Insulin Metabolism And Its Effect On Blood Electrolytes And Glucose In The Turkey Hen.
Abstract Insulin half-life (T1/2) was determined to be similar between egg-laying and non-laying turkey hens, averaging 7.5 vs 8.7 min, respectively. Infused insulin lowered plasma glucose 25% in both groups although the time course of each response was different. Circulating phosphorous decreased 30 min following insulin treatment and returned to preinjection concentrations at the end of sampling. Insulin initiated immediate decreases in plasma calcium and magnesium. It is evident that insulin is involved in electrolyte metabolism as well as glucose metabolism in birds. Continue reading >>
- Effect of Probiotics on Glucose and Lipid Metabolism in Type 2 Diabetes Mellitus: A Meta-Analysis of 12 Randomized Controlled Trials
- Exercise and Glucose Metabolism in Persons with Diabetes Mellitus: Perspectives on the Role for Continuous Glucose Monitoring
- International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #82: Insulin Actions In Vivo: Glucose Metabolism Part 9 of 9
The Effects Of Glucose And Insulin On Renal Electrolyte Transport.
Abstract The effects of hyperglycemia and hyperinsulinemia on renal handling of sodium, calcium, and phosphate were studied in dogs employing the recollection micropuncture technique. Subthreshold sustained hyperglycemia resulted in an isonatric inhibition of proximal tubular sodium, fluid, calcium, and phosphate reabsorption by 8-14%. Fractional excretion of sodium and phosphate, however, fell (P is less than 0.01) indicating that the increased delivery of these ions was reabsorbed in portions of the nephron distal to the site of puncture and in addition net sodium and phosphate transport was enhanced resulting in a significant antinatriuresis and antiphosphaturia. The creation of a steady state plateau of hyperinsulinemia while maintaining the blood glucose concentration of euglycemic levels mimicked the effects of hyperglycemia on proximal tubular transport and fractional excretion of sodium and calcium. Tubular fluid to plasma insulin ratio fell, similar to the hyperglycemic studies. These results suggest that the effects of hyperglycemia on renal handling of sodium and calcium may be mediated through changes in plasma insulin concentration. In contrast to hyperglycemia, however, hyperinsulinemia cuased a significant fall in tubular fluid to plasma phosphate ratio with enhanced proximal tubular phosphate reabsorption (P is less than 0.02). This occurred concomitantly with a significant inhibition of proximal tubular sodium transport. These data indicate that insulin has a direct effect on proximal tubular phosphate reabsorption, and this effect of insulin is masked by the presence of increased amounts of unreabsorbed glucose in the tubule that ensues when hyperinsulinemia occurs secondary to hyperglycemia. Fractional excretion of phosphate fell significantly during Continue reading >>
- Renal Handling of Ketones in Response to Sodium–Glucose Cotransporter 2 Inhibition in Patients With Type 2 Diabetes
- Effects of resveratrol on glucose control and insulin sensitivity in subjects with type 2 diabetes: systematic review and meta-analysis
- Effects of resveratrol on glucose control and insulin sensitivity in subjects with type 2 diabetes: systematic review and meta-analysis
The Effects Of Glucose And Insulin On Renal Electrolyte Transport.
