 PAPER 2H – FUN REVISION 

4.5.3 Hormonal coordination in humans

(focus = blood glucose and temperature regulation)

Q1. Many functions of the human body are controlled by chemicals called hormones.
(a) What is a hormone?

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(3)

(b) Name the two hormones that control blood glucose concentration.

_____________________________ and _____________________________

(1)

The graph shows changes in the concentration of glucose in the blood of a healthy person
following a meal.

(c) Explain how negative feedback controls the blood glucose concentration during the
first one and a half hours after the meal.
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(4)
(Total 8 marks)

Q2.
It is important to keep the blood glucose concentration within narrow limits.

(a) A person eats a meal containing a lot of carbohydrate. This causes an increase in
the person’s blood glucose concentration.

Explain how the hormones insulin and glucagon control the person’s blood glucose
concentration after the meal.

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(5)

(b) The body cells of a person with Type 2 diabetes do not respond to insulin.

A person with Type 2 diabetes often has a higher blood insulin concentration than a
non-diabetic person. Explain why.

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(3)
Metformin is a drug used for treating people who have Type 2 diabetes. Scientists
investigated the effects of metformin and two other drugs, A and B. The scientists wanted
to see how the drugs affected the blood glucose concentrations of 220 people with Type 2
diabetes. This is the method used.

1. Put the 220 people into five groups.

2. Treat each group with a different drug or combination of drugs for several weeks.

3. Give each person a meal high in carbohydrate.

4. Measure the blood glucose concentration of each person 30 minutes after the meal and
again 3 hours after the meal.

(c) Suggest three variables that the scientists should have controlled in the
investigation.

1 _________________________________________________________________

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2 _________________________________________________________________

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3 _________________________________________________________________

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(3)

The scientists recorded their results as a mean value for each group.

The scientists calculated the ‘standard deviation’ for each group’s result.

Standard deviation is a measure of the spread of the individual results above or below (±)
the mean value.

The scientists gave each group’s result as:

mean ± standard deviation

The larger the standard deviation, the greater is the spread of results around the mean.

(d) Which of the results is the most precise? Tick (✓) one box.

Mean = 171.6 ± 16.3

Mean = 177.2 ± 15.4

Mean = 182.5 ± 18.2

Mean = 205.2 ± 19.4

(1)
The following table and the figure show the scientists’ results.

Metformin Metformin
Drugs used Metformin A B
+A +B

Number of people 60 40 25 65 30

Mean blood
glucose
concentration 30
177.2 182.5 171.6 205.2 206.5
minutes after the
± 15.4 ± 18.2 ± 16.3 ± 19.4 ± 19.6
meal in mg/100 cm3
± standard
deviation

In the table and the figure some standard deviations of results overlap.

• An overlap of standard deviations shows the difference between the means is not
significant.

• No overlap of standard deviations shows a significant difference between the

means.

(e) A student looked at the scientists’ method and the results in the table and figure
above.
 The student stated:

‘Metformin works better when used with other drugs.’

Evaluate the student’s statement.

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(6)
(Total 18 marks)

Q3. Insulin controls blood glucose concentration.

(a) The rate at which blood glucose concentration changes is affected by the food
eaten. In an experiment a person who does not have diabetes ate two slices of
white bread. The change in her blood glucose concentration was recorded over the
next 120 minutes. The experiment was repeated; first with two slices of brown bread
and then with two slices of wholemeal bread.

The graph shows the results of the three experiments.

 (i) Which type of bread would be most suitable for a person with diabetes?

Type of bread ___________________________________________

Give two reasons for your answer.

1. ____________________________________________________________

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2. ____________________________________________________________

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(2)

(ii) Explain, as fully as you can, the reasons for the changes in blood glucose
concentration when the person ate the brown bread.

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(4)

(b) Pancreatic-cell transplantation is a new treatment for diabetes. Insulin-making cells

are taken from up to three dead donors. The cells are kept alive before being
injected into the diabetic in a small operation. The cells soon begin to make insulin.

In one recent study 58 % of recipients of pancreatic-cell transplants no longer

needed insulin injections.

Give the advantages and disadvantages of the new treatment for diabetes
compared with using insulin injections.

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(3)
(Total 9 marks)
Q4.
The hormone insulin is a protein. Insulin is produced in the pancreas and controls blood
glucose concentration.

(a) Which organ in the body monitors blood glucose concentration?

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(1)

(b) We now know that a lack of the hormone insulin causes diabetes. In the early
twentieth century there was no known cure for diabetes. Frederick Banting and
Charles Best carried out a number of experiments on dogs.

In the first experiment they removed part of the pancreas from a healthy dog (dog
A). They ground up the pancreas tissue and injected an extract into dog B, whose
pancreas had been removed to make it diabetic. Dog B’s diabetes was not cured.

Banting thought that an enzyme produced in the pancreas of dog A had digested
the hormone before it was injected.

Name the enzyme that might have been responsible for digesting the hormone.

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(1)

(c) In the second experiment with another healthy dog, Banting and Best tied off the
duct which normally carries digestive enzymes out of the pancreas. This did not kill
the dog.

(i) The dog survived even though enzymes from the pancreas could not digest
food in the intestine. Explain why the dog survived.

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(1)

(ii) As a result of these experiments, a method was developed to extract insulin

from the pancreas.

Insulin is used to treat humans with diabetes. The amount of insulin injected
needs to be carefully controlled. Explain why.

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(1)
 (d) Evaluate the use of dogs in experiments of this type. Remember to include a
conclusion to your evaluation.

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(3)
(Total 7 marks)

Q5.
People with type 1 diabetes inject insulin to control their blood glucose level. A pancreas
transplant is another treatment for type 1 diabetes. One risk of a pancreas transplant is
organ rejection.

(a) Explain why a transplanted organ may be rejected.

