C785 Glucose Regulation

25. Which of the following is stimulated by glucagon? (Choose all that apply.)

Gluconeogenesis Glycogenolysis

40. Glycogen is:

Glucose storage molecule. A polymer of glucose units. Also referred to as a polysaccharide. Glucose storage molecule. A polymer of glucose units. Also referred to as a polysaccharide.

29. Glucose is a monosaccharide. It can be used as the raw material to build which one of the following molecules?

Glycogen

47. Describe the relationship between insulin and Glut4.

Insulin

46. Once glucose is inside of a cell, it is phosphorylated. Why is this significant?

Glucose

19. Which process is stimulated when insulin is released into the bloodstream?

glycogenesis

8. How does glucagon increase blood glucose concentration?

Glucagon stimulates gluconeogenesis and glycogenolysis

36. Emma was prescribed metformin which is used to control blood glucose levels. One direct effect of metformin is inhibition of the _________ pathway in the liver.

Gluconeogenesis

17. Which process is stimulated when glucagon is released into the bloodstream?

Glycogenolysis Glycogenolysis is one such pathway that will result in increased glucose concentration. The correct answer is "Glycogenolysis ".

18. A patient with advanced cancer has not been able to eat a full meals for the past three months, and his intake has gradually diminished over the last month such that his entire intake in the prior three days consists solely of water. Which of the following is most likely?

He is likely to have lost adipose tissue and muscle mass

9. A patient with advanced cancer has not been able to eat a full meals for the past three months, and his intake has gradually diminished over the last month such that his entire intake in the prior three days consists solely of water. Which of the following is most likely?

He is likely to have lost adipose tissue and muscle mass

15. Billy is a 26-year-old male currently on his 12th day of a hunger strike to protest "government stuff." How can Billy keep going long after his glycogen supply has been used up? (Note: The brain requires a constant supply of glucose to function.)

He uses glycerol, some amino acids, and other molecules to create new glucose.

7. Billy is a 26-year-old male currently on his 12th day of a hunger strike to protest "government stuff." How can Billy keep going long after his glycogen supply has been used up? (Note: The brain requires a constant supply of glucose to function.)

He uses glycerol, some amino acids, and other molecules to create new glucose.

8. A woman is about to begin her ascent of Mount Everest and is preparing for Day 1 of the climb. Approximately 6 hours before the hike begins, she and her climbing team eat a meal containing 80% complex carbohydrates. What is the physiological benefit of this approach?

Improving glycogen stores in liver and muscle

27. Which of the following best describes why a patient on metformin is at risk for lactic acidosis?

In the liver, metformin inhibits gluconeogenesis.

13. Katrina is an 18-year-old female at Southwest High. Her high school is raising money by hosting a marathon pledge drive. She was advised to carb load before the big race. Why would this be recommended?

Loading on carbohydrates will increase glucose levels. Under high glucose conditions, cells perform glycogenesis, a process of building glycogen from glucose molecules. Glycogen can then be broken down rapidly into individual glucose units when glucose is low, such as during a marathon.

5. Katrina is an 18-year-old female at Southwest High. Her high school is raising money by hosting a marathon pledge drive. She was advised to carb load before the big race. Why would this be recommended?

Loading on carbohydrates will increase glucose levels. Under high glucose conditions, cells perform glycogenesis, a process of building glycogen from glucose molecules. Glycogen can then be broken down rapidly into individual glucose units when glucose is low, such as during a marathon.

14. Jason is a 17-year-old male with a glycogen storage disease. He is also planning on running the high school marathon. Should Jason consume a diet that is low in a) fats, b) protein/amino acids, or c) carbohydrates/glucose? Explain.

Low carbohydrate because he is unable to use stored glycogen for a quick source of energy.

6. Jason is a 17-year-old male with a glycogen storage disease. He is also planning on running the high school marathon. Should Jason consume a diet that is low in a) fats, b) protein/amino acids, or c) carbohydrates/glucose? Explain.

Low carbohydrate because he is unable to use stored glycogen for a quick source of energy.

4. A type II diabetes patient who has been on metformin treatment along with making some life style changes for over two months now has a current A1C level reading of 7% . Which of the following statements best describes his response to the treatment and management of the condition?

No, the patient is not responding to the treatment since the normal range of A1C levels in healthy individuals is 0-5% The normal range of A1C levels in healthy individuals is anywhere from 0-5%. A level above 6.5% indicates a high Glucose concentration. Since the patient's A1C levels are at 7%, it is clearly indicating that his/her blood sugars levels are not in the normal range and the patient is not responding well to the treatment.

1. Match the effects of insulin with the corresponding numbered diagram.

glucose, protein, glycogen synthesis, fatty acid synthesis Insulin has several effects on metabolism. It stimulates uptake of glucose into the cell. It also increases protein synthesis, glycogen synthesis and fatty acid synthesis and storage.

