2727159
Descrição
Mapa Mental por Alix Stonehouse, atualizado more than 1 year ago
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Criado por Alix Stonehouse
mais de 9 anos atrás
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|
ENDOCRINOLOGY (pancreas)
- Pancreas
- The pancreas
has both
endocrine and
exocrine
funtions
- The islets of Lngerhans
include alpha cells, beta
cells and delta cells
- Alpha cells secrete glucagon
- More predominant
effect than insulin
- Increased by
sympathetic signals,
adrenaline secretion
and decreased
plasma glucose
- Effects on the liver
include increased
gluconeogenesis and
increased protein
breakdown. Causes
increased lipolysis in
adipose tissue
- Glucagon secreted in the
post-absorptive/ catabolic state when
energy stores are metabolised
- More predominant
effect than insulin
- Delta cells secrete
somatostatin
- Beta cells secrete insulin
- Increased by
parasympathetic
signalling, increased
plasma glucose and
amino acid levels
- Insulin dominates in absorptive/
anabolic state. This is the period just
after eating when energy is stored in
macromolecules
- Effects on the liver
include decreased
gluconeogenesis and
increased triglyceride
synthesis. In the muscle it
causes increased glycogen
synthesis and decreased
glycogenolysis. Also
decreased lipolysis in
adipose tissue
- Increased glucose uptake by
GLUT4 transporter
translocation
- Increased glucose uptake by
GLUT4 transporter
translocation
- Increased by
parasympathetic
signalling, increased
plasma glucose and
amino acid levels
- Alpha cells secrete glucagon
- Secretes digestive
enzymes from acini
- The islets of Lngerhans
include alpha cells, beta
cells and delta cells
- Normal blood glucose =
70-140mg/dl
- Hypoglycaemia
- Symptoms include sweating,
pounding heart, shaking,
confusion, visual disturbance
- Treated with oral or
IV glucose or glucagon
- Symptoms include sweating,
pounding heart, shaking,
confusion, visual disturbance
- Hyperglycaemia
- Type 2 - insulin
resistance at target
tissue or impaired
insulin secretion
- Firstly managed by lifestyle
factor changes
- Drug treatments include sulphonylureas that increase
insulin secretion, thiazolidinediones (TZD's) that reduce
insulin resistance, as do biguanides (Metformin)
- Sulphonylureas block K+ ATP
channels so cause depolarisation
and therefore release of insulin
- TZD's bind to PPAP-y
receptors; more GLUT4
transporters
- Sulphonylureas block K+ ATP
channels so cause depolarisation
and therefore release of insulin
- Orlistat can be taken to reduce weight
- Long term complications
- Diabetic nephropathy - end stage renal
failure needs transplant
- Diabetic neuropathy -
nerve conduction velocity
slowed to lower limbs.
Effects sensation to pain
- Diabetic retinopathy -
increases cataracts due to
thickened membrane of
retinal blood vessels
- Diabetic nephropathy - end stage renal
failure needs transplant
- Firstly managed by lifestyle
factor changes
- Type 1 - beta cell destruction so
inability to produce insulin
- Autoimmune destruction of beta cells
- Treated by mimicking exogenous
insulin administered
subcutaneously around meal
times
- Can be short acting
(Ispro), delayed
(Lente) or long acting
(Ultralene')
- Can be short acting
(Ispro), delayed
(Lente) or long acting
(Ultralene')
- Autoimmune destruction of beta cells
- Diagnosed by: 1.symptoms 2. random plasma
glucose >200mg/dl 3.fasting plasma glucose
>126mg/dl 4. Oral glucose tolerance test >200mg/dl
after 2hours
- Type 2 - insulin
resistance at target
tissue or impaired
insulin secretion
- Hypoglycaemia
- The pancreas
has both
endocrine and
exocrine
funtions
Anexos de mídia
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