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(3)

(b) Scientists have developed an artificial pancreas to treat type 1 diabetes. The
diagram below shows how an artificial pancreas works.
 (i) A woman with type 1 diabetes has an artificial pancreas. The woman eats a
meal high in sugar. The meal causes her blood glucose level to rise.

Use information from the diagram above to describe what happens to bring
the blood glucose level of the woman back to normal.

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(4)

(ii) The traditional way of monitoring and treating type 1 diabetes is to take a small
sample of blood and put it on a test strip to find out how much insulin to inject.

Suggest one possible advantage, other than not having to do blood tests, of
the method used in the diagram above.

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(1)
(Total 8 marks)

Q6.
The pancreas and the liver are both involved in the control of the concentration of
glucose in the blood.

The liver has two veins:

• the hepatic portal vein taking blood from the small intestine to the liver

• the hepatic vein taking blood from the liver back towards the heart.

Scientists measured the concentration of glucose in samples of blood taken from the
hepatic portal vein and the hepatic vein. The samples were taken 1 hour and 6 hours
after a meal.

Graph 1 shows the concentration of glucose in the two blood vessels 1 hour after the
meal.
 Graph 1

Blood vessel

(a) The concentration of glucose in the blood of the two vessels is different.
Explain why.

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(3)

(b) Graph 2 shows the concentration of glucose in the two blood vessels 6 hours after
the meal.
 Graph 2

Blood vessel

(i) The concentration of glucose in the blood in the hepatic portal vein 1 hour after
the meal is different from the concentration after 6 hours. Why?

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(1)

(ii) The person does not eat any more food during the next 6 hours after the meal.

However, 6 hours after the meal, the concentration of glucose in the blood in
the hepatic vein is higher than the concentration of glucose in the blood in the
hepatic portal vein. Explain why.

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(3)
(Total 7 marks)

Q7.
The number of cases of Type 2 diabetes in the UK is increasing rapidly.

(a) Describe how insulin and glucagon help control the blood sugar concentration in a
healthy person.

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(6)

(b) What is Type 2 diabetes?

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(1)

(c) Body mass index (BMI) is a person’s body weight divided by the square of his or her
height.

(i) Graph 1 shows the relationship between BMI and the percentage probability
of developing Type 2 diabetes.

Graph 1

Percentage probability of developing Type 2 diabetes

 Suggest an explanation for the relationship between BMI and the risk of
developing Type 2 diabetes.

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(2)

(ii) Graph 2 shows changes in the number of new cases of Type 2 diabetes in the
UK.

Graph 2

Year

Suggest explanations for the trend shown by the data in Graph 2.

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(3)
(Total 12 marks)
Q8.
Conditions inside the body must be kept constant.

(a) Urea must be removed from the body.

(i) Name the organ which makes urea.

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(1)

(ii) Which organ removes urea from the body?

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(1)

(iii) What is urea made from?

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(1)

A man sat in a room where the temperature was maintained at 40 °C. The temperature on
the surface of his skin was monitored for 35 minutes. He swallowed an ice cold drink at
the time indicated on the graph.

(b) The sweat glands contribute to the change in the temperature on the surface of the
skin shown on the graph. Explain how.

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(2)
 (c) The blood vessels near the surface of the skin also contribute to the changes in skin
temperature shown on the graph.

(i) How do the blood vessels in the skin change when the core body temperature
falls?

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(1)

(ii) How does this change in the blood vessels explain the change in the skin
temperature shown on the graph?

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(1)
(Total 7 marks)

Q9.
Blood plasma is a solution of glucose, and many other substances, in water.

The urine of a healthy person contains water but does not contain glucose.

(a) Name two more substances found in the urine of a healthy person.

1. _________________________________________________________________

2. _________________________________________________________________
(2)

(b) (i) Describe what happens to the glucose in the blood of a healthy person when
the blood enters the kidney.

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(3)

(ii) A diabetic person’s blood often contains a high concentration of glucose.

The urine of a diabetic person may contain glucose.

Suggest an explanation why.

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(2)
(Total 7 marks)

Q10.
Many runners drink sports drinks to improve their performance in races.

A group of students investigated the effects of three brands of sports drink, A, B and C, on
the performance of three runners on a running machine. One of the runners is shown in
the image below.

© Keith Brofsky/Photodisc/Thinkstock

Table 1 gives information for each drink.

Table 1

Brand of sports drink

Nutrient per
A B C
dm3

Glucose in g 63 31 72

Fat in g 9 0 2

Ions in mg 312 332 495

(a) (i) In the investigation, performance was measured as the time taken to reach the
point of exhaustion.
 Exhaustion is when the runners could not run anymore.

All three runners:

• ran on a running machine until the point of exhaustion
• each drank 500 cm3 of a different brand of sports drink
• rested for 4 hours to recover
• ran on the running machine again and recorded how much time they ran
until the point of exhaustion.

The speed at which the runners ran was the same and all other variables were
controlled.

The students predicted that the runner drinking brand B would run for the
shortest time on the second run before reaching the point of exhaustion.

Use information from Table 1 to suggest an explanation for the students’

prediction.

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(2)

(ii) If the balance between ions and water in a runner’s body is not correct, the
runner’s body cells will be affected.

Describe one possible effect on the cells if the balance between ions and
water is not correct.

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(1)

(b) When running, a runner’s body temperature increases.

Describe how the brain monitors body temperature.

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(3)
 (c) (i) Table 2 is repeated here to help you answer this question.

Table 2

Brand of sports drink

Nutrient per
A B C
dm3

Glucose in g 63 31 72

Fat in g 9 0 2

Ions in mg 312 332 495

People with diabetes need to be careful about drinking too much sports drink.

Use information from Table 2 to explain why drinking too much sports drink
could make people with diabetes ill.

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(3)

(ii) Other than paying attention to diet, how do people with diabetes control their
diabetes?

