HSC 4558 Lecture Notes - Lecture 5: Diabetes Mellitus Type 1, Gestational Diabetes, Coronary Artery Disease

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12 Apr 2016
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Plasma membrane permeability to glucose is determined by the type and density of glucose transport proteins in the membrane. In some tissues, particularly muscle and fat, the density of glucose transporters is regulated by insulin. Insulin binding to receptors on the cell surface results in translocation of glucose transporters to the cell surface. Glucose enters the cell passively by facilitated diffusion. Neurons and erythrocytes have glucose transporters that do not require insulin. The metabolic effects of insulin include enhancing protein synthesis and inhibiting gluconeogenesis, enhancing fat deposition and inhibiting lipolysis, and stimulating cellular growth by enhancing somatomedin secretion. Insulin is synthesized in pancreatic cells as proinsulin. Proinsulin is stored in granules, where it is cleaved into insulin and c-peptide. A postprandial rise in glucose and other substrates stimulates the release of insulin into the bloodstream. During fasting, when blood glucose levels fall, the decrease in insulin and the increase in glucagon secretion lead to lipolysis, glycogenolysis, and gluconeogenesis.

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