Physiology Chapter 22 PDF

Physiology: Chapter 22 Part A Clip I started Juan J. Bustamante, Ph.D. Assistant Professor Pharmaceutical Science Phone (361) 221-0735 Email: [email protected] Office:...

Physiology: Chapter 22 Part A Clip I started Juan J. Bustamante, Ph.D. Assistant Professor Pharmaceutical Science Phone (361) 221-0735 Email: [email protected] Office: Room 223  Chapter Overview  Appetite and Satiety  Energy Balance  Metabolism  Homeostatic Control of Metabolism  Regulation of Body Temperature  Learning Objectives After completion of this topic the student should be able to 1.discuss energy balance and how the brain controls food intake 2.discuss metabolism and its relationship to biochemical pathway, dietary fats, fasted state  Learning Objectives 3. discuss homeostatic control of metabolism a. anatomy of the pancreas b. insulin and glucagon regulation and mechanism of action c. Type I and Type II Diabetes d. Metabolic syndrome 4. discuss the regulation of body temperature (i.e. thermoregulatory reflexes, environment). Brain Controls Food Intake  Hypothalamus  Feeding center  Satiety center S4 · sig Two Theories for Regulation of Food Intake  Glucostatic theory  Glucose metabolism by hypothalamic centers regulates food intake  Lipostatic theory I  Signals from fat stores to the brain modulate eating behavior E to maintain a particular weight  Leptin, neuropeptide Y, ghrelin, CCK, GLP-1, orexins YM ·i t hormone I Be F © 2013 Pearson Education, Inc.  Energy input = energy output  Metabolic rate  Age and gender  Amount of lean muscle mass  Activity level  Diet  Hormones  Genetics What is more important for losing weight? 1. Diet 2. Exercise 0% 0% 1. 2.  Gratuman hormone theone intestines& knocks down intake Copyright © 2010 Pearson Education, Inc.  : & Copyright © 2010 Pearson Education, Inc.  overproduce Most obese humans are deficient in leptin 1. True 2. False 0% 0% 1. 2. Copyright © 2010 Pearson Education, Inc.  Summary of metabolism Copyright © 2010 Pearson Education, Inc. Figure 22-2  The brain can use only __________ for energy. 1. glucose 2. FFA can use; 3. ketones > doesn't like - 4. lactate Copyright © 2010 Pearson Education, Inc.  Figure 22-2 Summary of metabolism Slide 2 DIET half Carbohydrates is stored in half liver muserguesother storage or Da Glycogenesis Glucose Fat Lipogenesis stores Excess glucose Glycogen stores Urine Glycogenolysis Glucose pool Range of normal plasma glucose Metabolism in Brain most tissues metabolism Copyright © 2010 Pearson Education, Inc.  Figure 22-2 Summary of metabolism Slide 3 DIET Fats 3 Free fatty acids + glycerol - Fat Lipogenesis stores Lipolysis , a &lipid Free fatty acid pool ↳ Metabolism in most tissues Excess nutrients Copyright © 2010 Pearson Education, Inc.  Figure 22-2 Summary of metabolism Slide 4 DIET Proteins can be broken Protein into down Amino synthesis acids glucose · - Body protein Glucose pool Gluconeogenesis Range of normal plasma glucose Amino acid pool Copyright © 2010 Pearson Education, Inc.  Figure 22-2 Summary of metabolism Slide 5 2 kinds of fat DIET Fats Carbohydrates Proteins Free fatty acids + glycerol Protein Glycogenesis Amino synthesis Glucose acids Fat Lipogenesis Lipogenesis stores Excess glucose Glycogen Body stores protein Lipolysis Urine Glycogenolysis Glucose pool Gluconeogenesis Free fatty Range of normal acid pool Amino acid plasma glucose pool Metabolism in Brain most tissues Excess nutrients metabolism Copyright © 2010 Pearson Education, Inc.  12 2 : 30-76 ↓ Justate E helps makes lipids Justake Glucose level 100 - 2-2. 