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(1)
(Total 10 marks)

Q11.
The graph shows the core body temperature and the skin surface temperature of a cyclist
before, during and after a race.
 Start
of race

(a) (i) When the cyclist finished the race, his core body temperature started to
decrease.

How long did the race last?

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(1)

(ii) Describe and explain the different patterns shown in the core body
temperature and skin surface temperature between 09.15 and 10.15.

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(6)
 (iii) After 10.30, the core body temperature decreased.

Explain how changes in the blood vessels supplying the skin caused the skin
surface temperature to increase.

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(2)

(b) During the race, the cyclist’s blood glucose concentration began to decrease.

Describe how the body responds when the blood glucose concentration begins to
decrease.

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(3)
(Total 12 marks)
Mark schemes

Q1. (a) any three from:

• a (chemical) messenger
or
an organic substance
allow correct named example – e.g. protein / modified amino
acid / catecholamine / steroid

• made by the endocrine system / an endocrine gland / endocrine organ

allow made by / released from a (ductless) gland

• affects (a) specific / target organ(s) / tissue(s)

• released into the blood

allow carried by the blood
3

(b) insulin and glucagon

both required for 1 mark correct spelling only for glucagon
1

(c) Level 2 (3-4 marks):

Relevant points (reasons / causes) are identified, given in detail and logically linked
to form a clear account.

Level 1 (1-2 marks):

Relevant points (reasons / causes) are identified, and there are attempts at logically
linking. The resulting account is not fully clear.

No relevant content (0 marks)

Indicative content

• (0−0.5 h: ) glucose from meal enters blood

or
increase in blood glucose (to 6.5 mmol / dm3)
• glucose detected by pancreas
• pancreas secretes insulin
• (insulin causes) glucose to move (out of blood) into cells / liver
• liver converts glucose to glycogen
• causing a fall in blood glucose (after 0.5h)
• low blood glucose (< 5.0 mmol / dm3) detected by pancreas
• pancreas releases glucagon
• liver converts glycogen to glucose (which enters blood)
• blood glucose rises (after 1 h or to 5.2 mmol / dm 3 (at 1.5 h))
[8]

Q2. (a)
ignore incorrect organ secreting insulin /
glucagon

(blood glucose increases after meal causing) insulin secretion

 allow (blood glucose increases after meal
causing) insulin increase
1

insulin causes glucose to enter cells / liver / muscles

1

(insulin causes) glucose conversion to glycogen

1
allow glucose converted to glycogen in cells /
liver / muscles for 2 marks

(so) blood glucose decreases causing glucagon secretion

allow increase in glucagon when blood glucose is
low
1

glucagon causes glycogen to be converted to glucose

1

(b) cells / liver / muscles absorb less glucose

allow cells / liver / muscles convert less glucose
to glycogen
do not accept no absorption / conversion of
glucose
1

(so) glucose concentration in blood remains high

allow (so) glucose concentration in blood does
not decrease
1

(high blood glucose stimulates / causes) pancreas to release more insulin

allow more insulin is released from pancreas to
‘try’ to reduce blood glucose
1

(c) any three from:

• age
• height and mass
allow BMI
• proportion of males and females or group size
allow sex of the participants
• (same) severity of diabetes
• (same) activity (during investigation)
• (same) type of meal
• dose of drug
• (similar) blood glucose concentrations at start
allow how much / type of food / drink consumed
before
• other health conditions or other drugs being taken
allow may not have followed drug-taking regime
beforehand
3

(d) Mean = 177.2 + 15.4

1

(e) Level 3: A judgement, strongly linked and logically supported

 by a sufficient range of correct reasons, is given.
5–6

Level 2: Some logically linked reasons are given. There may

also be a simple judgement.
3–4

Level 1: Relevant points are made. They are not logically

linked.
1–2

No relevant content
0

Indicative content

Pro:
• Met + A gives larger (%) reduction (in blood glucose) than Met alone
• so statement is supported

• Met + B gives larger (%) reduction (in blood glucose) than Met alone
• so statement is supported

• Met + A SD does not overlap with Met SD

• so difference is significant

Con:
• Met + B SD overlaps with Met SD
• so difference is not significant
• difference in results could be due to chance

----------------------------------------------------------------------------------------------
• number of people used is not very large
• number of people in each group is different
• so may not be representative or may not be repeatable / reproducible
• so anomalies will have a bigger impact on smaller groups

• 30 minute / starting levels of blood glucose are different

• all 30 minute / starting levels are higher in the 2-drug trial
• so may cause different % reductions

• no information about control variables or named e.g.

• concentration of drugs not given / may differ
• so results may not be valid

for level 3 an inclusion of a discussion of significance is required

[18]

Q3.
(a) (i) (wholemeal bread)
any two from:

lower maximum / peak / less change

1

slower rise / change

ignore references to rate of fall or first to peak
 need to take less insulin / less likely to hyper
no mark for identifying the type of bread but max 1 mark if
not identified
1

(ii) any four from:

• amylase / carbohydrase

• starch to sugar
allow starch to glucose

• (sugar) absorbed / diffused / passes into blood

• correct reference to pancreas

allow once only as rise or fall

• insulin produced

• glucose (from blood) into cells / tissue / organ or named

tissue / organ
allow glucose to glycogen

• glucose used in respiration / for energy

max 3 for explaining rise, max 3 for explaining fall
4

(b) any three from:

advantages (compared to insulin injections):

• (may be) permanent / cure

• no / less need for self monitoring

• no / less need for insulin / injections

ignore reference to cost

• no / less need for dietary control

disadvantages (compared to insulin injections):

• low success rate

• (may) still need insulin / dietary control

• operation hazards

• risk of infection from donor

• rejection / need for drugs to prevent rejection

max 2 if only advantages or only disadvantages discussed
can give converse if clear that it relates to insulin injections
3
[9]
Q4.
(a) pancreas
1

