KINE 2475 Lecture Notes - Lecture 26: Insulin Resistance, Incretin, Hypertension

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& low hdl-cholesterol levels: detects, impaired insulin secretion, deficiency & resistance to incretin hormone, insulin resistance involving muscle, liver & adipocytes, excess glucagon secretion, increased hepatic glucose production, upregulation of na+-glucose cotransporter in kidney, systemic inflammation, diminished satiety. In non-diabetes individuals, insulin increases in proportion to severity of insulin resistance: first-phase insulin releases stored insulin in beta-cells to prime liver for nutrient intake. Pre-diabetes & diabetes occurs when insulin can no longer normalize plasma glucose. In patients with type 2, b-cell mass & function are both reduced: progressive disease. Impaired glucose tolerance (igt): failure to compensate by increasing insulin secretion: reasons for progressive b-cell loss: Insulin resistance: glucotoxicity- when glucose levels >140mg/dl (7. 8mmol/l, age, genetics. Incretin deficient: decreased postprandial (post-lunch) insulin is due impaired b-cell function & diminished stimuli from gut hormones. Levels of glp decreases: hormones responsible for 90% insulin secretion after meals, glucagon-like-peptide-1 (glp-1, glucose-dependent insulinotropic polypeptide (gip, glp suppresses glucagon secretion, slows gastric emptying.

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