The effects of hyperglycemia and hyperinsulinemia on renal handling of sodium, calcium, and phosphate were studied in dogs employing the recollection micropuncture technique. Subthreshold sustained hyperglycemia resulted in an isonatric inhibition of proximal tubular sodium, fluid, calcium, and phosphate reabsorption by 8-14%. Fractional excretion of sodium and phosphate, however, fell (P is less than 0.01) indicating that the increased delivery of these ions was reabsorbed in portions of the nephron distal to the site of puncture and in addition net sodium and phosphate transport was enhanced resulting in a significant antinatriuresis and antiphosphaturia. The creation of a steady state plateau of hyperinsulinemia while maintaining the blood glucose concentration of euglycemic levels mimicked the effects of hyperglycemia on proximal tubular transport and fractional excretion of sodium and calcium. Tubular fluid to plasma insulin ratio fell, similar to the hyperglycemic studies. These results suggest that the effects of hyperglycemia on renal handling of sodium and calcium may be mediated through changes in plasma insulin concentration. In contrast to hyperglycemia, however, hyperinsulinemia cuased a significant fall in tubular fluid to plasma phosphate ratio with enhanced proximal tubular phosphate reabsorption (P is less than 0.02). This occurred concomitantly with a significant inhibition of proximal tubular sodium transport. These data indicate that insulin has a direct effect on proximal tubular phosphate reabsorption, and this effect of insulin is masked by the presence of increased amounts of unreabsorbed glucose in the tubule that ensues when hyperinsulinemia occurs secondary to hyperglycemia. Fractional excretion of phosphate fell significantly during insulin i Continue reading >>
- Renal Handling of Ketones in Response to Sodium–Glucose Cotransporter 2 Inhibition in Patients With Type 2 Diabetes
- Effects of resveratrol on glucose control and insulin sensitivity in subjects with type 2 diabetes: systematic review and meta-analysis
- Effects of resveratrol on glucose control and insulin sensitivity in subjects with type 2 diabetes: systematic review and meta-analysis
Diabetic Ketoacidosis Medication
Medication Summary Regular and analog human insulins [2] are used for correction of hyperglycemia, unless bovine or pork insulin is the only available insulin. Clinical considerations in treating diabetic ketoacidosis (DKA) include the following: The blood glucose level should not be allowed to fall lower than 200 mg/dL during the first 4-5 hours of treatment. Avoid induction of hypoglycemia because it may develop rapidly during correction of ketoacidosis and may not provide sufficient warning time. Treatment of ketoacidosis should aim to correct dehydration, reverse the acidosis and ketosis, reduce plasma glucose concentration to normal, replenish electrolyte and volume losses, and identify the underlying cause. According to the 2011 JBDS DKA guideline, patients who are already taking long-acting insulin analogues such as glargine or detemir should be maintained at their usual doses. [19, 20] Continue reading >>
Effects Of A Carbohydrate-electrolyte Solution On Cognitive Performance Following Exercise-induced Hyperthermia In Humans
Abstract There is limited information on the effects of sports drinks on cognitive function after exercise in the heat. We aimed to investigate the effects of ingesting a commercially available carbohydrate-electrolyte (CHO) solution on cognitive performance following exercise-induced hyperthermia. Twelve participants completed three practices of cognitive tests, one full familiarisation and two experimental trials in an environmental chamber (dry bulb temperature: 30.2 ± 0.3°C, relative humidity: 70 ± 3%). The experimental trials consisted of five cognitive tests (symbol digit matching, search and memory, digit span, choice reaction