(b) protease
allow proteinase
1

(c) (i) (same) enzymes / named enzymes produced in other parts /

named parts of digestive system
if named, enzymes and part must be correct
1

(ii) diet / activity varies / amount of glucose in blood varies

accept too much insulin leads to coma / hypo / low blood
sugar
accept too little insulin leads to coma / hyper / high blood
sugar
1

(d) any two from:

pros

• less / no experimentation on humans

• dogs (more) similar to humans (than lower / named organisms)

• it allows us to find a treatment or improves medical understanding

accept allows us to find a cure

cons

• harmful / cruel to dogs

accept kills dogs

• dogs may not be (metabolically) like humans

2

conclusion justified by argument

1
[7]

Q5.
(a) immune system
allow white blood cells / lymphocytes
ignore phagocytes
1

produces antibodies
1

(which) attack the antigens on the transplanted organ / pancreas

allow transplanted organs have foreign antigens at start of
explanation and linked to attacking the organ
1
 (b) (i) change / rise detected by the sensor
1

information used to calculate how much insulin she is going to need (bring her
blood glucose back to normal)
1

(pump delivers) insulin into the blood

1

(causing) glucose to move into cells

allow (liver) converts glucose to glycogen
1
max 2 if no ref. to artificial pancreas

(ii) any one from:

• it is more accurate or less chance of human error
• (glucose) level will remain more stable or no big rises and falls in blood
sugar levels
• you don’t forget to test and / or inject insulin
• if ill or in coma insulin is still injected
ignore continuous and automatic unqualified
1
[8]

Q6. (a) (concentration high) in the hepatic portal vein is blood with glucose absorbed from the
intestine
1

concentration is lower in the hepatic vein because insulin

1

(has caused) glucose to be converted into glycogen

1

or

allows glucose into liver cells

(b) (i) (after 6 hours) most of the glucose has been absorbed from the intestine
or from food into the blood
1

(ii) because glucagon (made in the pancreas) causes

if biological terms incorrectly spelt they must be phonetically
accurate
do not accept glucagon made / produced by the liver
1

glycogen to be converted into glucose

1

glucose released into blood

allow the liver maintains the correct / constant level of
glucose in the blood
1
[7]
Q7.
(a) any six from:

• hormone(s) / named produced by pancreas

• if blood glucose levels are too high, insulin is produced / released
• allowing glucose to move from the blood into the cells / named eg liver
• glucose is converted to glycogen
• if blood glucose levels fall, glucagon is produced / released
• glycogen is converted to glucose
• causing glucose to be released into the blood
6

(b) diabetes that occurs when the body (cells) do not respond / are less
responsive to insulin
1

(c) (i) higher BMIs due to increase in mass / weight (relative to height) / obesity
1

obesity / being overweight / being fat is a (significant) risk factor for Type
2 diabetes
allow causes Type 2 diabetes
1

(ii) any three from:

• related to described change in diet eg fast foods

• and less exercise
• which increases the chance of obesity / increases BMI
• increased awareness has helped to slow the increase
3
[12]

Q8.
(a) (i) liver
1

(ii) kidney
allow urethra / bladder
ignore ureter
1

(iii) (excess) protein / named / amino acids

accept amino / ammonia
1

(b) less / no sweating

allow ideas of how sweat glands change in order to reduce
sweating
1

less heat lost / evaporation

1

(c) (i) become narrower / constrict

allow contract / get smaller etc
 allow less blood flows through vessels
do not allow capillaries become narrower or reference to
movement of vessels
1

(ii) reduced / no heat loss

allow heat gained from room
1
[7]

Q9.
(a) any two from:
allow 2 correctly named substances for 2 marks
ignore water

• urea

• ions / salt(s) / correct named example

ignore minerals

• second correct named example

• hormones / named example

• allow ammonia

• allow creatinine

• allow uric acid

• allow bile pigment

2

(b) (i) glucose filtered (into kidney tubule)

accept Bowman’s capsule
1

glucose reabsorbed or glucose taken back into blood

1

all glucose taken back into blood / all reabsorbed

1

(ii) not all glucose reabsorbed

1

because not enough time / length or too high

a concentration in tubule / not enough carriers
1
[7]

Q10.
(a) (i) has the least amount of glucose allow least amount of fat or no fat
1
 (to) transfer energy (for the run)
allow (to) release energy (for the run)
do not allow produces energy
do not allow ‘energy for respiration’
1

(ii) any one from:

• cells will work inefficiently
• absorb too much water / swell / overhydrate
• lose too much water / shrink / dehydrate
ignore turgid / flaccid
cells burst is insufficient
allow cramp in muscle.
1

(b) any three from:

• thermoregulatory centre
• (has temperature) receptors
• (which) monitor blood temperature (as it flows through the brain)
• (temperature) receptors in the skin
• (receptors) send impulses to the brain
ignore vasoconstriction / vasodilation / sweating
allow hypothalamus
impulses sent to the thermoregulatory centre = 2 marks.
3

(c) (i) (sports drinks) contain a lot of glucose

1

(a person with diabetes) does not produce insulin or does not produce
enough insulin
allow (person with diabetes) has cells which do not respond
to insulin
do not allow insulin produced by liver
1

so blood glucose / sugar levels will rise too high or to a dangerous level
1

(ii) inject insulin

or
have an insulin pump (fitted)
do not allow swallow insulin
accept exercise
accept inhale insulin
accept take metformin or other correctly named drug
allow pancreatic transplant
1
[10]

Q11.
(a) (i) 1 hour 15 mins / 1.25 hours / 75 mins
allow 1:15
 ignore 1.15 hours
1

(ii) increase in (core / body) temperature

ignore numbers
1

(due to an) increase in respiration or more muscle contraction

1

releasing energy (as a waste product)

allow produces ‘heat’
do not allow making energy
1

skin temperature decreases

1

(because there is) sweating

1

(which) evaporates and cools the skin

ignore references to vasodilation or vasoconstriction
1

(iii) (there is) dilation of vessels (supplying skin capillaries)

allow vasodilation
allow blood vessels widen
ignore expand
do not accept dilating capillaries or moving vessels
1