48. What is the product of glycogenesis?

glycogen Glycogen is the product of glycogenolysis. Glycogenesis is the process of creating glucose from glycogen.

30. Carbohydrate loading is a common practice among endurance athletes. Often, three days before a big endurance event, they are known to eat large amounts of complex carbohydrates which leads to the storage of glycogen in their muscles. The stored glycogen increases their endurance by providing a steady supply of glucose during the event by the process of _______________.

glycogenolysis The process of breaking glycogen (a storage form of glucose) to release individual glucose molecules is known as glycogenolysis.

32. The complications of diabetes result from the accumulation of which of the following:

32. The complications of diabetes result from the accumulation of which of the following:

43. Insulin is a hormone that is secreted in response to high glucose levels (fed state) and does the following?

Accelerates diffusion of glucose into cells, converts glucose to glycogen, speeds fatty acid synthesis.

35. Which one of the following could result in better outcomes for type 2 diabetics?

An increased number of GluT4 transporters in the cell membrane.

34. While treatment with metformin is beneficial for many individuals with type 2 diabetes, patients are at increased risk for lactic acidosis. What effect of metformin directly contributes to this potential risk?

Decreased gluconeogenesis in the liver

Learning Objective

Given a scenario (person with glycogen storage disease running a marathon, fasting scenario, carb loading before a sport activity), the student will identify the impact on glucose production and/or storage. (3 questions on the assessment)

1.Insulin has many anabolic effects on the body. Which of the following terms best relates to anabolic?

Builds up

39. Gluconeogenesis is:

Creating new glucose

49. When does the body stimulate glycogenolysis?

During a fasting state

28. It is 6pm. Eric skipped lunch and hasn't eaten since 7am when he left the house this morning. Which of the following is expected?

Eric's body will have elevated levels of glucagon which will trigger gluconeogenesis and glycogenolysis Eric's body will have elevated levels of glucagon which will trigger gluconeogenesis and glycogenolysis. Since Erik skipped lunch, by 6 pm his glucose supply is low. Glucagon is the counteracting hormone to insulin and stimulates glucose production and release into the blood. Glucagon increases blood sugar between meals, supplying energy to the brain and active muscles. Glucagon stimulates the production of glucose via gluconeogenesis by the liver. Glucagon stimulates liver cells to break down stores of glycogen, releasing glucose into the blood. It also causes the breakdown of glycogen in muscle cells and the production of glucose from amino acids.

37. Emma has an A1C level of 7.0% in her blood. A1C is a form of__________________.

Hemoglobin he glycated form of hemoglobin is called A1C (other names are hemoglobin A1c, HbA1c), and it serves as a helpful indicator of blood glucose levels. In healthy bodies, a small percentage of A1C exists at any given point in time, due to the slow, constant rate of glycation. The percentage of A1C under normal conditions is usually less than 5% of hemoglobin. However, when blood sugar levels are high for extended periods of time, the A1C levels go above this standard range.

11. Hemoglobin A1c (sometimes referred to simply as A1c) is a molecule measured for a laboratory test. It is used to confirm the diagnosis of diabetes and to assess a diabetic patient's level of disease control. How and why do advanced glycation end products (AGEs) form?

High blood glucose causes glycation, a reaction where a covalent bond forms between a sugar molecule and a protein. Additional glycation reactions cross-link proteins together into AGEs, which can impair the function of the proteins and their associated organs.

16. A woman is about to begin her ascent of Mount Everest and is preparing for Day 1 of the climb. Approximately 6 hours before the hike begins, she and her climbing team eat a meal containing 80% complex carbohydrates. What is the physiological benefit of this approach?

Improving glycogen stores in liver and muscle

45. Explain how GluT4 transporters aid in glucose transport into a cell.

Insulin, which is secreted by the pancreas in response to elevated glucose levels in the blood, increases the insertion of one type of GluT (Glucose transporter), called GluT4, into the plasma membranes of most body cells, thereby increasing the rate of facilitated diffusion of glucose into those cells. This is especially evident in muscle and adipose cells. The GluT4 proteins are located on intracellular vesicles that fuse with the membrane and quickly increase the number of GluT4 transporters . This process is known as translocation of GluT4.

21. Which of the following chemicals can be produced in dangerous excess in a patient taking metformin because of its effect of decreasing the liver's participation in the Cori cycle?

Lactic acid

12. A type II diabetes patient who has been on metformin treatment along with making some life style changes for over two months now has a current A1C level reading of 7% . Which of the following statements best describes his response to the treatment and management of the condition?

