damage caused to the blood vessels in diabetic retinopathy?
What is the result of hyperinsulinemia?
What is the result of hyperinsulinemia?
What is the term for a combination of diabetic ketoacidosis and hyperglycemic non-ketotic coma?
What is the term for a combination of diabetic ketoacidosis and hyperglycemic non-ketotic coma?
What is the normal microalbumin level in a 24-hour period?
What is the normal microalbumin level in a 24-hour period?
What is the primary consequence of insulin resistance?
What is the primary consequence of insulin resistance?
What is the percentage of diabetic patients that develop nephropathy?
What is the percentage of diabetic patients that develop nephropathy?
What is the result of atherosclerotic ischemia of the coronary arteries?
What is the result of atherosclerotic ischemia of the coronary arteries?
What is the consequence of hyperglycemia-induced vascular complications?
What is the consequence of hyperglycemia-induced vascular complications?
What is the role of glucokinase in the body?
What is the role of glucokinase in the body?
What is the primary cause of hyperglycemia in Type 2 diabetes mellitus?
What is the primary cause of hyperglycemia in Type 2 diabetes mellitus?
Which of the following is a characteristic of Type 1 diabetes mellitus?
Which of the following is a characteristic of Type 1 diabetes mellitus?
What is the effect of increased metabolism on the ATP/ADP ratio?
What is the effect of increased metabolism on the ATP/ADP ratio?
What is the percentage of diabetic population affected by Type 1 diabetes mellitus?
What is the percentage of diabetic population affected by Type 1 diabetes mellitus?
What is the usual age of onset for Type 2 diabetes mellitus?
What is the usual age of onset for Type 2 diabetes mellitus?
What stimulates the secretion of insulin?
What stimulates the secretion of insulin?
What is the effect of glucagon on blood glucose level?
What is the effect of glucagon on blood glucose level?
How does insulin reduce glucose level in the blood?
How does insulin reduce glucose level in the blood?
What is the function of GLUT2 in insulin action?
What is the function of GLUT2 in insulin action?
What is the effect of somatostatin on insulin and glucagon secretion?
What is the effect of somatostatin on insulin and glucagon secretion?
What is the precursor molecule for mature insulin?
What is the precursor molecule for mature insulin?
What is a common feature of diabetic polyneuropathy?
What is a common feature of diabetic polyneuropathy?
What is a potential complication of diabetic polyneuropathy?
What is a potential complication of diabetic polyneuropathy?
What is a characteristic of autonomic neuropathy in diabetes?
What is a characteristic of autonomic neuropathy in diabetes?
What is a risk factor for diabetic foot ulcers?
What is a risk factor for diabetic foot ulcers?
What is a symptom of distal polyneuropathy?
What is a symptom of distal polyneuropathy?
What is a consequence of abnormal cell-mediated immunity in diabetes?
What is a consequence of abnormal cell-mediated immunity in diabetes?
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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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