(so) more blood flows (near skin) (surface) or blood is closer (to the
skin)
ignore ref to heat
1

(c) pancreas detects (low) blood glucose

1

produces glucagon
do not allow glucagon made in the liver
1

(so) glycogen is converted to glucose

allow adrenaline released which increases conversion of
glycogen to glucose
or
reduced insulin production so less glucose into cells / less
glucose converted to glycogen
for 1 mark
1
[12]
Examiner reports

Q2.
(a) About 31% of students were able to give a complete account of how insulin and
glucagon would control a person’s blood glucose concentration after a meal. These
students knew that insulin would be released to cause glucose to enter the body
cells, that the glucose would be converted into glycogen, that the consequential
lowering of the blood glucose level would cause glucagon secretion and that this
stimulated the conversion of glycogen back to glucose.

Some students confused the roles of the two hormones and often had problems
making themselves understood due to hybrid spellings between the terms glucagon
and glycogen. Despite glucose being mentioned in the question three times, many
students wrote about ‘blood sugar’.

(b) This question differentiated well between the higher-attaining students. Overall,
around 36% scored marks with a very small proportion of this gaining all three.
Since the cells of a person with Type 2 diabetes do not respond to insulin, this would
result in less glucose entering the cells (not ‘no glucose’ entering as many students
claimed, which would have resulted in the death of the cells). Consequently, much
glucose would remain in the blood, raising the blood’s glucose concentration which
in turn would stimulate the pancreas to keep on releasing insulin, hence the
elevated insulin levels.

Answers that did not gain credit often referred to ‘amounts’ of glucose ‘in the body’
rather than concentrations of glucose in the blood and the notion that, since insulin
was not ‘used up’ in stimulating the cells, it would therefore remain in the blood
leading to the observed high insulin concentration.

(c) Nearly all students were able to suggest at least one control variable for the
investigation, such as:

• the age of the participants

• their gender

• BMI

• severity of diabetes

• the dose of the drug given

• the same meal given to each

• other health conditions

• other drugs being taken.

A third of students gave the required three examples.

(d) The stem of this question introduced the students to the unfamiliar concept of
standard deviation. No prior knowledge of this concept was required as sufficient
detail was given to students to allow them to make use of it in answering parts (d)
and (e).

Given that standard deviation was a measure of the spread of results about the
 mean. Around 72% of students had no problem in selecting the answer ‘mean =
177.2 ± 15.4’ as being the most precise from the four examples given as this had
the smallest standard deviation.

(e) This question was intended for the highest-attaining students and differentiated well
at this level. A table of data and a bar graph of more data had to be used in the
evaluation of a student’s statement that the drug metformin worked better when
used with other drugs. Students had to decide what was meant by ‘worked better’
and they had to select appropriate data to use in their evaluation as not all of the
data was relevant.

The question was marked using a level of response mark scheme, with three levels.
The descriptors for Level 2 (3–4 marks) and Level 3 (5–6 marks) required that ‘some
logically linked reasons are given’ and, since this was an evaluation, at least one
logically linked reason supporting the statement and at least one that did not support
the statement were required. Many students did not meet this criterion, and around
84% of students were limited to Level 1 or below.

Both the table and the graph gave the standard deviation (SD) of each result. The
bullet points immediately before the actual question explained that an overlap of
SDs between two means shows there is no significant difference, whereas non-
overlap can be taken to show a significant difference.

Some students concentrated too much on the data in the table and claimed that the
blood glucose concentrations in people in the 2-drug trial were much higher than
those in the 1-drug trial. Although this was true, it was a result after only 30 minutes
(the graph showed results after 3 hours) and all the SDs overlapped, indicating that
the differences were insignificant. Some of these students also thought that the
higher blood glucose level was an ‘improvement’ of the patients’ condition.

The graph, however, showed clearly that the mean reduction in blood glucose
concentration was higher when metformin was used with drug A and when used
with drug B, which supported the student’s statement. In addition, the SD for
metformin + drug A did not overlap with the SD for metformin alone and hence
showed a significant improvement, thus supporting the student’s statement.
However, the results for metformin + drug B showed a small overlap of SDs with
metformin on its own and hence showed insignificant improvement. Consideration of
the effects of drug A and drug B on their own were irrelevant (although many
students included these in their answers).

Most students did not give any consideration to the scientists’ methodology.
However, some mentioned the low numbers of people in each drug trial and some
mentioned that there were different numbers in each trial, but few developed this
further in terms of anomalies having a greater effect on smaller groups. Hardly any
students stated that there was no mention of other control variables in the scientists’
investigation, despite having themselves suggested such control variables in their
answer to part (c); had these not been controlled, it might have invalidated the
results.

Finally, to attain Level 3, a judgement had to be made on whether the student’s

statement was correct or incorrect or partially correct. This judgement had to be
supported by a discussion of the evidence, as presented above.

Q3.
(a) (i) There was no mark for identifying the correct type of bread, wholemeal. Those
candidates who were confused as to what diabetes is, commonly suggested
 white bread and went on to explain that this raises blood glucose
concentration the fastest and for the longest period of time, with answers such
as gives you more sugar, which you need. Insufficient answers which got
closer to the point suggested that wholemeal bread gives a steadier rise in
blood glucose concentration, rather than a slower rise. It was interesting to
note that descriptions of graphs were often better for answers that were not
relevant, for example, descriptions of the fall in blood glucose concentration
often described the rate of fall correctly, whilst descriptions of the rise often did
not refer to rate.

Whilst many candidates gained one mark by referring to the lower maximum
rise in blood glucose concentration, relatively few gained a more difficult
second mark for describing the lower rate of rise, although some correctly
referred to the reduced need for insulin injections. A not insignificant minority
of candidates wrote about the time scale, either being quicker to reach the
maximum, which is correct but irrelevant, or quicker to get back to zero which
is clearly incorrect.