No, the patient is not responding to the treatment since the normal range of A1C levels in healthy individuals is 0-5%

41. Glycogenesis is:

Process to build glycogen Glycogen is a polymer built from individual glucose monomers.

10. A two year old boy is found to have an autosomal recessive glycogen storage disease that prevents him from being able to fully metabolize glucose. On examination, he has an enlarged liver and bulky appearing muscles. Biopsy of both the liver and the muscles shows markedly increased amounts of glycogen compared to normal. Which of the following is TRUE?

Since glucose can be partially but not fully metabolized, there is an increased concentration of the intermediate compounds and this causes a shift in enzymatic reactions, favoring the production of glycogen.

22. A two-year-old boy is found to have an autosomal recessive glycogen storage disease that prevents him from being able to fully metabolize glucose. On examination, he has an enlarged liver and bulky appearing muscles. Biopsy of both the liver and the muscles shows markedly increased amounts of glycogen compared to normal. Which of the following is TRUE?

Since glucose can be partially but not fully metabolized, there is an increased concentration of the intermediate compounds and this causes a shift in enzymatic reactions, favoring the production of glycogen.

31. Insulin controls both carbohydrate and fat metabolism. Which of the following statements describes the effects of insulin? Check all that apply.

Stimulates the glucose uptake Inhibits the glycogen breakdown

42. What are the end products of glycolysis from one molecule of glucose?

Two molecules of ATP, two molecules of NADH, and two pyruvate

5. Glycogenolysis is

This process is the breakdown of glycogen to release individual glucose molecules. It benefits the fasting state because it increases blood glucose.

4. Gluconeogenesis is

This process produces new glucose and is needed in a fasting state to increase blood sugar, supplying energy to the brain and muscle. Gluco means glucose; Neo means new; Genesis means creation. Gluconeogenesis means creating new glucose molecules to increase the blood sugar levels. Background: A suffix "genesis" is added to the molecule when that specific molecule is being built. Gluconeogenesis is the process of making glucose from new/alternative sources other than carbohydrates. Glucagon stimulates gluconeogenesis.

38. Disaccharides are:

Two sugar molecules linked by alpha or beta linkages. Saccharin means-sweet or sugar. Carbohydrates exist as monomers, known as monosaccharides, as well as polymers. Small polymers with two sugar molecules are known as disaccharides, while large polymers are called polysaccharides or complex carbohydrates. The linkages of the polysaccharides determine whether they are digestible by humans or not. The disaccharides of sucrose (glucose + fructose) and lactose (glucose + galactose) are some examples. The correct answer is, ' Two sugar molecules linked by alpha or beta linkages'.

2. There are two types of diabetes mellitus (DM) that lead to impairment in glucose utilization. Resistance to the effects of insulin leads to which type of DM?

Type II diabetes

9. There are two types of diabetes mellitus (DM) that lead to impairment in glucose utilization. Resistance to the effects of insulin leads to which type of DM?

Type II diabetes

6. Where is glucagon made?

alpha cells of the pancreas

54. The release of _________ is inhibited by hypoglycemia. The release of __________ is inhibited by hyperglycemia.

insulin, glucagon

3. GluT transporters aid in glucose transport into a cell

by acting as a channel to allow transport of glucose into the cell. GluT4 is a glucose transporter which acts as a channel that allows glucose passage into the cell. Glut4 translocation (movement) from inside of the cell to the cell surface is regulated by insulin.

44. Monosaccharides are ________________, Disaccharides are __________________ and Polysaccharides are __________________.

carbohydrates with one sugar molecule, carbohydrates with two sugar molecules, carbohydrates with three sugar molecules.

23. Metformin treatment is able to lower blood glucose levels by _______ gluconeogenesis in the liver cells and _________ Glut4 translocation in the muscle or fat cells.

decreasing, increasing

53. ___________ causes blood glucose levels to rise. ____________ causes blood glucose levels to fall.

glucagon, insulin

33. The pancreas can regulate and maintain glucose homeostasis by secreting different hormones in response to varying blood glucose levels. The pancreas secretes insulin in response to high blood glucose levels, whereas ______________ is secreted in response to ________________ glucose levels.

glucagon, low The pancreas can regulate and maintain glucose homeostasis by secreting different hormones in response to varying blood glucose levels. The pancreas secretes insulin in response to high blood glucose levels, whereas glucagon is secreted in response low glucose levels.