5hrs retrieving -100 -) the glucose to away Copyright © 2010 Pearson Education, Inc. you just Pray at 100  Figure 25.1 OVERVIEW OF MUSCLE METABOLISM ATP for muscle contraction is continuously produced by aerobic metabolism of glucose and fatty acids. During short bursts of activity, when ATP demand exceeds the rate of aerobic ATP production, aerobic glycolysis produces ATP, lactate, and H +. Intestine Blood Muscle tissue Glucose absorbed Glycogen Contraction Rest Exercise ADP Liver glycogen Glucose Liver + Myosin Pi ATPase Glucose Glycolysis (anaerobic) Ca-ATPase Pyruvate Lactate Lactate Pyruvate ATP Amino Lactate (2 students) Relaxation acids + Fatty Fatty Acetyl CoA creatine acids acids Contraction Adipose Glycerol + fatty acids Triglycerides Oxidative Rest tissue phosphorylation Lipids stored in O2 and adipose tissue CO2 citric acid cycle Creatine  P (PCr) Lungs (aerobic) + Gas exchange at the lungs: O ADP 2 CO2 Glucose comes Fatty acids can be Lactate from anaerobic Both aerobic and anaerobic from liver glycogen used only in aerobic metabolism can be converted metabolism provide ATP for or dietary intake. metabolism. to glucose by the liver. muscle contraction. Copyright © 2010 Pearson Education, Inc. Figure 25.1 Overview of muscle metabolism Slide 2 Intestine Blood Muscle tissue & Glucose absorbed Rest Glycogen Liver glycogen Exercise Glucose Liver Glucose Glycolysis (anaerobic) Pyruvate be Can Pyruvate Amino acids Acetyl CoA broken down & Adipose Glycerol + fatty acids Glycerol tissue Lipids stored in O2 Oxidative phosphorylation SSS fatty acids and adipose tissue CO2 citric acid 3 cycle Lungs (aerobic) Gas exchange at the lungs: O 2 CO2 Glucose comes from liver glycogen or dietary intake. © 2016 Pearson Education, Inc. Figure 25.1 Overview of muscle metabolism Slide 3 Intestine Blood Muscle tissue Glycogen Exercise Liver Glycolysis (anaerobic) turns into Pyruvate guese Fatty acids Fatty acids Acetyl CoA tissue OP Adipose Glycerol + fatty acids Lipids stored in become O2 Triglycerides Oxidative phosphorylation and adipose tissue ketonesCO 2 citric acid Orlipids cycle Lungs (aerobic) Gas exchange must be breathing at the lungs: O 2 CO2 to break down fat lipids are Fatty acids can be in every cell used only in aerobic metabolism. © 2016 Pearson Education, Inc. Figure 25.1 Overview of muscle metabolism Slide 4 Intestine Blood Muscle tissue Glycogen Rest Liver glycogen Exercise Glucose Liver Glucose Glycolysis & (anaerobic) Pyruvate > - Produces changes Lactate Lactate Pyruvate lactate the PH& Lactate Acetyl CoA causes cramping Adipose tissue Oxidative phosphorylation O2 and CO2 citric acid cycle Lungs (aerobic) Gas exchange at the lungs: O 2 CO2 Lactate from anaerobic metabolism can be converted to glucose by the liver. © 2016 Pearson Education, Inc. Figure 25.1 Overview of muscle metabolism Slide 5 Intestine Blood Muscle tissue Glucose absorbed Glycogen Rest Liver glycogen Exercise Glucose Liver Glucose Glycolysis (anaerobic) Pyruvate Lactate Lactate Pyruvate Amino Lactate acids Fatty Fatty Acetyl CoA acids acids Adipose Glycerol + fatty acids Triglycerides tissue Oxidative phosphorylation Lipids stored in O2 and adipose tissue CO2 citric acid cycle Lungs (aerobic) Gas exchange at the lungs: O 2 CO2 Glucose comes Fatty acids can be Lactate from anaerobic from liver glycogen used only in aerobic metabolism can be converted or dietary intake. metabolism. to glucose by the liver. © 2016 Pearson Education, Inc. Figure 25.1 Overview of muscle metabolism Slide 6 Intestine Blood Muscle tissue Glucose absorbed Glycogen goes all Contraction through- Rest Exercise ADP Liver glycogen Glucose + Liver Myosin out rebo Pi ATPase Glucose Glycolysis , (anaerobic) as Ca-ATPase Pyruvate Lactate Lactate Pyruvate ATP Amino Lactate Relaxation acids + Fatty Fatty Acetyl CoA creatine acids acids Contraction Adipose Glycerol + fatty acids Triglycerides tissue Oxidative Rest energy phosphorylation Lipids stored in O2 and adipose tissue & source CO2 citric acid cycle Creatine ~ P (PCr) Lungs (aerobic) + Gas exchange at the lungs: O ADP for 2 CO2 quiek burs/quick Glucose comes from liver glycogen Fatty acids can be used only in aerobic Lactate from anaerobic metabolism can be converted movement Both aerobic and anaerobic metabolism provide ATP for or dietary intake. metabolism. to glucose by the liver. muscle contraction. © 2016 Pearson Education, Inc.  