PHGY 210 Lecture Notes - Lecture 6: Osteoporosis, Acromegaly, Pituitary Gland

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20 Jul 2016
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o!At > 180mg% glucose spills over into urine, causing glycosuria. This leads to loss of water in
urine, causing polyuria- dehydration and increased thirst (polydipsia). As mentioned above,
untreated diabetes leads to ketosis and metabolic acidosis. Administration of insulin is needed to
restore the individual back to normal. In diabetic comas, acidosis and associated electrolyte
imbalance must be corrected, and in diabetic comas, acidosis and associated electrolyte imbalance
must be corrected in addition to insulin administration. %
!Causes of diabetes mellitus %
o!Diabetes: running through used by Greeks 2000 years ago to describe polyuria %
o!Mellitus: “sweet%distinguished urine polyuria of produced person suffering from ADH deficiency
(diabetes insipidus) %
o!In adults, diabetes mellitus may be due to a deficiency of insulin (type 1 insulin- dependent
diabetes mellitus) or hyporesponsiveness to insulin (type 2 or insulin independent diabetes
mellitus) %
!Type 1 or insulin dependent diabetes mellitus%
o!A) destruction of the B cells of pancreas- synthesis of insulin does not occur. Treatment:
administration of insulin is needed associated with proper diet%
o!B) defective insulin release- drugs stimulating insulin release could be administered again
associated with proper diet and exercise.%
o!When insulin is administered as treatment for diabetes mellitus, it is impt to control the dose since
too much %
!The pancreas as an endocrine organ (minus the other 99% of it). It has good vascularization. The B cells
produce insuling, the alpha cells synthesize glucagon. %
!Insulin stimulates the uptake of glucose into cells so that we can make energy%
!Glucose is a small molecule but it cant pass through the membrane like steroid hormones because it isn’t
hydrophobic. Glucose has a bunch of hydroxyl groups and it’s very hydrophilic, so it’s converted to
glycogen as a potential source of glucose. In adipose tissue, it is converted to fat. Insulin has to be a
membrane receptor because it’s a peptide%
!If the b cells are destroyed- diabetes %
!80mg% or 5 mmol is normal for glucose. Glucose is transported with water so if you’re expelling
glucose, you’re expelling a lot of water- polyuria and polydipsia %
!type 1 diabetes- autoimmune lack of insulin %
!type 2- no insulin signaling ie resistance to insulin- lack of target cells responding to insulin- ie
overeating overloads the system with glucose and there is a high release of insulin and neg feedback, so
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