2. Match the effects of insulin with the corresponding numbered diagram.

glucose, protein, glycogen synthesis, fatty acid synthesis

20. Glucose Regulation [randomized] The respondent's email address ([email protected]) was recorded on submission of this form. First Name Last Name Instructions on submitting, viewing feedback, and editing We wanted to provide you with ample practice for this topic, so we collected relevant questions from all over the course and put them together here for you. This video explains how to view feedback and continue practicing as you have time available. Please take a moment if you haven't seen it. Learning Objective Given a scenario (person with glycogen storage disease running a marathon, fasting scenario, carb loading before a sport activity), the student will identify the impact on glucose production and/or storage. (3 questions on the assessment) 6. Where is glucagon made? beta cells of the pancreas alpha cells of the pancreas hepatocytes of the liver adipose cells of the adipose tissue Correct answer alpha cells of the pancreas Feedback Incorrect. If you answered-beta cells of the pancreas- the answer is not correct. Beta cells of the pancreas secrete the hormone insulin and not the hormone glucagon. Pancreas are made up of alpha and beta cells. Glucagon is a hormone produced by the alpha cells of the pancreas. Glucagon is the counteracting hormone to insulin and stimulates glucose production and release into the blood. Glucagon stimulates the production of glucose via gluconeogenesis by the liver as well as fatty acid and amino acid catabolism for energy. The correct answer is "alpha cells of the pancreas". If you answered-hepatocytes of the liver- the answer is not correct. Hepatocytes are liver cells. They are in charge of producing various other biochemicals but not the hormone glucagon. Glucagon is produced by the alpha cells of the pancreas. Pancreas are made up of alpha and beta cells. Glucagon is a hormone produced by the alpha cells of the pancreas. Glucagon is the counteracting hormone to insulin and stimulates glucose production and release into the blood. Glucagon stimulates the production of glucose via gluconeogenesis by the liver as well as fatty acid and amino acid catabolism for energy. The correct answer is "alpha cells of the pancreas". If you answered- adipose cells of the adipose tissue- the answer is not correct. Adipose cells also known as fat cells do not produce the hormone glucagon. Pancreas are made up of alpha and beta cells. Glucagon is a hormone produced by the alpha cells of the pancreas. Glucagon is the counteracting hormone to insulin and stimulates glucose production and release into the blood. Glucagon stimulates the production of glucose via gluconeogenesis by the liver as well as fatty acid and amino acid catabolism for energy. The correct answer is "alpha cells of the pancreas". 4. Gluconeogenesis is This process produces new glucose and is needed in a fasting state to increase blood sugar, supplying energy to the brain and muscle. This process is the breakdown of glycogen to release individual glucose molecules. It benefits the fasting state because it increases blood glucose. None of these answers are correct Feedback Correct! Gluco means glucose; Neo means new; Genesis means creation. Gluconeogenesis means creating new glucose molecules to increase the blood sugar levels. Background: A suffix "genesis" is added to the molecule when that specific molecule is being built. Gluconeogenesis is the process of making glucose from new/alternative sources other than carbohydrates. Glucagon stimulates gluconeogenesis. A suffix "genesis" is added to the molecule when that specific molecule is being built. Gluconeogenesis is the process of making glucose from new/alternative sources other than carbohydrates. Glucagon stimulates gluconeogenesis. 17. Which process is stimulated when glucagon is released into the bloodstream? Triglyceride synthesis Glycogenolysis Glycogenesis Glucose uptake Correct answer Glycogenolysis Feedback Incorrect. If you answered-Triglyceride synthesis - the answer is not correct. Glucagon is a hormone which is released by the pancreas in response to low sugar levels. Glucagon affects the pathways that will lead to an increase in the glucose concentration. Triglycerides are a stored form of fat. An increase in storing fats will not improve the glucose concentration. Glucagon is a hormone released in response to the low levels of glucose. Glucagon hormone affects/promotes the pathways that will lead to increasing the concentration of glucose. Glycogenolysis is one such pathway that will result in increased glucose concentration. The correct answer is "Glycogenolysis ". If you answered-Glycogenesis - the answer is not correct.Glucagon is a hormone which is released by the pancreas in response to low sugar levels. Glucagon affects the pathways that will lead to an increase in the glucose concentration. Glycogenesis is a process to store glucose in the form of glycogen. An increase in storing glycogen will lower the glucose concentration further instead of increasing the concentration. Glucagon is a hormone released in response to the low levels of glucose. Glucagon hormone affects/promotes the pathways that will lead to increasing the concentration of glucose. Glycogenolysis is one such pathway that will result in increased glucose concentration. The correct answer is "Glycogenolysis ". If you answered-Glucose uptake - the answer is not correct. Glucagon is a hormone which is released by the pancreas in response to low sugar levels. Glucagon affects the pathways that will lead to an increase in the glucose concentration. Glucose uptake into the cell is an affect promoted by insulin and not by glucagon. Glucagon is a hormone released in response to the low levels of glucose. Glucagon hormone affects/promotes the pathways that will lead to increasing the concentration of glucose. Glycogenolysis is one such pathway that will result in increased glucose concentration. The correct answer is "Glycogenolysis ". 