Summary of biochemical pathways for energy production & & lowaing of a make & energy glucose & Figure 22-3 Copyright © 2010 Pearson Education, Inc.  Transport and fate of dietary fats carries cholestens tothe liver Y carries things to your body * know what's it's made of Chylomicron: Cholesterol Triglyceride Phospholipids Apoprotein (lipid-binding protein) Danger : When cholesten sits Copyright © 2010 Pearson Education, Inc.  Slide 1 Figure 22.6a Fat Synthesis Dietary fats Intestinal lumen Transport and Fate Monoglycerides of Dietary Fats Phospholipids Cholesterol Free fatty acids (FFA) Bile salts help break down dietary fats into components that can be apo absorbed. Intestinal cells CM Intestinal epithelial cells assemble Chylomicron FFA absorbed cholesterol, lipoproteins, and lipid complexes into Lymph chylomicrons. Bile Blood Adipose cells Chylomicrons are transported to the duct CM Lipolysis by lipases blood via the lymphatic vessels. lpl FFA Reassemble TG Lipoprotein lipase (lpl) converts Glycerol to triglycerides storage triglycerides into free fatty acids (TG) in the and glycerol. smooth ER CM remnants Adipose cells reassemble free fatty Most cells acids and glycerol into triglycerides HDL-C LDL-C for storage. Other cells use free fatty FFA oxidized acids for energy production. for energy Liver Cholesterol Chylomicron remnants and HDL-C for synthesis enter the liver for further processing, creating lipoprotein complexes such Metabolized as LDL and VLDL. Some of the Lipoprotein cholesterol is recycled in new bile salts. complexes KEY apo = apoproteins Cholesterol + FFA + Lipoproteins lpl = lipoprotein lipase LDL-C is transported via the blood to LDL = low-density lipoprotein most of the cells, where the Bile salts HDL = high-density lipoprotein cholesterol is used for synthesis. C = cholesterol Copyright © 2010 Pearson Education, Inc.  colipase Slide 2 Dietary allow lipaseto fats come through Intestinal and break & lumen down Transport and Fate t Monoglycerides of Dietary Fats Phospholipids Cholesterol Free fatty acids (FFA) Bile salts help break down dietary fats into components that can be absorbed. Intestinal cells Lymph Bile Blood Adipose cells duct lpl Most cells Liver KEY apo = apoproteins lpl = lipoprotein lipase LDL = low-density lipoprotein Bile salts HDL = high-density lipoprotein C = cholesterol Copyright © 2010 Pearson Education, Inc.  Slide 3 Dietary fats Intestinal lumen Transport and Fate Monoglycerides of Dietary Fats Phospholipids Cholesterol Free fatty acids (FFA) Bile salts help break down dietary fats into components that can be apo absorbed. Intestinal cells CM Intestinal epithelial cells assemble Chylomicron absorbed cholesterol, lipoproteins, and lipid complexes into Lymph chylomicrons. Bile Blood Adipose cells duct lpl Most cells Liver KEY apo = apoproteins lpl = lipoprotein lipase LDL = low-density lipoprotein Bile salts HDL = high-density lipoprotein C = cholesterol Copyright © 2010 Pearson Education, Inc.  Slide 4 Dietary fats Intestinal lumen Transport and Fate Monoglycerides of Dietary Fats Phospholipids Cholesterol Free fatty acids (FFA) Bile salts help break down dietary fats into components that can be apo absorbed. Intestinal cells CM Intestinal epithelial cells assemble Chylomicron absorbed cholesterol, lipoproteins, and lipid complexes into Lymph chylomicrons. Bile Blood Adipose cells Chylomicrons are transported to the duct CM blood via the lymphatic vessels. lpl Most cells Liver KEY apo = apoproteins lpl = lipoprotein lipase LDL = low-density lipoprotein Bile salts HDL = high-density lipoprotein C = cholesterol Copyright © 2010 Pearson Education, Inc.  