time and psychomotor vigilance test) performed before and after a 75-min run on a treadmill at 70% VO2 max. One ml/kg body mass of a 6.8% CHO solution or placebo was consumed at the start, every 15 min during exercise and between cognitive tests after exercise. Core temperature, heart rate, blood glucose concentrations, subjective ratings and cognitive performance were assessed (symbol digit matching, search and memory, digit span, choice reaction time and psychomotor vigilance). Participants were hyperthermic at the end of the run (placebo: 39.5 ± 0.4°C, CHO: 39.6 ± 0.5°C; Mean ± SD; p = 0.37). The change in blood glucose was higher with CHO ingestion (1.6, 0.7 to 4.5 mmol/L) (median, range) than with placebo ingestion (0.9, -0.1 to 4.7 mmol/L; p < 0.05). CHO ingestion reduced the maximum span of digits memorized, in contrast to an increase in maximum span with placebo ingestion (p < 0.05). CHO solution had no effect on other cognitive tests (p > 0.05). These results suggest that CHO solution ingestion may impair short-term memory following exertional heat stress. Background Diminished cognitive ability is of concern to a wide vari Continue reading >>
Significance Of Blood Sugar And Serum Electrolyte Changes In Cirrhosis Following Glucose, Insulin, Glucagon, Or Epinephrine §
Full text Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.0M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References. These references are in PubMed. This may not be the complete list of references from this article. Articles from The Yale Journal of Biology and Medicine are provided here courtesy of Yale Journal of Biology and Medicine Continue reading >>
Amino Acids, Electrolytes, Dextrose And Lipid Injectable Emulsion
KABIVEN® (amino acids, electrolytes, dextrose and lipid) Injectable Emulsion KABIVEN® is a sterile, hypertonic emulsion, for central venous administration, in a Three Chamber Bag. The product contains no added sulfites. Chamber 1 contains Dextrose solution for fluid replenishment and caloric supply. Chamber 2 contains the Amino Acid solution with Electrolytes, which comprises essential and nonessential amino acids provided with electrolytes. Chamber 3 contains Intralipid® 20% (a 20% Lipid Injectable Emulsion), prepared for intravenous administration as a credit of calories and essential fatty acids. See below for formulations of each chamber and Table 2 for strength, pH, osmolarity, ionic concentration and caloric content of KABIVEN® when all the chambers are mixed together. Chamber 1: Contains sterile, hypertonic solution of Dextrose, USP in water for injection with a pH range of 3.5 to 5.5. Dextrose, USP is chemically designated D-glucose, monohydrate (C6H12O6 • H2O) and has the following structure: Chamber 2: Contains a sterile, solution of amino acids and electrolytes in water for injection. In addition, glacial acetic acid has been added to adjust the pH so that the final solution pH is 5.4 to 5.8. The formulas for the individual electrolytes and amino acids are as follows: Sodium Acetate Trihydrate, USP CH3COONax3H2O Potassium Chloride, USP KCl Sodium Glycerophosphate C3H5(OH)2PO4Na2xH2O Magnesium Sulfate Heptahydrate, USP MgSO4x7H2O Calcium Chloride Dihydrate, USP CaCl2x2H2O Essential Amino Acids Lysine (added as the hydrochloride salt) H2N(CH2)4CH(NH2)COOH·HCl Phenylalanine CH2CH(NH2)COOH Leucine (CH3)2CHCH2CH(NH2)COOH Valine (CH3)2CHCH(NH2)COOH Threonine CH3CH(OH)CH(NH2)COOH Methionine CH3S(CH2)2CH(NH2)COOH Isoleucine CH3CH2CH(CH3)CH(NH2)COOH Tryptophan Continue reading >>
- Early-onset and classical forms of type 2 diabetes show impaired expression of genes involved in muscle branched-chain amino acids metabolism
- Type 2 Diabetes: Mastering Injectable Combination Therapies to Individualize & Optimize Outcomes
- Impact of menopause and diabetes on atherogenic lipid profile: is it worth to analyse lipoprotein subfractions to assess cardiovascular risk in women?
