1. Hormones that Affect Blood Sugar
Brief review of the structure of the kidney. Introduce the pancreas, the idea of high and low blood sugar, and using hormones to establish homeostasis. Another name for pancreas is sweetbread. Mention Dr. Hannibal Lecter?

2. Pancreatic Hormones Produced in the islets of Langerhans.
Beta (β) cells produce insulin.
Alpha (α) cells produce glucagon.
New photo added. Explain photo. Mention that these two hormones have opposite effects on blood sugar level.

3. Hormonal Response to High Blood Sugar
↑ blood sugar = release of insulin.
causes muscle, liver and other body cells to become permeable to glucose.
glucose stored as glycogen.
result = ↓ blood sugar.
Insulin is a peptide hormone. INsulin makes sugar go INto cells. Therefore blood sugar decreases. Acts mainly on muscle and adipose tissues. Glycogen is the equivalent of starch in plants.

4. Hormonal Response to Low Blood Sugar
↓ blood sugar = release of glucagon.
promotes breakdown of glycogen into glucose, which is released into the blood.
result = ↑ blood sugar.
Released during exercise and fight-or-flight response.

5. Negative feedback loop. Explain the diagram.

6. QUESTION 1
What happens when the body does not produce insulin or the receptors no longer responds to insulin?
Blood sugar will remain high. Disorder: diabetes.

7. Suffer from hyperglycemia (high blood sugar).
Diabetes
Type I Diabetes (Insulin Dependent):
Early degradation of beta cells.
Unable to produce insulin.
Type II Diabetes (Non-Insulin Dependent):
Decreased insulin production or ineffective use of insulin.
Controlled with diet, exercise and oral drugs.
Suffer from hyperglycemia (high blood sugar).
Symptoms: hunger, thirst, feeling of wanting to pee all the time, fatigue, and even coma. There is Type III diabetes, aka Alzeimer’s Disease. Explain this briefly.

8. QUESTION 2
If glucose is not taken into body cells, how does the body produce energy?
Energy from proteins and fats.

9. Diabetes Absence of insulin means little or no glucose in body cells.
Cells metabolize fats and proteins for energy.
Consequences: extra uric acid, ammonia, urea in urine.

10. QUESTION 3
If a person has very high blood sugar, how does this impact filtration?

11. QUESTION 4
With respect to kidney function and water balance, what happens when glucose reabsorption does not occur?
Glucose will appear in urine and this will force water to leave the body. Excess urine produced.

13. Diabetes
Kidneys are unable to reabsorb all of the blood glucose, so excess glucose appears in urine.
People with untreated diabetes are thirsty. Why?
Effects of diabetes.

14. Try This!
Describe why a person with untreated diabetes would urinate frequently. Refer to the two osmotic gradients in urine formation in your answer.

15. Adrenal Glands Each composed of two glands.
Adrenal medulla  short-term stress.
Adrenal cortex  long-term stress.
Short term stress: immediate effect. Long term stress: may take days, weeks, months or even years.

16. Adrenal Medulla
Produces epinephrine (adrenaline) and norepinephrine (noradrenaline).
“Fight-or Flight Response”.
↑ blood sugar (glycogen  glucose).
↑ HR, breathing rate & cell metabolism.
Dilation of blood vessels.
Pupil dilation.
Photo added. The feeling of blood rushing through the body. Mention Pulp Fiction adrenaline needle scene.

17. Adrenal Cortex Produces 3 types of hormones: Glucocorticoids.
Mineralcorticoids.
Sex hormones.
Cortex means outside. Only need to know glucocorticoids. Extra info: mineralcorticoids include aldosterone which is used to control water balance and blood pressure. Testosterone produced here.

18. Adrenal Cortex Glucocorticoids (e.g., cortisol): ↑ blood amino acids.
Converted to glucose.
Repairs damaged tissues.
Fats broken down into fatty acids to ↑ available energy.
↓ insulin to ↓ blood glucose uptake (except brain).
Promote the release of AA and fatty acids. Through gluconeogenesis, AA and FA are converted to glucose. Keep the blood sugar level high by preventing sugar absorption… meaning blocks insulin. Question: why block insulin during fight-or-flight response? Cortisol also has inflammatory ability. Often administered for allergic reactions.

19. Fight or Flight and Blood Sugar
Why block insulin during fight-or-flight response?