impact – n. 影响，冲击
energy balance – 能量平衡
adipocyte – n. 脂细胞
adiponectin – n. 脂连素
intraabdominal – a. 腹内的
endocannabinoid – a. 内源性大麻素
satiety – n. 饱和，饱满感
free fatty acid (FFA) – 游离脂肪酸
corticosteroids – n. 皮质甾类
diurnally – ad. 白天活动地
growth hormone – 生长激素
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★RN/ISPN Review ★
Other Factors Affecting Glucose Control 影响葡萄糖控制的其他因素
Other factors in the body have been found to have an impact on glucose, fat, and protein metabolism. These factors play a role in the overall energy balance in the body.
Adipocytes, or fat cells, were once thought to just store fat for energy. However, they have been found to have a major impact on glucose and fat metabolism throughout the body through the secretion of adiponectin. This hormone acts to increase insulin sensitivity, decrease the release of glucose from the liver, and protect the blood vessels from inflammatory changes. When adiponectin levels are high, it exerts a protective effect on the body. When adiponectin levels are low, as in cases of intraabdominal fat accumulation, glucose levels rise and blood vessel injury increases.
Endocannabinoid receptors have been identified in adipose tissue, muscles, liver, the satiety center, and the GI tract. These receptors seem to be part of a signaling system within the body to keep the body in a state of energy gain, to prepare for stressful situations. When stimulated, these receptors promote food intake, decrease adiponectin release, increase fat breakdown, decrease insulin sensitivity, increase fat storage, and alter gastric emptying to promote greater nutrient absorption. Patients who are obese have been shown to have increased stimulation of these receptors.
The sympathetic nervous system (SNS), through norepinephrine and epinephrine effects, directly causes a decrease in insulin release, an increase in the release of stored glucose, and an increase in fat breakdown. A person under stress will have increased glucose levels and increased free fatty acid (FFA) levels, which will provide the energy needed for the immediate “fight or flight” associated with a stress reaction. Prolonged stress can alter the control of metabolism that regulates the body’s energy balance.
Corticosteroids, which are released diurnally but also during a stress reaction, decrease insulin sensitivity, increase glucose release, and decrease protein building. All of these actions conserve energy and provide immediate glucose for any stressful situation.
Growth hormone causes decreased insulin sensitivity, increase of FFAs, and increase in protein building. Fluctuating levels of growth hormone can upset metabolic homeostasis.
生长激素引起胰岛素敏感性增强、FFAs增加、蛋白质构建增加。生长激素水平波动可能扰乱代谢动态平衡。
★Video ★
Glucose Regulation -- Nursing Assessment
★Tests ★
1. Risk factors for type 2 diabetes include all of the following except:
A. Advanced age
B. Obesity
C. Smoking
D. Physical inactivity
2. Untreated diabetes may result in all of the following except: A. Blindness B. Cardiovascular disease C. Kidney disease D. Tinnitus
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ISPN/RN复习练习、效果检验一站完成。
答案Answers 1. C. Smoking Rationale: Additional risk factors for type 2 diabetes are a family history of diabetes, impaired glucose metabolism, history of gestational diabetes, and race/ethnicity. African-Americans, Hispanics/Latinos, Asian Americans, Native Hawaiians, Pacific Islanders, and Native Americans are at greater risk of developing diabetes than whites. 2. D. Tinitus Rational: Untreated diabetes also may result in loss of lower limbs to amputation and death.
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