
1. Synthesis of insulin.
2. Storage of insulin
3. Releasing of insulin.
4. Regulation of insulin.
a) Exocrine function of pancreas.
b) Islets of Langerhans. (structure).
c) Alpha, beta, delta and PP cells. Location in islets of Langerhans.
d) Beta cells secretion. (insulin + c-peptide) amylin and proinsulin)
e) Alpha cells secretions. (glucagon)
f) Delta cells secretion. (somatostatin).
g) Paracrine effect in islet of Langerhans.
h) Blood circulation through islets of Langerhans.
i) Synthesis of insulin.
j) Preproinsulin.
k) Proinsulin
1. Sensory system for synthesis of insulin.
2. G-binding protein on the surface of beta cell. (glucose transporter type II)
3. GLUT-2.
4. Action of glucose kinase action on glucose.
5. TCA and production of ATP’S in beta cells.
6. ATP sensitive K+ channel. Regulation.
7. Ca++ channels and role in releasing of insulin by exocytosis.
8. Drugs acts on ATP sensitive K+ channels.
a) Sulphonyl urea.
b) Meglitinides.
9. Dioxide role in insulin secretion by acting on ATP sensitive K+ channel.
10. Concept of Insulinoma.
1. Brief revision of insulin synthesis and releasing into extra cellar fluid.
2. GIT wall release incretins (peptides) that increase releasing insulin.
3. Functions of incretins.
4. Action of Exenatide. (brief mechanism)
5. Sitagliptin pharmacological effects.
1. Hormones that influence on secretion of insulin.
2. Glucagon receptor on beta cells and its function.
3. Cortisol effect on insulin production.
4. GH effect on insulin releasing.
5. PNS acetylcholine role in releasing insulin.
6. SNS, nor adrenaline effect on insulin production.
7. Somatostatin role in inhibiting insulin.
8. Some important facts about C-peptide.
9. C-Peptide is the better marker to check beta cell function.
10. Differences between type 1 and type 2 diabetes mellitus.
11. Differences between human insulin, pig insulin and cow insulin.
12. Exogenous insulin characteristics.
13. C- peptide biological action.
14. C-peptide importance in diabetic mellitus management.
1. Introduction.
2. General concepts about insulin;
i) What is insulin?
ii) Insulin synthesis.
iii) Role of insulin.
iv) Insulin regulation.
v) Islet of Langerhans.
vi) Types of cells inside islet of Langerhans.
vii) Releasing of insulin (Brief mechanism.)
3. The action of insulin.
4. Structure of insulin receptor.
5. Autophosphorylation of Beta subunits of IR.
6. Tyrosine kinase receptors.
Role of Na+ - K+ ATPases.
1. Introduction.
2. Normal values of serum K+.
3. How body regulate K+ level.
4. Role of Kidneys in maintaining serum K+ levels.
5. Post-prandial insulin importance to regulate K+.
6. Molecular mechanism of shifting K+ into intracellular compartment.
7. Insulin receptor and PI3K/AKT pathway.
8. Effect of insulin on Na+ - K+ ATPases.
9. Role of protein phosphatases.
1. K+ levels clinical correlates.
a) In type 1 DM.
b) Pathophysiology of DKA. ( brief mechanisms).
c) Principle of management of DKA with hyperkalemia, normal serum K+ level and hypokalemia.
2. Hyperkalemia.
a) Acute renal failure.
b) Extensive tissue injury ( breakdown).
c) ECG changes during hyperkalemia.
d) Importance of calcium gluconate.
e) Drugs used to manage hyperkalemia.
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