Diabetic Ketoacidosis Treatment & Management
Approach Considerations Managing diabetic ketoacidosis (DKA) in an intensive care unit during the first 24-48 hours always is advisable. When treating patients with DKA, the following points must be considered and closely monitored: It is essential to maintain extreme vigilance for any concomitant process, such as infection, cerebrovascular accident, myocardial infarction, sepsis, or deep venous thrombosis. It is important to pay close attention to the correction of fluid and electrolyte loss during the first hour of treatment. This always should be followed by gradual correction of hyperglycemia and acidosis. Correction of fluid loss makes the clinical picture clearer and may be sufficient to correct acidosis. The presence of even mild signs of dehydration indicates that at least 3 L of fluid has already been lost. Patients usually are not discharged from the hospital unless they have been able to switch back to their daily insulin regimen without a recurrence of ketosis. When the condition is stable, pH exceeds 7.3, and bicarbonate is greater than 18 mEq/L, the patient is allowed to eat a meal preceded by a subcutaneous (SC) dose of regular insulin. Insulin infusion can be discontinued 30 minutes later. If the patient is still nauseated and cannot eat, dextrose infusion should be continued and regular or ultra–short-acting insulin should be administered SC every 4 hours, according to blood glucose level, while trying to maintain blood glucose values at 100-180 mg/dL. The 2011 JBDS guideline recommends the intravenous infusion of insulin at a weight-based fixed rate until ketosis has subsided. Should blood glucose fall below 14 mmol/L (250 mg/dL), 10% glucose should be added to allow for the continuation of fixed-rate insulin infusion. [19, 20] In established patient Continue reading >>
Patho Practice Questions
Sort A 26-year-old female recently underwent surgery and is now experiencing dyspnea, cough, fever, and leukocytosis. Tests reveal that she has a collapsed lung caused by removal of air from obstructed alveoli. What condition will the nurse observe on the chart? absorption atelectasis An infant was born 10 weeks premature and put on mechanical ventilation. Two months later he presents with hypoxemia and hypercapnia. Which of the following is the most likely diagnosis the nurse will observe documented on the chart? Bronchopulmonary Dysplasia (BPD) A 50-year-old male presents with hypotension, hypoxemia, and tracheal deviation to the left. Tests reveal that the air pressure in the pleural cavity exceeds barometric pressure in the atmosphere. Based upon these assessment findings, what does the nurse suspect the patient is experiencing? Tension pneumothorax A 42-year-old female presents with dyspnea; rapid, shallow breathing; inspiratory crackles; decreased lung compliance; and hypoxemia. Tests reveal a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury. Which of the following is the most likely diagnosis the nurse will observe on the chart? Acute Respiratory Distress Syndrome (ARDS) A 19-year-old female with type 1 DM was admitted to the hospital with altered consciousness and the following lab values: serum glucose 500 mg/dl (high) and serum K+ 2 (low). Her parents state that she has been sick with the "flu" for a week. The diagnosis is hyperosmolar hyperglycemia nonketotic syndrome (HHNKS). What relationship do these values have with her insulin deficiency? __ __ causes __ and __ __ decreased insulin causes hyperglycemia and osmotic diuresis A 19-year-old female with type 1 DM was admitted to the hospital wi Continue reading >>
Effect Of Insulin On Potassium Flux And Water And Electrolyte Content Of Muscles From Normal And From Hypophysectomized Rats
It was reported previously that insulin hyperpolarized rat skeletal muscle and decreased K+ flux in both directions. The observations on K+ flux are now extended to take advantage of the greater sensitivity to insulin of hyperphysectomized rats. Insulin caused a shift of water from extracellular to intracellular space if glucose was present, but not in its absence. Insulin caused net gain of muscle fiber K+, though not necessarily an increase in K+ concentration in fiber water. It probably also decreased intrafiber Na+ and Cl-. Insulin decreased K+ efflux. The effect was dose-dependent. Muscles from hypophysectomized rats were more sensitive to the action of insulin on K+ flux than were those from normal rats. The effect was demonstrable within the time resolution of the system, suggesting that insulin's action is on cell surfaces. K+ influx was also decreased by insulin. Bookkeeping suggests that some K+ influx be called active. Insulin seemed to decrease active K+ influx and passive K+ efflux. It is not resolved whether insulin has a true dual effect or whether it acts only on passive fluxes in both directions (the apparent action on active K+ influx being an artefact of incomplete definition of passive flux) or whether a single alteration in the membrane may affect both active and passive fluxes. Full Text Selected References These references are in PubMed. This may not be the complete list of references from this article. Continue reading >>
Nur 3125 Exam 2 Endocrine Practice Questions