Slide 5 Dietary fats Intestinal lumen Transport and Fate Monoglycerides of Dietary Fats Phospholipids Cholesterol Free fatty acids (FFA) Bile salts help break down dietary fats into components that can be apo absorbed. Intestinal cells CM Intestinal epithelial cells assemble Chylomicron FFA absorbed cholesterol, lipoproteins, and lipid complexes into Lymph chylomicrons. Bile Blood Adipose cells Chylomicrons are transported to the duct CM blood via the lymphatic vessels. lpl Most cells Liver KEY apo = apoproteins lpl = lipoprotein lipase LDL = low-density lipoprotein Bile salts HDL = high-density lipoprotein C = cholesterol Copyright © 2010 Pearson Education, Inc.  Slide 6 Figure 22.6a Fat Synthesis Dietary fats Intestinal lumen Transport and Fate Monoglycerides of Dietary Fats Phospholipids Cholesterol Free fatty acids (FFA) Bile salts help break down dietary fats into components that can be apo absorbed. Intestinal cells CM Intestinal epithelial cells assemble Chylomicron FFA absorbed cholesterol, lipoproteins, and lipid complexes into Lymph chylomicrons. Bile Blood Adipose cells Chylomicrons are transported to the duct CM blood via the lymphatic vessels. lpl FFA Lipoprotein lipase (lpl) converts Glycerol triglycerides into free fatty acids and glycerol. CM remnants Most cells HDL-C Liver KEY apo = apoproteins lpl = lipoprotein lipase LDL = low-density lipoprotein Bile salts HDL = high-density lipoprotein C = cholesterol Copyright © 2010 Pearson Education, Inc.  Slide 7 Dietary fats Intestinal lumen Transport and Fate Monoglycerides of Dietary Fats Phospholipids Cholesterol Free fatty acids (FFA) Bile salts help break down dietary fats into components that can be apo absorbed. Intestinal cells CM Intestinal epithelial cells assemble Chylomicron FFA absorbed cholesterol, lipoproteins, and lipid complexes into Lymph chylomicrons. Bile Blood Adipose cells Chylomicrons are transported to the duct & CM blood via the lymphatic vessels. lpl FFA Reassemble TG Lipoprotein lipase (lpl) converts Glycerol to triglycerides storage triglycerides into free fatty acids (TG) in the and glycerol. smooth ER CM remnants Adipose cells reassemble free fatty Most cells & acids and glycerol into triglycerides HDL-C for storage. Other cells use free fatty FFA oxidized acids for energy production. for energy Liver KEY apo = apoproteins lpl = lipoprotein lipase LDL = low-density lipoprotein Bile salts HDL = high-density lipoprotein C = cholesterol Copyright © 2010 Pearson Education, Inc.  Slide 8 Dietary fats Intestinal lumen Transport and Fate Monoglycerides of Dietary Fats Phospholipids Cholesterol Free fatty acids (FFA) Bile salts help break down dietary fats into components that can be apo absorbed. Intestinal cells CM Intestinal epithelial cells assemble Chylomicron FFA absorbed cholesterol, lipoproteins, and lipid complexes into Lymph chylomicrons. Bile Blood Adipose cells Chylomicrons are transported to the duct CM Lipolysis by lipases blood via the lymphatic vessels. lpl FFA Reassemble TG Lipoprotein lipase (lpl) converts Glycerol to triglycerides storage triglycerides into free fatty acids (TG) in the and glycerol. smooth ER CM remnants e Adipose cells reassemble free fatty Most cells acids and glycerol into triglycerides HDL-C for storage. Other cells use free fatty FFA oxidized acids for energy production. for energy Liver KEY apo = apoproteins lpl = lipoprotein lipase LDL = low-density lipoprotein Bile salts HDL = high-density lipoprotein C = cholesterol Copyright © 2010 Pearson Education, Inc.  