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How To Insulin And Glucagon Work Together

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Question: Describe The Way In Which Insulin And Glucagon Work Together To Maintain Blood-glucose Homeostasi...

Describe the way in which insulin and glucagon work together to maintain blood-glucose homeostasis. Include in your answer a discussion of the ways in which insulin can enhance the effects of Growth Hormone. Your answer should : begin with a short introductory paragraph; cover the topic in two, three, four or more distinct paragraphs; end with a concluding paragraph that ties your answer together The cells in the body are affected by the amount of glucose circulating in the blood Therefore; if the concentration of glucose in the body is increased or decreased the body would be greatly affected. The homeostasis of blood glucose levels is based... view the full answer Continue reading >>

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  1. justadream

    Current (2016) edition of FA indicates that Beta2-binding causes increased insulin release.
    Previous editions of FA (although not the current one I think) and Wikipedia (see quote below) indicate that Beta2-binding causes increased glucagon release.
    "Hypoglycemia can occur with beta blockade because β2-adrenoceptors normally stimulate hepatic glycogen breakdown (glycogenolysis) and pancreatic release of glucagon, which work together to increase plasma glucose. Therefore, blocking β2-adrenoceptors lowers plasma glucose. "
    https://en.wikipedia.org/wiki/Beta_blocker#Adverse_effects
    So is it both?
    Assuming it is both, then why would Beta2-blockage cause the hypoglycemia effect illustrated in the Wikipedia quote? Blocking Beta2 ==> blocking insulin AND glucagon ==> ??? ==> hypoglycemia?

  2. Kendragon

    Beta 2 binding can cause both insulin release and glucagon release. I've tried looking through this article to figure out the mechanisms, but it seems like the exact mechanisms still aren't quite clear yet. So I wouldn't get too caught up on the wikipedia quote.
    I think the important higher yield things to focus on are:
    -The first aid "Glycogen regulation by insulin and glucagon/epinephrine" chart, showing how Beta receptor stimulation by epinephrine triggers glycogenolysis via cAMP.
    -That beta blockers can increase the risk of severe hypoglycemia because it masks the epinephrine induced warning signs of neuroglycopenia (sweating, anxiety).

  3. Taco Time

    Kendragon said: ↑
    Beta 2 binding can cause both insulin release and glucagon release. I've tried looking through this article to figure out the mechanisms, but it seems like the exact mechanisms still aren't quite clear yet. So I wouldn't get too caught up on the wikipedia quote.
    I think the important higher yield things to focus on are:
    -The first aid "Glycogen regulation by insulin and glucagon/epinephrine" chart, showing how Beta receptor stimulation by epinephrine triggers glycogenolysis via cAMP.
    -That beta blockers can increase the risk of severe hypoglycemia because it masks the epinephrine induced warning signs of neuroglycopenia (sweating, anxiety).
    Click to expand... Also, the biggest beta-adrenergic effect to keep in mind that'll be masked is tachycardia. This is especially important because the patient that isn't adherent with their meds comes into the hospital with a blood glucose of nearly 1,000 with their serum osmolarity off the charts, but they're urine is loaded with glucose and they're peeing out a ton of fluids. A patient not on B-blockers will get tachycardia to counter the volume depleted state, CO = HR x SV. Whereas a patient on a B-blocker will have their tachycardia masked. It's important to keep this in mind on exams (I remember Rx had a question on it) and in real life with T2DM patients that are on a B-blocker for CHF and diabetes meds.

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