Sort An endocrinologist is teaching about aldosterone secretion. Which information should the endocrinologist include? Aldosterone secretion is regulated by: The sympathetic nervous system ACTH feedback The renin-angiotension system Positive feedback The renin-angiotension system A patient wants to know what can cause ACTH to be released. How should the nurse respond? High serum levels of cortisol Hypotension Hypoglycemia Stress Stress A student asks the instructor which of the following is the most potent naturally occurring glucocorticoid. How should the instructor respond? Aldosterone Testosterone Cortisol Prolactin Cortisol Which nutrient would the nurse encourage the patient to consume for thyroid hormone synthesis? Zinc Sodium Iodine Calcium Iodine A patient has high levels of hormones. To adapt to the high hormone concentrations, the patient's target cells have the capacity for: Negative feedback Positive feedback Down-regulation Up-regulation Down-regulation A nurse recalls insulin has an effect on which of the following groups of electrolytes? Sodium, chloride, phosphate Calcium, magnesium, potassium Hydrogen, bicarbonate, chloride Potassium, magnesium, phosphate Potassium, magnesium, phosphate Which gland secretes ADH and oxytocin? Anterior pituitary Posterior pituitary Hypothalamus Pineal gland Posterior pituitary A 30-year-old male was diagnosed with hypothyroidism. Synthesis of which of the following would decrease in this patient? Corticosteroid B globulin Sex hormone-binding globulin Thyroid-binding globulin Albumin Thyroid-binding globulin A nurse is teaching a patient about insulin. Which information should the nurse include? Insulin is primarily regulated by: Metabolic rate Serum glucose levels Prostaglandins Enzyme activation Serum glucose levels A 50 Continue reading >>
Starvation And Refeeding In Rats: Effect On Some Parameters Of Energy Metabolism And Electrolytes And Changes Of Hepatic Tissue
Regarding the importance of starvation and refeeding and the occurrence of refeeding syndrome in various conditions, the present study was conducted to investigate the effects of refeeding on some parameters of energy metabolism and electrolytes and changes of hepatic tissue in male Wistar rats. Fifty-seven rats were divided into six groups, having 6 to 11 rats. Food was provided ad-libitum until three months and then the first group was considered without starvation (day 0). Other rats were fasted for two weeks. Group 2 was applied to a group immediately after starvation (day 14). Groups 3 to 6 were refed in days 16 till 22, respectively. At the end of each period, blood and tissue samples were taken and histopathological and serum analysis, including serum electrolytes (calcium, phosphorus, sodium, potassium), the energy parameters (glucose, insulin, cortisol) and the liver enzymes (ALT, AST, ALP) were determined. Insulin decreased by starvation and then showed an increasing trend compared to starvation period, which the highest amount of this parameter was observed eight days post-refeeding. Serum glucose level showed the opposite pattern of insulin. Histopathological examination of the tissue sections revealed clear vacuoles after starvation and refeeding, in which the severity of lesions gradually decreased during refeeding. The cortisol level decreased by starvation and then increased during refeeding. Also, potassium and phosphorus concentrations declined by refeeding and the serum sodium and potassium levels were changed in the relatively opposite manner. The calcium level decreased by starvation and then increased during refeeding. These results could help recognize and remedy the refeeding syndrome. Index Terms: Refeeding; fasting; serum biochemical; histopath Continue reading >>
Physiologic Effects Of Insulin
Stand on a streetcorner and ask people if they know what insulin is, and many will reply, "Doesn't it have something to do with blood sugar?" Indeed, that is correct, but such a response is a bit like saying "Mozart? Wasn't he some kind of a musician?" Insulin is a key player in the control of intermediary metabolism, and the big picture is that it organizes the use of fuels for either storage or oxidation. Through these activities, insulin has profound effects on both carbohydrate and lipid metabolism, and significant influences on protein and mineral metabolism. Consequently, derangements in insulin signalling have widespread and devastating effects on many organs and tissues. The Insulin Receptor and Mechanism of Action Like the receptors for other protein hormones, the receptor for insulin is embedded in the plasma membrane. The insulin receptor is composed of two alpha subunits and two beta subunits linked by disulfide bonds. The alpha chains are entirely extracellular and house insulin binding domains, while the linked beta chains penetrate through the plasma membrane. The insulin receptor is a tyrosine kinase. In other words, it functions as an enzyme that transfers phosphate groups from ATP to tyrosine residues on intracellular target proteins. Binding of insulin to the alpha subunits causes the beta subunits to phosphorylate themselves (autophosphorylation), thus activating the catalytic activity of the receptor. The activated receptor then phosphorylates a number of intracellular proteins, which in turn alters their activity, thereby generating a biological response. Several intracellular proteins have been identified as phosphorylation substrates for the insulin receptor, the best-studied of which is insulin receptor substrate 1 or IRS-1. When IRS-1 is activa Continue reading >>
The Effect Of Insulin On Renal Handling Of Sodium, Potassium, Calcium, And Phosphate In Man.
