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Type 2 Diabetes Defeated

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TestYour Knowledge ofTerms and Facts

Match these:

absorption of a carbohydrate meal

2. fasting a. rise in insulin; rise in glucagon b. fall in insulin; rise in glucagon c. rise in insulin; fall in glucagon d. fall in insulin; fall in glucagon

Match these:

3. growth a. increased protein hormone synthesis; increased

4. thyroxine cell respiration

5. hydrocortisone b. protein catabolism in muscles; gluconeogenesis in liver c. protein synthesis in muscles; decreased glucose utilization d. fall in blood glucose; increased fat synthesis

6. A lowering of blood glucose concentration promotes a. decreased lipogenesis.

b. increased lipolysis.

c. increased glycogenolysis.

7. Glucose can be secreted into the blood by a. the liver.

b. the muscles.

c. the liver and muscles.

d. the liver, muscles, and brain.

The basal metabolic rate is determined primarily by a. hydrocortisone.

b. insulin.

c. growth hormone.

d. thyroxine.

Somatomedins are required for the anabolic effects of a. hydrocortisone.

b. insulin.

c. growth hormone.

d. thyroxine.

The increased intestinal absorption of calcium is stimulated directly by a. parathyroid hormone.

b. 1,25-dihydroxyvitamin D3.

c. calcitonin.

A rise in blood calcium levels directly stimulates a. parathyroid hormone secretion.

b. calcitonin secretion.

c. 1,25-dihydroxyvitamin D3 formation.

At rest, about 12% of the total calories consumed are used for a. protein synthesis.

b. cell transport.

d. DNA replication.

Which of these hormones stimulates anabolism of proteins and catabolism of fat?

a. growth hormone b. thyroxine c. insulin d. glucagon e. epinephrine

14. If a person eats 600 kilocalories of protein in a meal, which of these statements will be false?

a. Insulin secretion will be increased.

b. The metabolic rate will be increased over basal conditions.

c. The tissue cells will use some of the amino acids for resynthesis of body proteins.

d. The tissue cells will obtain 600 kilocalories worth of energy.

e. Body-heat production and oxygen consumption will be increased over basal conditions.

15. Ketoacidosis in untreated diabetes mellitus is due to a. excessive fluid loss.

b. hypoventilation.

c. excessive eating and obesity.

d. excessive fat catabolism.

16. Which of these statements about leptin is false?

a. It is secreted by adipocytes.

b. It increases the energy expenditure of the body.

c. It stimulates the release of neuropeptide Y in the hypothalamus.

It promotes feelings of satiety, decreasing food intake.

Test Your Understanding of Concepts and Principles

Compare the metabolic effects of 3.

fasting to the state of uncontrolled type 1 diabetes mellitus. Explain the hormonal similarities of these conditions.1 4.

Glucocorticoids stimulate the breakdown of protein in muscles but the synthesis of protein in the liver. 5.

Explain the significance of these different effects.

Describe how thyroxine affects cell respiration. Why does a person who is hypothyroid have a tendency to gain weight and less tolerance for cold? Compare and contrast the metabolic effects of thyroxine and growth hormone.

Why is vitamin D considered both a vitamin and a prehormone? Explain why people with osteoporosis might be helped by taking controlled amounts of vitamin D.

6. Define the term insulin resistance. Explain the relationship between insulin resistance, obesity, exercise, and non-insulin-dependent diabetes mellitus.

7. Describe the chemical nature and origin of the somatomedins and explain the physiological significance of these growth factors.

lNote: This question is answered in the chapter 19 Study Guide found on the Online Learning Center at

Regulation of Metabolism

8. Explain how insulin secretion and glucagon secretion are influenced by (a) fasting, (b) a meal that is high in carbohydrate and low in protein, and (c) a meal that is high in protein and high in carbohydrate. Also, explain how the changes in insulin and glucagon secretion under these conditions function to maintain homeostasis.

9. Using a cause-and-effect sequence, explain how an inadequate intake of dietary calcium or vitamin D can cause bone resorption. Also, describe the cause-and-effect sequence whereby an adequate intake of calcium and vitamin D may promote bone deposition.

10. Describe the conditions of gigantism, acromegaly, Laron dwarfism, and kwashiorkor, and explain how these conditions relate to blood levels of growth hormone and IGF-1.

Test Your Ability to Analyze and Apply Your Knowledge

1. Your friend is trying to lose weight and at first is very successful. After a time, however, she complains that it seems to take more exercise and a far more stringent diet to lose even one more pound. What might explain her difficulties?

2. How can a high-fat diet in childhood lead to increased numbers of adipocytes? Explain how this process may be related to the ability of adipocytes to regulate the insulin sensitivity of skeletal muscles in adults.

Discuss the role of GLUT4 in glucose metabolism and use this concept to explain why exercise helps to control type 2 diabetes mellitus. You are running in a 10-K race and, to keep your mind occupied, you try to remember which physiological processes regulate blood glucose levels during exercise. Step by step, what are these processes?

5. Discuss the location and physiological significance of the |33 adrenergic receptors and explain how a hypothetical p3 adrenergic agonist drug might help in the treatment of obesity.

6. A person with type 1 diabetes mellitus accidentally overdoses on insulin. What symptoms might she experience, and why? If she remains conscious, what treatment might be offered to adjust her blood glucose level?

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