Transcript control of intermediary metabolism

ACUTE EFFECTS OF INSULIN
DEFICIENCY IN DIABETES MELLITUS
D. C. MIKULECKY
Dept. Physiology
EFFECTS OF INSULIN
DEFICIENCY
INCREASED HEPATIC GLUCOSE OUTPUT
FROM GLYCOGEN STORES
FAT AND MUSCLE CELLS UNABLE TO TAKE
UP GLUCOSE
FALL IN TRIGLYCERIDE SYNTHESIS IN
ADIPOCYTES
INCREASED LYPOLYSIS
FALL IN AMINO ACID UPTAKE BY CELLS
INCREASED PROTEIN DEGRADATION
EFFECTS OF INSULIN
DEFICIENCY: HYPERGLYCEMIA
INCREASED HEPATIC GLUCOSE OUTPUT
FROM GLYCOGEN STORES
FAT AND MUSCLE CELLS UNABLE TO TAKE
UP GLUCOSE
EFFECT OF HYPERGLYCEMIA
GLUCOSURIA
OSMOTIC DIURESIS
POLYURIA
DEHYDRATION
EFFECTS OF DEHYDRATION
 POLYDIPSIA
 CELLULAR
SHRINKING
 BRAIN CELLS ARE
DYSFUNCTIONAL AS A
RESULT NERVOUS
SYSTEM
MALFUNCTION
 DEATH
 FALL IN BLOOD
VOLUME
 PERIPHERAL
CIRULATORY FAILURE
 RENAL FAILURE
 DEATH
EFFECTS OF INSULIN DEFICIENCY:
INCREASED BLOOD FATTY ACIDS
FALL IN TRIGLYCERIDE SYNTHESIS IN
ADIPOCYTES
INCREASED LYPOLYSIS
EFFECT OF INCREASED BLOOD FATTY
ACIDS AND FAILURE OF GLUCOSE TO
ENTER CELLS
 UTILIZATION OF FAT AS PRIMARY ENERGY
SOURCE
 KETOSIS
 METABOLIC ACIDOSIS AND INCREASED
VENTILATION AS A RESULT
 DEPRESSIVE EFFECT ON BRAIN FROM ACIDOSIS
 DIABETIC COMA
 DEATH
EFFECTS OF INSULIN
DEFICIENCY: PROTEIN
FALL IN AMINO ACID UPTAKE BY CELLS
INCREASED PROTEIN DEGRADATION
LOSS OF MUSCLE MASS
WEIGHT LOSS
AGGRIVATION OF HYPERGLYCEMIA DUE
TO GLUCONEOGENESIS