The effects of insulin on the renal handling of sodium, potassium, calcium, and phosphate were studied in man while maintaining the blood glucose concentration at the fasting level by negative feedback servocontrol of a variable glucose infusion. In studies on six water-loaded normal subjects in a steady state of water diuresis, insulin was administered i.v. to raise the plasma insulin concentration to between 98 and 193 muU/ml and infused at a constant rate of 2 mU/kg body weight per min over a total period of 120 min. The blood glucose concentration was not significantly altered, and there was no change in the filtered load of glucose; glomerular filtration rate (CIN) and renal plasma flow (CPAH) were unchanged. Urinary sodium excretion (UNaV) decreased from 401 plus or minus 46 (SEM) to 213 plus or minus 18 mueq/min during insulin administration, the change becoming significant (P smaller than 0.02) within the 30-60 min collection period. Free water clearance (CH2O) increased from 10.6 plus or minus 0.6 to 13 plus or minus 0.5 ml/min (P smaller than 0.025); osmolar clearance decreased and urine flow was unchanged. There was no change in plasma aldosterone concentration, which was low throughout the studies, and a slight reduction was observed in plasma glucagon concentration. Urinary potassium (UKV) and phosphate (UPV) excretion were also both decreased during insulin administration; UKV decreased from 66 plus or minus 9 to 21 plus or minus 1 mueq/min (P smaller than 0.005), and tupv decreased from 504 plus or minus 93 to 230 plus or minus 43 mug/min (P smaller than 0.01). The change in UKV was associated with a significant reduction in plasma potassium concentration. There was also a statistically significant but small reduction in plasma phosphate concentration whi Continue reading >>
Capt Review
Which of the following drugs is categorized as a hallucinogen? Hint: Review hallucinogens. Flashcards Matching Hangman Crossword Type In Quiz Test StudyStack Study Table Bug Match Hungry Bug Unscramble Chopped Targets Pharamacology Question Answer Which of the following drugs is categorized as a hallucinogen? Hint: Review hallucinogens. Mescaline Lithium toxicity may be seen when the client also used which of the following medications? Hint: Review use of lithium. Indomethacin The client treated for anorexia may receive which of the following medications? Hint: Review pharmacologic treatment of anorexia. Periactin (cyproheptaadine) Most of the medications used to treat the co-morbid conditions of eating disorders may cause which of the following side effects? Hint: Review pharmacologic treatment of eating disorders. Insomnia or somnolence Clients taking sucralfate (Carafate) may have the absorption of which of the following drugs reduced? Hint: Review the drug interactions of sucralfate. Dilantin Mellaril (Thioridazine) is most commonly given for which of the following reasons? Hint: Review use of mellaril. To increase level of alertness. Triazolam (Halcion) is used to treat which of the following? Hint: Review use of Halcion. Insomnia Clients who are receiving both an MAO inhibitor and valproate (Depakote, Depakene, Depacon) may experience which of the following? Hint: Review the drug interactions of valproate. The seizure threshold may be lowered and the effectiveness of valproate decreased. Vitamin E has which of the following actions? Hint: Review use and action of Vitamin E. Antioxidant Trihexyphenidyl (Artane or Trihexane) is used for which of the following reasons? Hint: Review use of trihexyphenidyl. To reduce the signs and symptoms of parkinsonian syndrome. Hyd Continue reading >>
