Hormones and Physiology
Which hormone suppresses glucagon release and slows gastric emptying after meals?
Amylin
Why do patients with Type 1 diabetes develop ketosis, while Type 2 patients typically do not?
Type 1 lacks insulin → fat breakdown → ketone production; Type 2 has enough insulin to suppress lipolysis
This insulin is given with meals
rapid-acting insulin (lispro)
Interpret ABG: pH 7.25, HCO₃ 16, CO₂ 30
Metabolic acidosis with respiratory compensation
This hormone signals satiety
What is leptin?
This hormone TYPE increases appetite
What is Orexigenic (ghrelin and glucagon)
What compensatory mechanism initially maintains normal glucose levels in early Type 2 diabetes?
Increased insulin production (hyperinsulinemia)
This insulin has NO peak
What is glargine (long-acting insulin)?
Why do patients with DKA develop Kussmaul respirations?
Respiratory compensation for metabolic acidosis (blowing off CO₂)
What is the most clinically significant risk associated with central adiposity?
Cardiovascular disease (metabolic syndrome)
This process creates new glucose
What is gluconeogenesis?
A1C level that diagnoses diabetes
6.5%
This drug class can cause lactic acidosis
What are biguanides (metformin)?
What key lab difference distinguishes DKA from HHS? This breathing pattern is seen in DKA
DKA = metabolic acidosis; HHS = little to no acidosis
What is the key physiological difference between hunger and appetite?
Hunger = physiological need; appetite = psychological desire satiety
What incretin-based mechanism improves postprandial glucose control?
GLP-1 effect → ↑ insulin, ↓ glucagon, slowed gastric emptying
What underlying defect leads to HHS instead of DKA?
Enough insulin to prevent ketosis but not enough to prevent severe hyperglycemia Pre-diabetes (5.7-6.4)
This insulin type is safest IV
Regular Insulin
This condition has extreme dehydration without ketosis (and why?)
What is HHS? Prolonged osmotic diuresis due to extremely high glucose levels
Explain why weight loss plateaus
Metabolic adaptation (↓ metabolism + ↑ hunger hormones)?
How does insulin promote both glucose uptake and protein synthesis at the cellular level?
By activating GLUT4 transporters for glucose entry and increasing amino acid uptake for protein synthesis (anabolism)
How does chronic hyperglycemia lead to microvascular complications?
Damage to small blood vessels → retinopathy, nephropathy, neuropathy
Why do sulfonylureas carry a higher hypoglycemia risk than metformin?
They stimulate continuous insulin release regardless of blood glucose levels
Explain WHY potassium is high in DKA
Acidosis causes potassium to shift OUT of cells into bloodstream
Why do GLP-1 agonists promote both weight loss and improved glycemic control?
They increase insulin, decrease glucagon, slow gastric emptying, and increase satiety