20. Which of the following drives glucose from the bloodstream into cells? glucagon insulin Glycogen Correct answer insulin Feedback Incorrect. If you answered-glucagon-the answer is not correct. Glucagon does not directly impact the transport of glucose. When insulin binds to its receptor on cell membranes, it stimulates the translocation of GLUT4 to the cell membranes. This allows glucose from the bloodstream to enter the cell. The correct answer is "insulin ". If you answered-Glycogen - the answer is not correct. Glycogen is the storage form of glucose. It does not directly impact the transport of glucose into the cell. When insulin binds to its receptor on cell membranes, it stimulates the translocation of GLUT4 to the cell membranes. This allows glucose from the bloodstream to enter the cell. The correct answer is "insulin ". 19. Which process is stimulated when insulin is released into the bloodstream? gluconeogenesis glycogenesis glycogenolysis Correct answer glycogenesis Feedback Incorrect. If you answered-gluconeogenesis - the answer is not correct. Gluconeogenesis is a process where new glucose is made. Insulin which is secreted in response to high glucose levels will play a part in uptake and storage of glucose to decrease the blood glucose concentration levels instead of creating additional new glucose. Insulin stimulates the uptake and storage of glucose from the blood by cells in the body. This results in increased glycogenesis as well as fatty acid synthesis. Glucagon stimulates the production of glucose via gluconeogenesis by the liver as well as fatty acid and amino acid catabolism for energy. The correct answer is " glycogenesis ". If you answered-Glycogenolysis - the answer is not correct. Glycogenolysis is a process where glycogen is broken down into glucose to increase the blood glucose levels. Insulin is secreted in response to high glucose levels. Once secreted, Insulin plays a part in uptake and storage of glucose to decrease the blood glucose concentration levels. One of the processes by which it decreases the glucose levels is by storing the excess glucose in the form of glycogen. This process is known as glycogenesis. Insulin stimulates the uptake and storage of glucose from the blood by cells in the body. This results in increased glycogenesis as well as fatty acid synthesis. Glucagon stimulates the production of glucose via gluconeogenesis by the liver as well as fatty acid and amino acid catabolism for energy. The correct answer is " glycogenesis ". 15. Billy is a 26-year-old male currently on his 12th day of a hunger strike to protest "government stuff." How can Billy keep going long after his glycogen supply has been used up? (Note: The brain requires a constant supply of glucose to function.) He uses fatty acids to create new glucose through gluconeogenesis. He uses glycerol, some amino acids, and other molecules to create new glucose. All amino acids can be used to create glucose through gluconeogenesis. Correct answer He uses glycerol, some amino acids, and other molecules to create new glucose. Feedback Incorrect. If you answered-He uses fatty acids to create new glucose through gluconeogenesis - the answer is not correct. Fatty acids are not used to create new glucose. Instead they are used to build triglyceride a stored form of fat. The glycerol part of triglycerides (more on this in the next module on lipids), lactate (recall the Cori cycle), and certain amino acids can be converted in the liver to glucose. The process by which glucose is formed from these noncarbohydrate sources is called gluconeogenesis (gluco = glucose, neo = new, genesis = make). About 60% of the amino acids in the body can be used for gluconeogenesis. Lactate and amino acids such as alanine and serine are converted to pyruvate, which then may be synthesized into glucose or enter the citric acid cycle. Glycerol may be converted into glyceraldehyde 3-phosphate, which may continue on in glycolysis to make pyruvate or be used to synthesize glucose via gluconeogenesis. The correct answer is "He uses glycerol, some amino acids, and other molecules to create new glucose ". If you answered-All amino acids can be used to create glucose through gluconeogenesis - the answer is not correct. All amino acids are not diverted to create new glucose. Instead, amino acids are utilized to build proteins. Only a few amino acids can be utilized to create new glucose. The glycerol part of triglycerides (more on this in the next module on lipids), lactate (recall the Cori cycle), and certain amino acids can be converted in the liver to glucose. The process by which glucose is formed from these noncarbohydrate sources is called gluconeogenesis (gluco = glucose, neo = new, genesis = make). About 60% of the amino acids in the body can be used for gluconeogenesis. Lactate and amino acids such as alanine and serine are converted to pyruvate, which then may be synthesized into glucose or enter the citric acid cycle. Glycerol may be converted into glyceraldehyde 3-phosphate, which may continue on in glycolysis to make pyruvate or be used to synthesize glucose via gluconeogenesis. The correct answer is "He uses glycerol, some amino acids, and other molecules to create new glucose ". 