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Physiological role of insulin. Release of insulin by beta cells Response to elevated blood glucose level Effects of insulin Somewhat global Major effects on muscle, adipose tissues, and liver Increased glucose uptake Glucose Energy source Glycogen synthesis.
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Physiological role of insulin • Release of insulin by beta cells • Response to elevated blood glucose level • Effects of insulin • Somewhat global • Major effects on muscle, adipose tissues, and liver • Increased glucose uptake • Glucose • Energy source • Glycogen synthesis
Increased hepatic glycogen synthesis • Increased glycogen synthase activity • Increased synthesis of glucose-6-P • Prevention of glucose release
Effects on adipocytes • Glycerol synthesis • Increased glucose metabolism • Increased lipoprotein metabolism • Lipoprotein lipase • Increased free fatty acids release • net results • Increased triglyceride synthesis
Effects on adipocytes • Enzymes activated by insulin • Citrate lipase • Acetyl-CoA carboxylase • Fatty acid synthase • Glycerol-3-phosphate dehydrogenase
Effects on muscle • Increased transport of glucose and amino acids • Increased synthesis of proteins • Energy from glucose • Maintenance of potassium homeostasis • Increased K uptake • Extreme concentrations of insulin • Extracellular hypokalemia
Mechanism of insulin action • Insulin receptor • Similar to type I IGF receptor • Two sets of subunits (alpha and beta) • Insulin binding • Alpha • Receptor tyrosine kinase • Beta • Phosphorylation of intracellular domain • Docking sites for intracellular proteins • Insulin receptor substrate-1 (IRS-1)
Phosphorylation of IRS-1 • Secondary messenger system • Somewhat complicated • Ca ions • PKA • PKC • Activation of glucose transport system
Effects on glucose transport system • Glucose transport • Facilitated diffusion • Diverse • Types of proteins • Tissue-dependent distribution pattern • Evolved to accommodate specific energy needs
Physiological role of glycogen • Decreased blood glucose level • Insulin-induced • Subsequent elevation of glucose • Glycogen break-down • Gluconeogenesis • Glycogen • Antagonistic to insulin • Gluconeogenesis • Glycogen break-down
Glycogen break-down • Short-term maintenance of glucose level • Gluconeogenesis • Long-term • Exercise • Fasting • Neonates
Effects on amino acid and lipid metabolism • Used as precursor for gluconeogenesis • Amino acids • Glycerol • Lipolysis • Release of free fatty acids and glycerol • Substrate for glucose synthesis • Occurs when insulin concentrations are low • Potent inhibitor of lipolysis
Undernutrition/fasting • Prevention of hypoglycemia • Reduced insulin level • Elevated glucagon • Adrenal catecholamines • Critical if glucagon is low
Mechanism of glucagon action • Target organs • Liver • Adipose tissues
Interaction of glucagon with its receptor • Increased cAMP production • Activation of PKA system • Glycogen break-down • Gluconeogenesis • Lipolysis • Inhibition of ketone formation from free fatty acid metabolism by liver • Glucose sparing effects (use of fatty acids as energy source)
Control of pancreatic islet function • Several factors • Hormones • Nervous system • Metabolic signals • Blood glucose level • Most important • Hyperglycemia • Stimulation of insulin secretion • Inhibition of glucagon synthesis
Adrenal and neural catercholamines • Adrenal epinephrine • Inhibition of insulin secretion • Alpha receptor-mediated • Glucose availability during stress • Stimulation of glucagon secretion • Epinephrine and norepinephrine • Activation of beta receptors
Amino acids and other metabolites (acetoacetic acid) • Increased insulin secretion • Protein synthesis • Fatty acid synthesis • Increased glucagon secretion • Prevention of hypoglycemia • Counteracts effects of insulin • Abolished when CHO and proteins are ingested together
Stimulation by GI tract (entero-insular axis) • Secretion of gastrointestinal inhibitory peptide (GIP) and glucagonlike peptide 1 (GLP-1) • Response to orally ingested glucose • Stimulates secretion of insulin • GLP-1 stimulates cAMP production • Secretion of insulin above the level secreted in response to glucose alone • Beta cells must be “competent” to respond to increased glucose level
Stimulation by GI tract (entero-insular axis) • Secretion of gastrointestinal inhibitory peptide (GIP) and glucagonlike peptide 1 (GLP-1) • Inhibition of glucagon secretion • Elevated glucose level • Elevated insulin level
Neural control • Vagus nerves • Stimulate insulin secretion • Endocrine factors • Glucose homeostasis • GH • Diabetogenic (stimulates insulin secretion but reduces peripheral insulin sensitivity) • Glucocorticoids
Glucose counterregulation • Glucose • Primary energy source for brain • No gluconeogenesis • No glycogen • No regulatory mechanisms for level of uptake • Prevention of hypoglycemia • Decreased insulin secretion • Increased glucagon secretion • Release of epinephrine