DIABETES

PHYSIOLOGY
pancreas
insulin vs glucagon

PATHOLOGY
DKA

PHARMACOLOGY
insulin types
non insulin drugs
 PHYSIOLOGY
PANCREAS
FUNCTION
Exocrine - digestive proteins
Amylase - carbs
Lipase - fats
Trypsin - proteins
Endocrine - hormone secretion
Langerhans a - glucagon (25%)
Langerhans b - insulin (70%)
Langerhans d - somatostatin (5%)
Langerhans f - pancreatic polypeptide
 PHYSIOLOGY
INSULIN
PRODUCTION Carbohydrates, protein
FUNCTION and fat storage
CONTROL
Enhances energy
EFFECTS uptake of cells
RECEPTORS
 PHYSIOLOGY
Stimulate Inhibit
INSULIN low glucose
glucose 5mmol/L,
PRODUCTION amino acids Leptin
FUNCTION glucagon alpha 2
CONTROL digestive hormones
(gastrin, CCK, secretin)
EFFECTS
Beta 2
RECEPTORS
 PHYSIOLOGY
G-protein coupled

Gs Gi Gq

INSULIN
TSH
ligand gated
GABA angiotensin II (AT II)
ION CHANNELS alpha 1 - metaraminol

PRODUCTION
Ach (M1, M3, M5) - atropine

FUNCTION Ach n
CONTROL
EFFECTS ENZYME linked
glutamate

RECEPTORS
tyrosine kinase
INOTROPIC
growth hormones
prostaglandins
cell function
cancer (chemotherapy)
 Insulin INDEPENDANT
PHYSIOLOGY GLUT -1
Basal uptake all GLUT 2
cells Liver,
Mostly in pancreas,
GLUT 3
INSULIN RBC, BBB, kidneys, Neurons
Lang Alpha cells intestines
PRODUCTION
FUNCTION
CONTROL
EFFECTS
RECEPTORS
Insulin dependant
GLUT - 4
GLUT
Fat, muscles*
**NOT exercising muscle
 PHYSIOLOGY
Early - within seconds
activation of GLUT4 proteins
INSULIN
Intermediate - within 20mins
PRODUCTION metabolic enzymes phosphorylation
FUNCTION potassium shift into cells
+ glyconeogenesis, glycolyis, protein synth.
CONTROL - glycogenolysis, gluconeogenesis, lipolysis
EFFECTS Long term
fat storage
RECEPTORS
glucose storage
 EFFECTS

GLUCAGON

BM
 EFFECTS

GLUCAGON
GLUT 2

BM

GLYCOGEN GLUCOSE
 EFFECTS

GLYCOGEN GLUCOSE

GLYCO neo GENESIS GLUCO neo GENESIS

GLYCOGEN -o- lysis GLYCO- lysis

 EFFECTS

GLUCAGON

GLUT 4
BM LYPOGENESIS LYPOLYSIS
 EFFECTS

GLYCOGEN -o- lysis

GLYCO- lysis GLUT 4

BM
AMINO ACID uptake

PROTEIN synthesis
 EFFECTS

GLYCOGEN -o- lysis

GLYCO- lysis GLUT 4

BM
AMINO ACID uptake

PROTEIN synthesis
 EFFECTS

GLUCAGON

INOTROPY

BM
CHRONOTROPY
 DKA

DEHYDRATION

KETONES

ACIDOSIS
INSULIN TYPES
OTHERS
OTHERS SGLT -2 INHIBITORS