Discussion presentation – May

12, 2016
 glucose

Regular meals
during a day –
averages for 4
people glucagon

insulin

• IRG = glucagon
• IRI = insulin
• What is driving insulin up?
• Why doesn't glucagon decrease after meal when glucose goes up?
 Insulin clamp expts –
another way to open the loop

blood
glucose

glucose
production

glucose
utilization

Why is glucose production rising when insulin is high?

 NEFA (FFA) concentration after a meal. Very big drop!
Why don’t fats increase like glucose does if we eat a meal containing
fat?

96 g carbohydrate; 33 g fat
More TG (TAG) must be in VLDL, even after a meal, than is in
chylomicrons
Exercise in a fasting person causes a modest decrease in blood glucose, but glucose is
regulated in order prevent severe hypoglycemia. Suppose we perform an experiment to
determine what would happen during exercise in the absence of the normal mechanisms that
protect against hypoglycemia. In our experiment, volunteers are fasted for 12 hours and
then they engage in moderate exercise (walking rapidly on a treadmill) for an hour. Half of
the subjects (treatment) receive an intravenous treatment to block glucose regulation, and
the other half (control) receive a “sham” injection of saline solution. Blood glucose
measurements made at 10 minute intervals in this experiment are shown in the graphs
below, which are averages for the control and experimental subjects. Exercise and the
intravenous infusion both start at time = zero.

Assuming that we achieved a complete block of the glucose regulatory system in

the experimental group, what is the closed loop gain of the normal regulatory
system?
 Half of the subjects (treatment) receive an intravenous treatment to block glucose
regulation, and the other half (control) receive a “sham” injection of saline solution. Blood
glucose measurements made at 10 minute intervals in this experiment are shown in the
graphs below, which are averages for the control and experimental subjects. Exercise and
the intravenous infusion both start at time = zero.

You could have achieved the blockade of glucose regulation with an infusion that
1) blocked endocrine secretions, or 2) blocked receptors.
• Suppose you block endocrine secretions. What are the two most important
endocrine secretions to block in order to achieve the effect? Why?
• Suppose, instead, that you block receptors. In what organs(s) are the most
important receptors to block? Why?