Slide 9 9 Dietary fats Intestinal lumen Transport and Fate Monoglycerides of Dietary Fats Phospholipids Cholesterol Free fatty acids (FFA) Bile salts help break down dietary fats into components that can be apo absorbed. Intestinal cells CM Intestinal epithelial cells assemble Chylomicron FFA absorbed cholesterol, lipoproteins, and lipid complexes into Lymph chylomicrons. Bile Blood Adipose cells Chylomicrons are transported to the duct CM Lipolysis by lipases blood via the lymphatic vessels. lpl FFA Reassemble TG Lipoprotein lipase (lpl) converts Glycerol to triglycerides storage triglycerides into free fatty acids (TG) in the and glycerol. smooth ER CM remnants Adipose cells reassemble free fatty Most cells acids and glycerol into triglycerides HDL-C for storage. Other cells use free fatty FFA oxidized acids for energy production. for energy Liver Chylomicron remnants and HDL-C enter the liver for further processing, creating lipoprotein complexes such Metabolized as LDL and VLDL. Some of the cholesterol is recycled in new bile salts. KEY apo = apoproteins Cholesterol + FFA + Lipoproteins lpl = lipoprotein lipase LDL = low-density lipoprotein Bile salts HDL = high-density lipoprotein C = cholesterol Copyright © 2010 Pearson Education, Inc.  Cholester is only Slide 10 Dietary bad when it stays fats Intestinal lumen in too Transport and Fate long Monoglycerides of Dietary Fats Phospholipids Cholesterol Free fatty acids (FFA) Bile salts help break down dietary fats into components that can be apo absorbed. Intestinal cells CM Intestinal epithelial cells assemble Chylomicron FFA absorbed cholesterol, lipoproteins, and lipid complexes into Lymph chylomicrons. Bile Blood Adipose cells Chylomicrons are transported to the duct CM Lipolysis by lipases blood via the lymphatic vessels. lpl FFA Reassemble TG Lipoprotein lipase (lpl) converts Glycerol to triglycerides storage triglycerides into free fatty acids (TG) in the and glycerol. smooth ER CM remnants & Adipose cells reassemble free fatty Most cells acids and glycerol into triglycerides HDL-C LDL-C for storage. Other cells use free fatty FFA oxidized acids for energy production. for energy Liver Cholesterol Chylomicron remnants and HDL-C for synthesis enter the liver for further processing, creating lipoprotein complexes such Metabolized as LDL and VLDL. Some of the Lipoprotein cholesterol is recycled in new bile salts. complexes KEY apo = apoproteins Cholesterol + FFA + Lipoproteins lpl = lipoprotein lipase LDL-C is transported via the blood to LDL = low-density lipoprotein most of the cells, where the Bile salts HDL = high-density lipoprotein cholesterol is used for synthesis. C = cholesterol Copyright © 2010 Pearson Education, Inc.  Figure 22-6 end of clip ↓ The higher LDL the higher corulation Copyright © 2010 Pearson Education, Inc.  Fasted-state metabolism must maintain plasma glucose for the brain Copyright © 2010 Pearson Education, Inc. Figure 22-7, overview  Figure 22-7 Fasted-state metabolism must maintain plasma glucose for the brain Slide 2 1 Liver glycogen becomes glucose. Liver Free fatty glycogen acids stores Glycogenolysis -oxidation Energy Ketone production Glucose bodies Copyright © 2010 Pearson Education, Inc.  Figure 22-7 Fasted-state metabolism must maintain plasma glucose for the brain Slide 3 1 Liver glycogen 2 Adipose lipids becomes glucose. become free Triglyceride stores fatty acids and glycerol that enter blood. Liver Free fatty Free fatty Glycerol glycogen acids acids stores Glycogenolysis -oxidation Gluconeogenesis Energy Ketone production Glucose bodies Copyright © 2010 Pearson Education, Inc.  Figure 22-7 Fasted-state metabolism must maintain plasma glucose for the brain Slide 4 1 Liver glycogen 2 Adipose lipids becomes glucose. become free Triglyceride stores fatty acids and glycerol that enter blood. Liver Free fatty Free fatty Glycerol glycogen acids acids stores Glycogenolysis -oxidation Gluconeogenesis Energy Ketone production bodies Energy production Glucose Glycogen Proteins Gluconeogenesis Pyruvate or Lactate Amino acids 3 Muscle glycogen can be used for energy. Muscles also use fatty acids and break down their proteins to amino acids that enter the blood. Copyright © 2010 Pearson Education, Inc.  