1.Insulin has many anabolic effects on the body. Which of the following terms best relates to anabolic? Builds up Breaks down Stays the same None of these options Feedback Correct! Metabolism consists of anabolic and catabolic pathways. While catabolic pathways means typically breaking down larger molecules into smaller molecules, anabolic pathways refer to building up larger molecules from the smaller molecules. Insulin has several effects on glucose regulation. One of which is its promotion of some anabolic pathways such as glycogenesis. When there is excess of glucose present, some glucose is diverted towards building up a larger molecule called glycogen. This process is known as Glycogeneis. Since anabolic pathways mean building up molecules, you will typically see the term Genesis as a suffix to many anabolic pathways. 3. GluT transporters aid in glucose transport into a cell by assisting in the transport of glucose into the cell. by inhibiting the binding of insulin with insulin receptors. by phosphorylating glucose and converting it to glucose-6-phosphate. by assisting in the transport of insulin into the cell. Feedback Correct! GluT4 is a glucose transporter which acts as a channel that allows glucose passage into the cell. Glut4 translocation (movement) from inside of the cell to the cell surface is regulated by insulin. Insulin, which is secreted by the pancreas in response to elevated glucose levels in the blood, increases the insertion of one type of GluT, called GluT4, into the plasma membranes of most body cells, thereby increasing the rate of facilitated diffusion of glucose into those cells. This is especially evident in muscle and adipose cells. The GluT4 proteins are located on intracellular vesicles that fuse with the membrane and quickly increase the number of GluT4 transporters. This process is known as translocation of GluT4. 21. Which of the following chemicals can be produced in dangerous excess in a patient taking metformin because of its effect of decreasing the liver's participation in the Cori cycle? Pyruvic acid Lactic acid Citric acid Correct answer Lactic acid Feedback Incorrect. If you answered-pyruvic acid-it is not the correct answer. Pyruvic acid is an acid produced as an end result of glycolysis. Under anaerobic conditions, this is converted into lactate in the muscle cells. One of the ways that metformin controls diabetes is by the reduction in liver gluconeogenesis. However, gluconeogenesis is essential for conversion of lactate (produced as part of the cori cycle) back to glucose after anaerobic fermentation in muscle and red blood cells. Treatment with metformin can therefore increase the risk of elevated lactate levels in the blood, a condition known as lactic acidosis. The correct answer is "Lactic acid". If you answered- citric acid-it is not the correct answer. Citric acid is a form of product made as part of the citric acid cycle. This is not related to metformin's action. One of the ways that metformin controls diabetes is by the reduction in liver gluconeogenesis. However, gluconeogenesis is essential for conversion of lactate (produced as part of the cori cycle) back to glucose after anaerobic fermentation in muscle and red blood cells. Treatment with metformin can therefore increase the risk of elevated lactate levels in the blood, a condition known as lactic acidosis. The correct answer is "Lactic acid". 41. Glycogenesis is: Process to build glycogen Process to build glucose Process to build glycerol Feedback Correct! Process to build glycogen. Glycogen is a polymer built from individual glucose monomers. 7. What stimulates the release of glucagon? low blood glucose only high blood glucose only a fasting state only low blood glucose and a fasting state. Correct answer low blood glucose and a fasting state. Feedback If you answered- low blood glucose only- the answer is not correct. Although partially correct that low blood glucose will trigger the production of the glucagon hormone, based on the choices provided, that is not the only option leading to the production of glucagon. The correct answer is "low blood glucose and a fasting state". If you answered- high blood glucose only - the answer is not correct. High glucose does not signal the production of glucagon. Instead, a high glucose level is a signal for the production of the insulin hormone. Embedded within the pancreas are specialized clusters of cells called the islets of Langerhans, which secrete hormones directly into the blood. The islets include alpha and beta cells. The alpha cells secrete the hormone glucagon when blood glucose levels are low (the name, which sounds like "glucose gone," suggests its function). Glucagon stimulates liver cells to break down stores of glycogen, releasing glucose into the blood. It also causes the breakdown of glycogen in muscle cells and the production of glucose from amino acids. Glucagon increases blood sugar between meals, supplying energy to the brain and active muscles. The correct answer is "low blood glucose and a fasting state". If you answered- a fasting state only - the answer is not correct. Although partially correct that fasting state results in a low glucose concentration which ultimately is a signal for the production of the hormone glucagon, based on the choices provided, that is not the only option leading to the production of glucagon. Embedded within the pancreas are specialized clusters of cells called the islets of Langerhans, which secrete hormones directly into the blood. The islets include alpha and beta cells. The alpha cells secrete the hormone glucagon when blood glucose levels are low (the name, which sounds like "glucose gone," suggests its function). Glucagon stimulates liver cells to break down stores of glycogen, releasing glucose into the blood. It also causes the breakdown of glycogen in muscle cells and the production of glucose from amino acids. Glucagon increases blood sugar between meals, supplying energy to the brain and active muscles. The correct answer is "low blood glucose and a fasting state". 