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Blood glucose levels: 80-140 mg/dL FBS: 60-90 mg/dL Importance of blood glucose regulation- brain, retina and gonads 100gm of glycogen is stored in liver Liver acts as GLUCOSTAT
Endocrine Pancreas
Insulin Glucagon Somatostatin Pancreatic Polypeptide
Islet of Langerhans
2% of volume of pancreas 1-2 millions 76 x 175 m collections A cells- Glucagon B cells- Insulin (60-75%) D cells- Somatostatin F cells- Pancreatic Polypeptide
Insulin
Hormone of abundance Polypeptide Anabolic hormone Structure of Insulin:
Insulin Actions
Glucose transporters
Facilitated diffusion (GLUTs) Secondary active transporters (SGLTs) Glucose Transporters (GLUTs) GLUT 4- muscle & adipose tissue- insulin & exercise sensitive GLUT 2- basolateral membrane & B cells SGLT 1 & 2- intestine & kidney
Other actions
Actions on K - insulin & glucose cause inward movement of K ion Stimulates growth
Hyperglycemia Disorders of protein metabolism Disorders of fat metabolism Clinical features: polydipsia, polyuria and polyphagia Loss of weight Increased atherogenesis Diabetic ketoacidosis Hyperosmolar coma Microvascular and macrovascular complications
Treatment of DM
Insulin preparations Oral hypoglycemic drugs - Biguanides- Phenformin & Metformin - Sulfonylureas- Glipizide, Glibenclamide - Thiozolidinediones- Rosiglitazone
Insulin preparations
Bovine, porcine, recombinant insulin Short, intermediate and long-acting Subcutaneous, intravenous Nasal, rectal, trans peritoneal
Insulin excess
Hypoglycemia