Figure 22-7 Fasted-state metabolism must maintain plasma glucose for the brain Slide 5 1 Liver glycogen 2 Adipose lipids becomes glucose. become free Triglyceride stores fatty acids and glycerol that enter blood. Liver Free fatty Free fatty Glycerol glycogen acids acids stores Glycogenolysis -oxidation Gluconeogenesis Energy Ketone production bodies Energy production Glucose Glycogen Proteins Gluconeogenesis Pyruvate or Lactate Amino Ketone acids Glucose bodies Energy production 3 Muscle glycogen can be used for energy. 4 Brain can use Muscles also use fatty acids and break only glucose and down their proteins to amino acids that ketones for energy. enter the blood. Copyright © 2010 Pearson Education, Inc. Physiology: Chapter 22 part B Juan J. Bustamante, Ph.D. Assistant Professor Pharmaceutical Science Phone (361) 221-0643 Email: [email protected] Office: Room 223  Transport and fate of dietary fats Start Clip 2 Chylomicron: Cholesterol Triglyceride Phospholipids tothe it bechean& i Apoprotein (lipid-binding protein) Copyright © 2010 Pearson Education, Inc.  Figure 22-6 Copyright © 2010 Pearson Education, Inc.  Fasted-state metabolism must maintain plasma glucose for the brain Copyright © 2010 Pearson Education, Inc. Figure 22-7, overview  Figure 22-7 Fasted-state metabolism must maintain plasma glucose for the brain Slide 2 1 Liver glycogen 2 ways fatty becomes glucose. acdscangoa oms PP Liver Free fatty glycogen acids stores Glycogenolysis -oxidation Energy Ketone production Glucose bodies Copyright © 2010 Pearson Education, Inc.  Figure 22-7 Fasted-state metabolism must maintain plasma glucose for the brain Slide 3 1 Liver glycogen 2 Adipose lipids becomes glucose. become free Triglyceride stores fatty acids and glycerol that enter blood. Liver Free fatty Free fatty Glycerol glycogen acids acids stores Glycogenolysis -oxidation Gluconeogenesis Energy Ketone production Glucose bodies Copyright © 2010 Pearson Education, Inc.  Figure 22-7 Fasted-state metabolism must maintain plasma glucose for the brain Slide 4 1 Liver glycogen 2 Adipose lipids becomes glucose. become free Triglyceride stores fatty acids and glycerol that enter blood. Liver Free fatty Free fatty Glycerol glycogen acids acids stores Glycogenolysis -oxidation Gluconeogenesis Energy Ketone production bodies Energy production Glucose & Glycogen Proteins *O canbae Gluconeogenesis Pyruvate or Lactate Amino acids usedcanbe energy sorale 3 Muscle glycogen can be used for energy. Muscles also use fatty acids and break down their proteins to amino acids that enter the blood. Copyright © 2010 Pearson Education, Inc.  Figure 22-7 Fasted-state metabolism must maintain plasma glucose for the brain Slide 5 1 Liver glycogen 2 Adipose lipids becomes glucose. become free Triglyceride stores fatty acids and glycerol that enter blood. Liver Free fatty Free fatty Glycerol glycogen acids acids stores Glycogenolysis -oxidation Gluconeogenesis Energy Ketone production bodies Energy production Glucose Glycogen Proteins Gluconeogenesis Pyruvate or 50 % Lactate Amino & of glucose Glucose Ketone bodies acids goes to the brain will a Energy production act 4 Brain can use only glucose and likedoesnt due 3 Muscle glycogen can be used for energy. Muscles also use fatty acids and break down their proteins to amino acids that ketones for energy. p yo enter the blood. Copyright © 2010 Pearson Education, Inc. Anatomy of the pancreas & Figure 22-8 - Overview  Hormonal control of glucose homeostasis. Start 1668 eat 2 , 00 when sugarbegin one & ↳ ~ > - get activated Metabolism is controlled by insulin and glucagon P stored Figure 22-9a Metabolism is controlled by insulin and glucagon Stored Breaking down & fat Yamino alids Figure 22-9b put food away glucagon levels - -O Of spikes spikes because &+ you are to put trying food - away &  Increase Insulin secretion Increase glucose concentrations Increased-- -food amino acid concentrations Feedforward