29. Glucose is a monosaccharide. It can be used as the raw material to build which one of the following molecules? Proteins Glycogen Nucleic acids Correct answer Glycogen Feedback If you answered-Protein-it is not the correct answer. Proteins are made up of amino acids and not monosaccharides such as glucose. Glucose is a monosaccharide that builds the polysaccharide such as glycogen. The correct answer is the option 'glycogen'. If you answered-Nucleic acids-it is not the correct answer. Nucleic acids are DNA and RNA. They are not monosaccharides. Glucose is a monosaccharide that builds the polysaccharide such as glycogen. The correct answer is the option 'glycogen'. 35. Which one of the following could result in better outcomes for type 2 diabetics? An increased rate of gluconeogenesis in the liver. Lower production of insulin. An increased A1C percentage. An increased number of GluT4 transporters in the cell membrane. Correct answer An increased number of GluT4 transporters in the cell membrane. Feedback If you answered- An increased rate of gluconeogenesis in the liver - it is not the correct answer. An increased rate of gluconeogenesis will increase the overall blood sugar levels. Instead, insulin, increases the number of GluT4 transporters on the cell membranes. This will result in a higher intake of glucose into the cell. Glucose will be further metabolized to produce ATP. Thus, the correct answer is, 'An increased number of GluT4 transporters in the cell membrane'. If you answered- Lower production of insulin - it is not the correct answer. Insulin is the primary hormone that is essential in regulating the blood glucose levels. Lower production of insulin results in diabetes. Normally, insulin increases the number of GluT4 transporters on the cell membrane. This will result in a higher intake of glucose into the cell. Glucose will be further metabolized to produce ATP. Thus, the correct answer is, 'An increased number of GluT4 transporters in the cell membrane'. If you answered- An increased A1C percentage - it is not the correct answer. The glycated form of hemoglobin is called A1C (other names are hemoglobin A1c, HbA1c), and it serves as a helpful indicator of blood glucose levels. In healthy bodies, a small percentage of A1C exists at any given point in time, due to the slow, constant rate of glycation. The percentage of A1C under normal conditions is usually less than 5% of hemoglobin. However, when blood sugar levels are high for extended periods of time, the A1C levels go above this standard range. Normally, insulin increases the number of GluT4 transporters on the cell membrane. This will result in a higher intake of glucose into the cell. Glucose will be further metabolized to produce ATP. Thus, the correct answer is, 'An increased number of GluT4 transporters in the cell membrane'. 48. What is the product of glycogenesis? glycogen glucose glucagon Feedback Correct! Glycogen is the product of glycogenolysis. Glycogenesis is the process of creating glucose from glycogen. 9. There are two types of diabetes mellitus (DM) that lead to impairment in glucose utilization. Resistance to the effects of insulin leads to which type of DM? Type I diabetes Type II diabetes Both types of diabetes Correct answer Type II diabetes Feedback Incorrect. If you answered- Type I diabetes - the answer is not correct. Type I DM is due to an inability of the the pancreas to produce insulin and is not due to resistance to the effects of insulin. Diabetes results from a decreased ability to produce insulin or a decreased sensitivity of cells to the insulin produced by the body (type I and type II, respectively). This leads to excessively high blood glucose levels that are damaging to various organs and systems in the body. The correct answer is : "Type II diabetes". If you answered- Both types of diabetes - the answer is not correct. Type I diabetes is a result of decreased ability to produce the hormone insulin. Whereas, in the type II diabetes, the cells can produce insulin but the cells are resistant to the effects of insulin. Diabetes results from a decreased ability to produce insulin or a decreased sensitivity of cells to the insulin produced by the body (type I and type II, respectively). This leads to excessively high blood glucose levels that are damaging to various organs and systems in the body. The correct answer is : "Type II diabetes". 