(ii) A considerable number of candidates misunderstood the command word

explain and filled all the space and often more beyond with detailed
descriptions of every rise and fall in blood glucose concentration and gained
no marks. Others attempted to compare brown bread with white and/or
wholemeal bread, also often gaining no marks. Those who realised that the
question was asking them to apply their knowledge of digestion, absorption
and the action of the pancreas often gave extensive and detailed answers that
could have gained six or seven marks had they been available, sometimes
extending their answers with references to glucagon production once blood
glucose levels fell too far. Misconceptions existed with ideas that glucose is
broken down into starch or that sugar is turned into glucose or even that bread
is turned into sugar. As usual on this topic, hybrid terms such as glucagen and
glycogon were not uncommon.

(b) The vast majority of candidates picked up one mark by referring to diabetics no
longer needing to take or inject insulin. Better candidates went on to discuss the
reduced need for dietary control or self monitoring. Fewer candidates clearly
explained the permanency of the treatment. A few candidates perhaps became
confused with work they had done on kidney transplants and suggested an
improved lifestyle. As a disadvantage, reference to low success rate was the most
common, however when using figures, candidates were expected to add at least
something to the information 58%... in the question to indicate that they recognised
this was a low success rate.

Many candidates also referred to the possibility of rejection and the need for
immunosuppressant drugs. Fewer included ideas about operation hazards or the
possibility of disease transmission. Amongst the disadvantages many candidates
also referred to ethics or patients not liking the idea of having cells from dead
people, neither of which was considered relevant here.

The examiners were willing to accept answers that did not clearly state which were
advantages and which disadvantages, as the context of responses was inevitably
implicit. A few answers showed poor understanding of what was going on, with
references to the need for healthy donors or for donors to be asked after they are
dead.

Q4.
Part (a) may have been seen as something of a giveaway to those candidates who did not
 understand the difference between production and monitoring. However others might
have thought it was a trick question and offered any organ other than the pancreas; with
liver being the most common incorrect answer.

As with question 1(a), a wide variety of phonetic spellings was accepted for the enzyme,
in part (b); even so, there were many suggestions, including all kinds of real or imaginary
chemicals.

Some candidates gave a clear and complete answer to part (c)(i), whereas others only
got half way there, by suggesting that enzymes are made in other parts of the body. A
wide variety of strange suggestions were also given, almost imbuing dogs with mystical
powers, dogs don’t need a pancreas or dogs can grow a new duct, being two.

In part (c)(ii) the majority of candidates described the effects of injecting excess or
insufficient insulin; unfortunately many appeared to be confused as to what insulin actually
does, suggesting that it raises blood sugar, whilst others were confused about
hypoglycaemia and hyperglycaemia. Insulin, or the lack of it, was also credited with a wide
range of medical conditions, including anaphylactic shock, raised or lowered blood
pressure, high cholesterol and blood clots.

Part (d) required candidates to offer a conclusion to their evaluation. A significant number
of candidates appeared to be unprepared for this and gave both pros and cons without
attempting to offer their own opinion, thus forfeiting one mark. Those candidates who gave
either only pros or only cons were more able to gain the mark for a conclusion; however
those who gave a mixture, needed then to explain their decision more carefully. Weaker
candidates merely summarised Banting and Best’s experiments and rarely gained marks.
However many candidates could offer at least two pros and/or cons of the use of dogs,
although it was often difficult for examiners to untangle poorly constructed answers from
candidates with weak language skills. Candidates who laid out their response in a logical
format usually gained all three marks. It would certainly be helpful to candidates if they
were given more experience in constructing answers to this type of question.

Q5.
(a) (i) Approximately three quarters of all students gained some credit for explaining
why a transplanted organ may be rejected as they could relate the question to
the immune system. Although a significant number did write about
immunosuppressive drugs instead of answering the question asked.

There was generally a good understanding of the idea of antigens being

different on the transplanted pancreas but the need for specific antibodies to
be produced in order to attack the antigens on the transplanted pancreas was
less well known.

Students usually gained one mark for referring to the immune system or white
blood cells but only the more able students gained marking point 2.

(b) (i) Most students gained one or two marks in this question and a further fifth gave
enough detail to gain three or four marks. The question required students to
use the information provided to explain what would happen for the woman in
the question and therefore answers needed to relate to this for marking points
1 and 2. Information taken from the figure needed value added to gain the
mark.

Many students achieved marking points 1 and 2 as they could explain how the
rise in blood glucose in the woman was detected and how the insulin dose
needed to return blood glucose levels to normal was calculated. A significant
 proportion of students failed to gain marking point 3 as they simply restated
the information from the diagram regarding insulin being injected under the
skin but did not go further to explain that this passes into the bloodstream.
When students did complete the explanation and attempted to give marking
point 4, a significant minority stated that glucose was converted to glucagon or
glycerol or glucogen, which are all incorrect.

(ii) Many students did not gain credit in this question as they did not appear to
understand or read the question fully. When students did gain credit it was for
stating that the artificial pancreas would avoid human error or was more
accurate.

The idea that it would reduce spikes in blood glucose level was rarely seen,
with most simply saying it was automatic or continuous or even that you could
live a normal life for which they gained no mark. It was clear in some answers
that students were mixing up the need to attend hospital for dialysis with the
question asked this year.

Q6.
(a) This was a challenging question aimed at giving students the chance to analyse data
and apply detailed higher level concepts to interpret and explain. Many students did
not gain full marks on this question due to imprecise language in which they failed to
link their explanation to the blood glucose level in the hepatic portal vein or hepatic
vein. For the second mark point, students needed to be clear in their answer that it
was the action of insulin that caused the lower concentration in the hepatic vein.

