1. REVIEW: hypovolemia
A Decrease in Blood Pressure:
Heart baroreceptors cause posterior pituitary to secrete VP
VP increases vasoconstriction
VP increases water pores in the collecting duct, increasing water absorbtion from filtrate
Cells in glomerulus secrete renin
 angiotensin II
Increases aldosterone
Increases vasoconstriction
Increases VP
Stimulates drinking
 aldosterone
Increase sodium retention

2. What about an increase in blood pressure?
Baroreceptors in heart stop sending releasing signals to SON and PVN
Glomerulosa cells produce less renin
Under conditions of excessively high blood pressure:
The atria of the heart secrete Atrial Natriuretic Peptide (ANP)
ANP:
Shuts down secretion of VP, renin, and ALDO
Increases sodium excretion in the urine
Increases diuresis (water loss in urine)

3. Osmotic Imbalance Review
High blood osmolality causes:
Osmoreceptors in the brain to signal SON and PVN nuclei to increase VP secretion
VP increases water retention in the kidney
Glomerular cells decrease secretion of Renin
Decrease Aldosterone secretion
Decrease Angiotensin II levels

4. INSULIN Regulation of Secretion Hyperglycemia stimulates release
Glucose sensors in  cells
Gastric Inhibitory Peptide
Released from cells of the small intestine
Potent stimulator of insulin secretion
Somatostatin: inhibits insulin release (paracrine)
Autonomic nervous system
Parasympathetic activation increases insulin release
Sympathetic activation blocks insulin release
Epinephrine (from adrenal) blocks insulin release

5. INSULIN Action at Target Tissues Activation of insulin receptor:
Increases transport of glucose, amino acids, and fatty acids into cells
Glucose transporter:

6. Type 1 Diabetes Insulin Dependent: IDDM
Possibly results from autoimmune reaction
The body’s immune system attacks the  cells
Pancreatic  markedly reduced
Symptoms only appear after ~80% loss of cells
No insulin……physiological repercussions?
Treatment
Insulin injections
Recent methods

7. Type 2 Diabetes: Non-Insulin Dependent: NIDDM
Accounts for 90-95% of all Diabetes cases
Usually occurs in overweight individuals over 40 years of age
But ages are getting younger and younger
Associated with abdominal fat in women
Target cells become resistant to insulin
insulin receptor
Fewer receptors
Receptors have lower affinity
Receptor blocked (possibly by antibody)
Post-receptor mechanisms

8. Diabetes Prevelence in US%
Incidence of diagnosed diabetes
1980
1990
2000
2007
Increase in diabetes cases between was 33%
For people between years of age the increase was 70%
For people between years of age the increase was 40%

9. 2004
% of adults >20
2007

10. Type 2 Risks 2006 7th leading cause of death With Type 2 diabetes
2 to 4-fold increase in heart disease related death
2-fold risk of death
Type 2 associated complications
2-4 fold risk of stroke
75% of adults with Type 2 have high blood pressure
leading cause of blindness in adults aged 20-74
Leading cause of kidney failure