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Hannah Holmes

BIOCHEM 3H03February 610 2014Lecture 13 Pancreas Insulin and Glucose Metabolism Chapter 11 in Marshall a little out of dateHOUSEKEEPINGWill try to find time next week to review the really difficult questions from the midterm and figure out any administrative mistakes in the testNOWTalking about diabetes glucose metabolism o Will refer back to fluid and electrolyte balance acidbase renal function o Introduce you to new things AND take you back to practical applications of the other stuff we didCDN Diabetes Association does a big guideline on diagnossi management treatment of diabetes every 5 yearsTHE PANCREASSits tucked up underneath your stomach in a loop of the duodenumMade up of 2 parts o Exocrine pancreas mostlargest part in terms of volume 98 of glandProduction of digestive enzymes that are secreted into the duodenumMake and secrete digestive things that go into your gut to help with digestion o Endocrine pancreas small 2 by volume but very importantIn islets scattered through pancreas gland secretes insulin and glucagon two of the key hormones in the control of substrate metabolismSeveral cell types2 main typescells secrete glucagon andcells secrete insulinDelta cells secrete somatostatin which inhibits growth hormoneIslet cells are rich in apparatuses required for protein synthesis protein packaging and secretion Organelles like the RER Golgi apparatus secretory granulesMAJOR SOURCES OF FUEL FOR METABOLISMBig 3o GlucoseFrom dietEat it Lots of carbohydrate sources that provide glucose which is broken down through glycolysis used for energyStoresglycogen in muscles and liver broken down to glucoseNew synthesisMake itGluconeogenesis from amino acids lactate glycerol from storedingested fats as triglycerides o Triglycerides from diet or storesStore lots of it in adipose tissueBreak them back down into free fatty acids FFA and glycerolCan be oxidized to AcetylCoA which can be used for energy as well in the citric acid cycleGlycerol can be used for energy by conversion to glucose o KetonesFFAs oxidized in liver to AcetylCoA if its not burned in TCA right away it can be converted to ketone bodies in the liver mitochondria or it can be converted to cholesterol oneway streetcant go back from cholesterolKetones acetoacetic acid OHbutyric acid acetoneThere is NO net conversion of fatty acids to glucoseREMEMBER there is NO net conversion of fatty acids to glucose cant convert fatty acids to glucose overall o Can easily make fat from glucose but not the other way BIOCHEM 3H03February 610 2014 Almost all tissues can use glucose can convert ketones and fatty acids most tissues can use glucose ketones and fatty acids as energy sources entry into these cells in insulindependent o Glucose gets into most cells by insulindependent process insulin activates glucose transporters so cells can uptake glucose and use it for energyBrain and most nervous tissue can only use glucose and ketones o Brain cant break down fatty acids also cannot store or synthesize glucose or metabolize substrates other than glucose or ketones o Glucose uptake into these tissues is insulinindependent noninsulin mediated only thing driving glucose into these cells is the concentration gradient from ECF to ICF o As glucose concentration falls ability for these cells to take up and use glucose becomes diminishedHow you move energy sources aroundo Take up lots of carbohydrates in your diet glucose fructose and galactose are the big 3 monosaccharides you get from breaking other more complex carbohydrates CHOs down most glucose ingested as sucrose and lactose disaccharides o Monosaccharides especially glucose taken up into systemic circulation used immediately by peripheral cells o Send some off to liver to convert some to glucose iegalactose or fructoseglucose store some excess glucose as glycogen or send off to adipose tissue to convert to triglycerides for storage o If you need more glucose use glycerol portion of triglycerides amino acids from protein breakdown convert to glucose convert lactate back to glucose then pump it out to general circulation to be used as needed o Can store glucose as glycogen and use it as needed o Glucosesend around as needed or store then mobilize and send it off as neededHow do we manage this
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