(b) (i) Students found this question very difficult and there were many
misconceptions evident in the responses. These included glucose used in
respiration, acted on by insulin, filtered into the blood and the suggested
involvement of the kidneys.

(ii) Of the students who gained credit on this question there was an even spread
across the mark range 1 to 3. A significant number of students incorrectly
described the role of insulin here and hybrid words such as glycose, glucagen
and glycogon meant that marks were lost. A significant number of potentially
high-scoring answers were reduced to 0 or 1 due to poor spelling and / or lack
of attention to detail. There was evidence of confusion between the roles of
the pancreas, liver and hepatic vein.

Q7.
(a) The regulation of blood sugar concentration by insulin and glucagon was a topic
well-known by most students, with over a half scoring either 5 or 6 marks out of the
6 available. The remainder of the students were fairly evenly dispersed over the rest
of the mark range. Most students knew that both hormones were produced by the
pancreas and that, when blood glucose was too high, insulin would be released to
stimulate its uptake by cells and conversion into glycogen for storage, the converse
points being given for the action of glucagon. Some students unfortunately lost
marks due to imprecise spelling of the terms glycogen and glucagon, with hybrids
between the two being ambiguous.

(b) Unfortunately, less than half of the students knew that Type 2 diabetes was due to
an inability of cells to respond to insulin rather than to a reduced production of
insulin.

(c) In part (i), students were required to suggest an explanation for the relationship
 between BMI and the risk of developing Type 2 diabetes, as shown in the bar graph.
Unfortunately, many students went no further than just describing the trend shown in
the graph. Sufficient information was given in the stem of the question for students
to deduce that BMI was proportional to body mass and hence a function of obesity.
Thus the graph could be interpreted as showing that the incidence of Type 2
diabetes correlated with increased obesity and hence it would appear that obesity is
a significant risk factor for Type 2 diabetes. Less than a quarter of students fully
appreciated this.

Most students fared much better in part (ii). The vast majority appreciated that the
increase in Type 2 diabetes between 1994 and 2003, as shown by the graph, was
probably due to changes in diet, especially an increase in the consumption of ‘fast
foods’, and a decrease in exercise. Those that added that these habits would tend to
increase the incidence of obesity were able to score full marks. A mark was also
available for suggesting that the decrease in slope of the graph after 2001 was
possibly due to an increase in awareness of the consequences of bad eating and
exercise habits. Nearly all students scored at least one mark in this section, with
over half scoring at least two of the three available.

Q8.
It was intended that part (a) should be fairly straightforward, requiring only recall of well-
learned facts, but that part (b), in particular, should be more demanding and discriminate
at the upper end of the mark range.

(a) (i) This was correctly answered by two thirds of the candidates.

(ii) The vast majority, candidates knew the answer here.

(iii) Candidates appeared less confident in this part, often confusing urea with
urine and quoting a list of substances in urine, including water, salts and urea
itself, along with a range of incorrect substances such as the amino acids and
protein. These last two would have scored the mark if candidates had read the
question more carefully and restricted answers to just these. A few excellent
candidates gave detailed descriptions of much of the ornithine cycle, but could
still only score the one mark.

(b) As expected, proved to be demanding for all but the best candidates, and although
there were few complete blank spaces, it was evident that many had only partly read
the question and/or information. Omitting the last four words, shown on the graph, in
the stem of the question put a completely different slant on the type of answer given.
It was this that, it appeared, most candidates had done, as there were extensive and
detailed explanations of how the evaporation of sweat leads to a cooling effect.
Unfortunately for these candidates the information in the graph showed an increase
in skin temperature, which can only be explained, in terms of the sweat glands, by a
reduction in sweat production.

Examiners were surprised by how many candidates carefully described how the skin
would be cooled, which diametrically opposed the evidence in the graph. Some
candidates, who did refer to the graph, yet still insisted on describing additional
sweat production, tried to explain the rise in temperature in terms of heat coming to
the skin from the core, to evaporate the sweat. It was also evident that a significant
minority of candidates believe that the blood is at a considerably different
temperature to the tissues through which it flows.

A number of candidates, again perhaps not using the information, described both
sides of the sweat story, increase when too hot and decrease when too cold, leaving
 the examiner to choose which to mark. Unfortunately for the candidate this is not in
the examiners’ remit and no mark is awarded unless there was a clearly stated link
to the drink.

It was of particular note that a considerable number of candidates crossed out their
original answers, continuing on additional paper to give the correct explanation.
Clearly these candidates had had second thoughts, perhaps as they worked their
way through part (c) and realised that their original explanation was the reverse of
what was really happening.

(c) Candidates again often contradicted themselves between the two sub-sections.

(i) Should have been a piece of simple recall for most candidates, however there
was considerable misunderstanding of the terms constrict and dilate, with
many answers quoting one of these and then going on to describe the
opposite, for example they dilate and get narrower. There is a widespread
misunderstanding that blood vessels move through the skin to allow
temperature control.

(ii) It was surprising, again, how many candidates failed to read the question
properly, as it refers to this change in the blood vessels. Hence, having
previously described constriction in part (c)(i), it might be expected that
answers would follow on and explain how constriction of blood vessels
reduces heat loss. This was often not the case, as candidates frequently
began their answers with the opposite effect. Those candidates who
suggested that blood vessels go deeper into the skin, in part (c)(i) were still
able to gain the mark in part (c)(ii).

Q9.
(a) Around two-thirds of students were able to name two substances, in addition to the
water given in the question, which were present in the urine of a healthy person. The
most common correct answers were urea and mineral ions. The most common
incorrect ones were ‘amino acids’ and ‘protein’. Despite its exclusion by the
question, some students included ‘water’ in their answers.

(b) (i) The points required in were that glucose would be filtered out of the blood in
the kidney and that it would then all be reabsorbed. The question differentiated
very well across the ability range. There was the usual confusion by some
students of the meanings of the two terms, filtration and reabsorption, which
were often interposed and some stating that glucose was too big to pass
through the filter and yet, somehow, it was still reabsorbed. One-fifth of
students scored the full 3 marks, while over a half scored 2, often due to
omission of the detail that all the glucose was reabsorbed.

