test 4 notes 2 - TreatmentofDiabetesMellitus Physiologic...

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Treatment of Diabetes Mellitus Physiologic Actions of Natural Insulin Hormone Insulin, once it is released from its site of synthesis in the Beta cells of the pancreas, is widely distributed to its target cells located in many tissues in the body. Three of these tissue types (liver, muscle, and fat) seem to have response elements capable of interacting with insulin through receptor actions. Insulin hormone interacts with receptors on the surface of these cells and this interaction triggers secondary intracellular messengers that produce a variety of cellular reactions specific for each type of target cell. Insulin accomplishes these actions in several ways. It can activate a number of separate enzymes that, in turn, activate metabolic processes dealing with carbohydrate, protein and fat metabolism . With respect to glucose metabolism, insulin promotes the release of glucose transporter molecules (GLUT's) which then migrate to the surface of the cell membranes. It is these glucose transporter units that actually provide the means for glucose to enter cells. Effects on the liver: * Activates the storage of glucose in the form of glycogen (i.e., glycogen synthesis) * Inhibits glycogenolysis (the release of stored glucose into the bloodstream) * Increases the synthesis of triglycerides and very low density lipoproteins * Decreases the catabolism of protein Effects on fat: * Reduction in circulating free fatty acids * Increases the synthesis of triglycerides within the fat cell * Promotes the entry of glucose into fat cells * Decreases lipolysis and release of fatty acids from fat cells * Reduces the amount of triglycerides in the form of lipoprotein Effects on muscle: * Increases the entry of glucose into muscle cells * Increases protein synthesis within muscle cells * Increases amino acid transport into muscle cells for protein synthesis * Increases the storage of glycogen within muscle Diabetes Mellitus - Types 1 and 2 This disease is characterized by elevated blood glucose, either because the pancreas is unable to produce insulin (type 1) or the target tissues do not react to insulin appropriately (type 2). Patients with type 1 diabetes require exogenous 1
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Treatment of Diabetes Mellitus insulin to survive, and a deficiency of insulin can result in ketoacidosis, a potentially fatal condition. Patients with type 2 diabetes are typically overweight adults or children, and initial therapy should include weight management and daily control of caloric intake. In both types of diabetes the management goal is to maintain blood glucose in a near-normal range (glycemic control) to avoid or delay long-term complications (blindness, renal failure, neuropathy, cardiovascular disease). Insulin Preparations Available
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test 4 notes 2 - TreatmentofDiabetesMellitus Physiologic...

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