6.1 Diabetes Flashcards
what stimulates insulin secretion from B cells?
-increased glucose
-incretins (GLP-1, GiP)
-parasymp activity M3
insulin half life
5 mins
what inhibits insulin secretion?
decrease glucose
cortisol
sympathetic activity
exogenous steroids
why is insulin secreted even during fasting?
prevents receptor down regulation
DKA triad
hyperlgycaemia
ketonaemia
acidosis
when to suspect DKA
blood glucose >11 ANDA
polydipsia
polyuria
abdo pain
V+D
lethargy
confusion
acetonic breath
shock
precipitating factors to DKA
infection
trauma
non adherence to insulin treatment drug drug interactions
treatment pathway for DKA
iv fluids
iv insulin
k+ correction
different ways to slow insulin absorption:
- soluble insulin forms hexamers (takes longer so get to monomers)
- analogues, change a few AAs (changes PK, not PD)
- complex with zinc/protamine
important drug drug interactions for diabetes treatments
-other hypoglycaemic agents
-exogenous steroids
-NSAIDS, ACEi (impair renal function)
-loop/thiazide diuretics (increase glucose)
basal bolus dosing
3 meals per day: rapid acting insulin
long acting each day
diabulimia
type 1 diabetic stops/reduces insulin to control weight
why can sulfonylureas cause weight gain?
anabolic effects of insulin
MOA for SGLT-2 inhibitors
competitively reversibly inhibit SGLT-2 in PCT, so decrease glucose reabsorption from filtrate and increase urinary glucose excretion
aside from diabetes, what else can SGLT-2 inhibitors be used for?
HFrEF, HFpEF