(ii) Students performed very poorly here, with only a third scoring any marks.
Students were expected to apply their understanding of kidney functioning to
the given situation by realising that because so much glucose would be filtered
from the blood of a diabetic, there would not be enough time, or enough length
of tubule, or enough glucose carriers to reabsorb all of it and hence some
would remain in the urine. Many thought that excess glucose had to be
excreted by the diabetic because there was too much in the blood. Others did
not present their argument clearly and it was not clear whether the
concentration to which they were referring was that in the kidney tubule or in
the blood.
Q10.
(a) (i) The vast majority of students scored marks in this question. Many students
had obviously looked carefully at the data and as a result quoted figures from
the table, such as 0 g fat. Where students did not gain full credit, they often did
not make it clear that B contains the least glucose. They missed out the all-
important idea of least, and statements such as ‘less’ or ߢ32 g’ were not
creditworthy. A common misconception seen by a significant number of
students was a belief that respiration produces or makes energy.

(ii) Many students struggled to clearly express their ideas for this question, and
consequently only half gained the mark. Correct answers were evenly split
between marking points two and three with students either describing cells
absorbing too much water or losing too much water. These points were
expressed in a variety of ways, but there were many answers that described
the movement of water, indicating a good understanding of osmosis. It was
much rarer to see answers describing the inefficient working of cells. It is worth
noting that the response of ‘burst’ was insufficient to gain credit. A significant
number of students referred to cells becoming flaccid or turgid and this may
indicate a lack of understanding that these terms are only appropriate for use
with plant cells.

(b) This question discriminated very well with most students gaining one or more marks.
Most students gained one mark for correctly identifying that the thermoregulatory
centre is involved. Reference to the thermoregulatory system was encountered
frequently, although many students did not achieve this mark because they used
incorrect words with the prefix ‘thermo’. Many students used the alternative term
hypothalamus which correctly identified the anatomical part of the brain which is
involved in thermoregulation, for this same mark point. Students needed to state that
the temperature of the blood is monitored as it flows through the brain, for marking
point three and several students stated that the brain ‘senses’ the temperature
change, which was not creditworthy. Many students incorrectly used the terms
detectors or sensors instead of receptor. The last possible mark point was for skin
receptors sending impulses to the brain, but many students used incorrect terms
such as sending messages or information around the body. A significant number of
students simply referred to the effects of increased temperature on the body such as
vasodilation, vasoconstriction or sweating.
Students need to understand the difference between the process of monitoring body
temperature and controlling body temperature.

(c) (i) Students answered this question well and a full range of marks was seen. A
significant number of students started their explanations with ‘it’ or ‘they’ and
did not make it clear that they were referring to the sports drink. ‘Drinking too
many sports drinks’ was a common error rather than stating that the issue, for
diabetics, was that the sports drink contains a lot of glucose. Some students
referred simply to the presence of glucose which was insufficient to gain credit.
Correct answers about the person with diabetes not producing insulin or not
responding to insulin were frequently encountered but occasionally students
stated that insulin is produced by the liver, which is incorrect. The final mark
point was seen frequently and often students correctly stated that the blood
glucose levels were therefore too high or at a dangerous level in the person
with diabetes after consuming sports drinks that are high in sugar. Incorrect
responses were usually referring to ‘levels in the body’ rather than the blood.
Several students referred to the wrong hormone, most commonly ‘glucagon’.

(ii) The vast majority of students stated exercise or injections of insulin for one
mark in this question. Other correct responses were seen involving insulin
pumps, inhaling insulin and pancreatic transplants. Non-creditworthy
 responses included simply taking insulin or insulin tablets, shots, epipens,
therapy, monitoring blood glucose or dialysis.

Q11.
(a) (i) Approximately three quarters of students gained credit in this question.

(ii) About two thirds of all students gained three or more marks in this question.
Most students were correctly able to describe the shape of both lines on the
graph. Many students used data to enhance their descriptions giving more
depth than was required in the mark scheme. Some students had not read the
question correctly and described the body and skin temperatures before 9.15
or after 10.15 in addition to the section between 9.15 and 10.15 as the
question asked.

Marking point 2 was very rarely awarded as most students did not refer to
respiration or muscle contractions as the reason for body temperature
increasing. Those that did often did not include the idea of more respiration or
muscle contraction and therefore were not awarded this mark.

Few marks were awarded for the marking point of ‘releasing energy’. Often
students did not mention this but when they did many referred to energy being
made or produced as opposed to released and so could not be awarded this
mark.

The majority of students referred to sweating as the reason that skin

temperature decreases during exercise and many of these students then
explained how this happens by referring to cooling by evaporation in their
answers.

Many students spent time explaining how blood vessels could alter the blood
flow to the skin as a method of heat loss, which was not relevant. Others
included information about hairs lying flat on the skin or about the role of the
thermoregulatory centre, both of which were ignored by examiners.

Some students who did not realise the importance of the command words
used in the question wrote lengthy descriptions of the graph instead of
explaining the shape of the graph as well.

(iii) Students found this question difficult, and over half did not gain any marks.
Many students thought that the body needed to conserve heat and so
described vasoconstriction. Many of those who chose vasodilation lost a mark
by referring to blood vessels moving about in the skin.

(b) Students were generally scoring two marks for realising that glucagon was involved
and that this caused the conversion of glycogen into glucose.

Few students stated that the pancreas ‘detects’ changes in blood glucose levels, but
they did say that it was the pancreas that was involved or was producing the
glucagon.

There were a significant number of spelling errors, students maybe ‘knowing the
story’ but not gaining marks because the spellings were ambiguous, such as
glygogon or glucogen. A number of students stated that glucagon was an enzyme.