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Endocrine Module

Endocrine Module. 1b . Pancreas Gland. 6 ” long Horizontal Behind stomach Upper left abdominal quadrant Both endocrine & exocrine functions. Endocrine Pancreas. Islets of Langerhans Alpha cells Glucagon Beta cells Insulin Delta cells Somatostatin. Insulin.

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Endocrine Module

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  1. Endocrine Module 1b

  2. Pancreas Gland • 6” long • Horizontal • Behind stomach • Upper left abdominal quadrant • Both endocrine & exocrine functions

  3. Endocrine Pancreas • Islets of Langerhans • Alpha cells • Glucagon • Beta cells • Insulin • Delta cells • Somatostatin

  4. Insulin • Produced and secreted by… • Beta cells

  5. Insulin • Primary function… • Stimulates the active transport of glucose • from the blood into muscle, liver and adipose tissue  • __?__ blood glucose levels • i

  6. Glucose Content of Food • What % of the carbohydrates consumed breaks down into glucose? • 100% • What % of the protein consumed breaks down into glucose? • 58% • What % of the fat consumed breaks down into glucose? • 10%

  7. Secretion of Insulin • Is stimulated by: • What change in homeostasis does the sensor identify and then stimulates the beta cells to secrete insulin? • Hyperglycemia • Glucose levels in the bloodstream regulate the rate of insulin secretion

  8. The major action of insulin • i blood glucose levels • h the permeability of target cell membrane to glucose • Main target cells • Muscle • Liver • Adipose tissue

  9. Insulin info • The glucose is either metabolized or stored • In the absence of insulin, glucose is not able to get into the cells and it is excreted in the urine • Brain cells are not dependent on insulin for glucose intake

  10. Insulin • Eat the glucose • Muscle  energy • Storage of glucose • Liver = freezer • Glycogen • Synthesis of Adipose tissue = 2nd freezer • Give it away • Glycosuria

  11. Other functions of Insulin • Promote the conversion of glucose  glycogen • Glycogenesis • Also inhibits the conversions of glycogen  glucose • Glycogenolysis • Glycogen = the form in which glucose is stored in the liver

  12. Other functions of Insulin • Promoting the conversion of fatty acids  fat • Adipose tissue

  13. Other functions of Insulin • Preventing the breakdown of fat ketone bodies • Ketone bodies: the byproduct of fat metabolism

  14. Other functions of Insulin • Stimulating protein synthesis • Inhibiting the breakdown of protein amino acids

  15. Insulin Summary • Insulin i blood glucose levels • Promotes the storage of glucose • i energy production from other sources • Glycogen, fat or protein metabolism

  16. Glucagon • Produced and secreted by the • Alpha cells of the Islets of Langerhans • Glucagon stimulates the release of • Glucose by the liver

  17. Glucagon stimulates the release ofGlucose by the liver • What “G” word means the release of glucose by the liver? • Glycogen • Glycogenesis • Glycogenolysis • Glucose • Gone-is-my-brain

  18. The affect of glucagon • h blood glucose level • Hyperglycemia

  19. Glucagon • Glucagon is secreted is response to • Hypoglycemia • Stress • Hypoglycemia may occur during • Stress • Exercise • Fasting

  20. Somatostatin • A hormone secreted by the delta cells of the Islets of Langerhans • Secreted in response to • Hyperglycemia • Action • Interferes with glucagon • Interferes with growth hormone

  21. Somatostatin • Has a hypoglycemic effect

  22. Diagnostic tests • Blood glucose / Fasting blood glucose • 2 hr PPG • Glucose tolerance Test • Glycosylated Hemoglobin Assay

  23. Blood Glucose Fasting blood Glucose • Measures blood glucose levels after fasting • Results • Normal – 70-115 mg/dL • Diabetic level > 126 mg/dL • Critical > 400 mg/dL • Critical < 50 mg/dL

  24. Fasting Blood GlucoseNursing Responsibility • Fast 6-8 hours • Water OK • No insulin or anti-diabetic meds • Exercise will effect results • Meds that interfere

  25. 2-hour post-prandial glucose • Measure blood glucose 2 hours after a meal • Normal • 70-140 mg/dL • Diabetic level • > 140 mg/dL

  26. 2-hour post-prandial glucoseNursing responsibility • Eat entire meal • Don’t eat anything more until blood draw • Water  OK • Notify lab when meal is finished • Exercise with effect results

  27. Glucose Tolerance TestNursing responsibility • Evaluates blood glucose and urine glucose • 30 minutes before • 1 hour after • 2 hours after • 3 hours after • 4 hours after • A glucose load

  28. Glucose Tolerance Test • Normal • Blood glucose < 140mg/dL at 2 hours • Urine negative for glucose (all times) • Diabetic level • Blood glucose > 140 mg/dL at 2 hours • Glucose in urine

  29. Glucose Tolerance TestNursing responsibility • Fasting 6-8 hours before test • Hold meds that interfere • Administer glucose load • Water  encouraged • Collect urine hourly • Administer meal and meds afterwards

  30. Glycosylated Hemoglobin Assays (Hgb A1C) • Percentage of glycosylated hemoglobin • RBC lifecycle • @ 120 days (4 months) • Glucose slowly binds with Hgb  glycosylated • h serum glucose level  h glycosylated Hgb levels

  31. Hgb A1C • Provides an average blood glucose levels • Past 2-3 months • Can be taken any time

  32. Normal levels (non-diabetic) • 4-6% • Diabetic level (goal) • <8%

  33. Small group questions • What is the difference between exocrine and endocrine glands? • Describe anatomically the location of the pancreas. • What are the Islets of Langerhans? • Name the three hormones of the pancreas and identify what cells secrete what hormone.

  34. Small group questions 5. What stimulates each hormone to be secreted? 6. What effect does insulin have on… • Glucose • Glycogen • Protein metabolism • Protein synthesis • Fat metabolism • Fat synthesis

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