effects of GI hormones glucagon-like peptide -1 CCK yo When l ink food abou gastrin Parasympathetic activity  Insulin Promotes Anabolism 1. Insulin increases glucose transport into most, but not # all, insulin-sensitive cells. not every tissue requires 2. Insulin enhances cellular utilization and storage of glucose 3. Insulin enhances utilization of amino acids 4. Insulin promotes fat synthesis doenace a Me activemuscle requir a  stoma Streten &us feeds into the increase Bluscose brain release inswin  & &  - - & -yme & & FIGURE 32-3 Structure of proinsulin. With removal of the connecting peptide (C-peptide), proinsulin is converted to insulin.  Insulin enables glucose uptake by adipose tissue and resting skeletal muscle - - & Snor Willt wil equilibr gucou - a set Figure 22-12 - Overview Insulin acts indirectly to altar glucose uptake in hepatocytes # · are · Break down Shored sugar Figure 22-13 - Overview  75 - Break &  Slide 5 1 Liver glycogen 2 Adipose lipids becomes glucose. become free Triglyceride stores fatty acids and glycerol that enter blood. Liver Free fatty Free fatty Glycerol glycogen acids acids stores Glycogenolysis -oxidation Gluconeogenesis Energy Ketone production bodies Energy production Glucose Glycogen Proteins Gluconeogenesis Pyruvate or Lactate Amino Ketone acids Glucose bodies Energy production 3 Muscle glycogen can be used for energy. 4 Brain can use Muscles also use fatty acids and break only glucose and down their proteins to amino acids that ketones for energy. enter the blood. Copyright © 2010 Pearson Education, Inc. Figure 22.19b (2 of 2) 47 : 50 Diagnostic criteria for diabetes Fasting blood After 2-hour oral glucose glucose tolerance test Normal  100 mg/dL ( 5.6 mM)  140 mg/dL (7.8 mM) Pre-diabetes & 100–125 mg/dL get can't 140–199 mg/dL (5.6–6.9 mM) under (7.8–11 mM) 100 Diabetes  125 mg/dL ( 6.9 mM)  199 mg/dL ( 11 mM)  Diabetes Mellitus Is a Family of Diseases end clip z  Diabetes mellitus is characterized by abnormally elevated plasma glucose concentrations, or hyperglycemia  Diabetes is reaching epidemic proportions in the United States  Complications of diabetes affect blood vessels, eyes, kidneys, and nervous system  Type 1 - characterized by insulin deficiency  Type 2 - known as insulin-resistant diabetes © 2013 Pearson Education, Inc.  Slide 1 ACUTE PATHOPHYSIOLOGY OF TYPE 1 DIABETES MELLITUS FAT METABOLISM GLUCOSE METABOLISM PROTEIN METABOLISM Meal absorbed Plasma Plasma Plasma fatty acids amino acids glucose No insulin released Glucose uptake Amino acid Protein Fat Fat Glucose utilization (muscle and adipose) uptake by breakdown, breakdown storage most cells especially muscle Liver Plasma Plasma fatty acids Ketone Glycogenolysis Brain interprets amino acids production Gluconeogenesis as starvation Substrate for Substrate for ATP ATP production Hyperglycemia production Polyphagia Tissue Tissue loss METABOLIC ACIDOSIS DEHYDRATION loss Exceeds renal threshold for glucose Glucosuria Osmotic diuresis and polyuria Ventilation Metabolic acidosis Thirst Polydipsia Urine acidification Dehydration and ADH secretion hyperkalemia Blood volume Attempted compensation Lactic acid and by cardiovascular production Blood pressure control center Anaerobic Circulatory compensation metabolism failure fails Coma or death Figure 22-16 Copyright © 2010 Pearson Education, Inc.  Slide 2 ACUTE PATHOPHYSIOLOGY OF TYPE 1 DIABETES MELLITUS FAT METABOLISM GLUCOSE METABOLISM PROTEIN METABOLISM Meal absorbed Plasma Plasma Plasma fatty acids amino acids glucose Figure 22-16 Copyright © 2010 Pearson Education, Inc.  Slide 3 ACUTE PATHOPHYSIOLOGY OF TYPE 1 DIABETES MELLITUS FAT METABOLISM GLUCOSE METABOLISM PROTEIN METABOLISM Meal absorbed Plasma Plasma Plasma fatty acids amino acids glucose No insulin released Amino acid Protein uptake by breakdown, most cells especially muscle Liver Plasma amino acids Substrate for ATP