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REGUB: Path of T1DM (ii) (Insulin (key anabolic hormone, regulated glucose…
REGUB: Path of T1DM (ii)
Insulin
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synthesised in B-cells of endocrine pancreas (islets of Langerhans) as pro-insulin, secreted as insulin + C-peptide
C-peptide = remnant, longer T1/2 so bettie measure of insulin secretory activity (blood test if required)
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blood glucose controlled by insulin + other counter-regulatory hormones (glucagon secreted by alpha cells, adrenaline, steroids, GH)
constant basal level of insulin secretion, then bursts of insulin following eating
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most tissues require insulin for uptake of glucose (exceptions - brain, renal tubules, RBCs)
key effects on tissues a/w energy storage - adipose tissue, skeletal muscle, liver
insulin promotes glucose uptake by adipose tissue + muscle (used as energy, in muscle for glycogen synthesis)
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insulin promotes glycogen synthesis in liver (glycogen can be broken down between meals to supply obligate glucose metabolisers, e.g. brain)
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insulin promotes AA uptake + protein synthesis, inhibits protein breakdown, inhibits ketone body formation
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Classification of DM
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T2
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insulin levels may be initially high, decline later in disease
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