14. Jason is a 17-year-old male with a glycogen storage disease. He is also planning on running the high school marathon. Should Jason consume a diet that is low in a) fats, b) protein/amino acids, or c) carbohydrates/glucose? Explain. Low fat because he is unable to used store triglycerides for energy due to non-functioning enzymes. Low protein since he is unable to deaminate amino acids. Low carbohydrate because he is unable to use stored glycogen for a quick source of energy. Correct answer Low carbohydrate because he is unable to use stored glycogen for a quick source of energy. Feedback Incorrect. If you answered-Low fat because he is unable to used store triglycerides for energy due to non-functioning enzymes - the answer is not correct. Jason is unable to store glycogen which is a stored form of glucose that is used as a quick source of energy when glucose is not readily available in the diet. This means that he needs to compensate in other ways to have enough stored energy. If he were to go on a low fat diet, he would not have any form of stored fat(triglycerides) to meet his needs. Glucose, fatty acids, and amino acids that are not broken down for energy are used in anabolic pathways to synthesize structural, regulatory, or storage molecules. Glucose molecules can be used to synthesize glycogen, a storage form of carbohydrate. If the body has enough glycogen, glucose can also be used to synthesize fatty acids. Fatty acids can be used to synthesize triglycerides that are stored as body fat. Amino acids can be used to synthesize the various proteins that the body needs, such as muscle proteins, enzymes, protein hormones, and blood proteins. Excess amino acids can be converted into fatty acids and stored as body fat. The correct answer is "Low carbohydrate because he is unable to use stored glycogen for a quick source of energy". If you answered-Low protein since he is unable to deaminate amino acids- the answer is not correct. Jason is unable to store glycogen which is a stored form of glucose that is used as a quick source of energy when glucose is not readily available in the diet. This means that he needs to compensate in other ways to have enough stored energy. If he were to go on a low protein diet, he would not have any enough energy to meet his needs. Glucose, fatty acids, and amino acids that are not broken down for energy are used in anabolic pathways to synthesize structural, regulatory, or storage molecules. Glucose molecules can be used to synthesize glycogen, a storage form of carbohydrate. If the body has enough glycogen, glucose can also be used to synthesize fatty acids. Fatty acids can be used to synthesize triglycerides that are stored as body fat. Amino acids can be used to synthesize the various proteins that the body needs, such as muscle proteins, enzymes, protein hormones, and blood proteins. Excess amino acids can be converted into fatty acids and stored as body fat. The correct answer is "Low carbohydrate because he is unable to use stored glycogen for a quick source of energy" 47. Describe the relationship between insulin and Glut4. Insulin Feedback Insulin, which is secreted by the pancreas in response to elevated glucose levels in the blood, increases the insertion of one type of GluT (Glucose transporter), called GluT4, into the plasma membranes of most body cells, thereby increasing the rate of facilitated diffusion of glucose into those cells. This is especially evident in muscle and adipose cells. The GluT4 proteins are located on intracellular vesicles that fuse with the membrane and quickly increase the number of GluT4 transporters . This process is known as translocation of GluT4. 46. Once glucose is inside of a cell, it is phosphorylated. Why is this significant? Glucose Feedback Once glucose is transported into the cell, it is phosphorylated so that it does not re-enter the bloodstream by the same transporters that allowed the passage. In short, it is a way to ensure that there is only one way passage to the glucose. Once inside the cell, glucose can be used as a fuel to make ATP. 10. Autoimmune destruction of the beta cells in the islets of Langerhans of pancreas leads to which type of DM? Type I diabetes Type II diabetes both types of diabetes Feedback Correct! Type I diabetes results from the destruction of insulin-producing pancreatic beta cells. There are two main types of diabetes. Type 1 diabetes (juvenile-onset or insulin-dependent diabetes) is an autoimmune disease in which the immune system destroys pancreatic beta cells, thus impairing insulin production. Symptoms first appear in childhood as insulin production begins to drop off. Because the disease results from the lack of insulin, it must be treated with insulin supplementation to maintain normal blood glucose levels. 40. Glycogen is: Glucose storage molecule. A polymer of glucose units. Also referred to as a polysaccharide. A hormone released by the pancreas during fasting or low blood glucose levels. Carbohydrates with several sugar molecul 51. __________ acts on liver cells to facilitate glucose production. __________ acts on various cells to facilitate glucose uptake into the cell.

glucagon, insulin

24. Insulin is a hormone that is secreted when blood glucose is _______. This hormone stimulates _______ in the cell.

high, glycogenesis Insulin is secreted when blood glucose is high. This leads to glycogenesis. The hormone insulin, from pancreatic beta cells, is secreted in response to high glucose levels in the blood. Insulin stimulates liver and skeletal muscle cells to carry out glycogenesis, the synthesis of glycogen.

20. Which of the following drives glucose from the bloodstream into cells?

insulin When insulin binds to its receptor on cell membranes, it stimulates the translocation of GLUT4 to the cell membranes. This allows glucose from the bloodstream to enter the cell.

50. High blood glucose levels stimulate the release of ___________, low blood glucose levels stimulate the release of ____________.

insulin, glucagon High glucose levels stimulate the release of insulin, whereas, low glucose levels stimulate the release of glucagon. Insulin and glucagon are released by the pancreas beta and alpha cells respectively.

52. Glycogenolysis is stimulated by __________. Glycogenesis is stimulated by ___________.

insulin, glucagon'.

7. What stimulates the release of glucagon?

low blood glucose and a fasting state.