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Alix Stonehouse
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Pancreas hormone revison

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Alix Stonehouse
Created by Alix Stonehouse over 9 years ago
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ENDOCRINOLOGY (pancreas)PancreasThe pancreashas bothendocrine andexocrinefuntionsThe islets of Lngerhansinclude alpha cells, betacells and delta cellsSecretes digestiveenzymes from aciniNormal blood glucose =70-140mg/dlAlpha cells secrete glucagonMore predominant effectthan insulinIncreased bysympathetic signals,adrenaline secretionand decreased plasmaglucoseEffects on the liverinclude increasedgluconeogenesis andincreased proteinbreakdown. Causesincreased lipolysis inadipose tissueGlucagon secreted in the post-absorptive/catabolic state when energy stores aremetabolisedDelta cells secretesomatostatinBeta cells secrete insulinIncreased byparasympathetic signalling,increased plasma glucoseand amino acid levelsInsulin dominates in absorptive/ anabolicstate. This is the period just after eatingwhen energy is stored in macromoleculesEffects on the liver includedecreased gluconeogenesisand increased triglyceridesynthesis. In the muscle itcauses increased glycogensynthesis and decreasedglycogenolysis. Alsodecreased lipolysis inadipose tissueIncreased glucose uptake byGLUT4 transportertranslocationHypoglycaemiaSymptoms include sweating, poundingheart, shaking, confusion, visualdisturbanceTreated with oral or IVglucose or glucagonHyperglycaemiaType 2 - insulin resistanceat target tissue orimpaired insulin secretionFirstly managed by lifestyle factorchangesDrug treatments include sulphonylureas that increase insulinsecretion, thiazolidinediones (TZD's) that reduce insulinresistance, as do biguanides (Metformin)Sulphonylureas block K+ ATP channelsso cause depolarisation and thereforerelease of insulinOrlistat can be taken to reduce weightTZD's bind to PPAP-yreceptors; more GLUT4transportersLong term complicationsDiabetic nephropathy - end stage renal failureneeds transplantDiabetic neuropathy - nerveconduction velocity slowedto lower limbs. Effectssensation to painDiabetic retinopathy -increases cataracts due tothickened membrane ofretinal blood vesselsType 1 - beta cell destruction so inabilityto produce insulinAutoimmune destruction of beta cellsTreated by mimicking exogenousinsulin administered subcutaneouslyaround meal timesCan be short acting(Ispro), delayed(Lente) or long acting(Ultralene')Diagnosed by: 1.symptoms 2. random plasmaglucose >200mg/dl 3.fasting plasma glucose>126mg/dl 4. Oral glucose tolerance test >200mg/dlafter 2hoursDouble click this nodeto edit the textClick and drag this buttonto create a new node