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Question 1

What happens to glucose during feeding

Answer 1

Excess calories stored as fat or glycogen

Question 2

What happens to glucose during fasting

Answer 2

Calories need to be available in the form of glucose

Question 3

What is diabetes the result of

Answer 3

Reduced or absent insulin secretion or sensitivity

Question 4

What is type 1 diabetes

Answer 4

Immune-mediated loss of beta cells

Question 5

What is type 2 diabetes

Answer 5

Insulin resistance

Question 6

What are some less common forms of diabetes (3)

Answer 6

Latent autoimmune diabetes in adults (LADA)
Maturity onset diabetes of the young (MODY)
Gestational diabetes (Onset in pregnancy)

Question 7

How is insulin released in a normal person given glucose infusion

Answer 7

2 phase

Question 8

What are some long term health complications with diabetes (5)

Answer 8

Diabetic retinopathy
Diabetic nephropathy
Diabetic neuropathy
Stroke
Cardiovascular disease

Question 9

What are insulin sensitizers (2)

Answer 9

Biguanide

Glitazone

Question 10

What are medications that increase production/secretion of insulin

Answer 10

Sulfonylurea

Thiazolidinedione

Question 11

What are medications that decrease absorption of carbohydrates

Answer 11

Acarbose

Question 12

What are medications that boost the incretin response

Answer 12

GLP-1, exenatide, liraglutide, sitagliptin, viltagliptin

Question 13

What are medications that increase glucose clearance

Answer 13

SGLT2 inhibitors

Question 14

What are the components of preproinsulin

Answer 14

Insulin A, B chains and C-peptide

Question 15

What are some problems with insulin replacement therapy

Answer 15

Administration
Control of blood glucose kinetics
Optimisation of analogues

Question 16

What are the effects of metformin (3)

Answer 16

1) Improve sensitivity of liver to insulin
2) Reduce liver glucose production
3) Increase glucose uptake in skeletal muscle

Question 17

What are advantages of metformin (3)

Answer 17

Does not induce:

1) Hypoglycaemia
2) Weight gain
3) Increased insulin release

Question 18

What are some side-effects of metformin (2)

Answer 18

Gastro-intestinal symptoms

Decreased B12 absorption

Question 19

MOA of drugs which increase insulin secretion from pancreatic beta-cells (3)

Answer 19

Binding of drugs blocks ATP-sensitive K+ channel
Leads to depolarisation and opening of Ca2+ channels
Ca2+ influx leads to insulin secretion

Question 20

Examples of sulfonylureas

Answer 20

Glibenclamide (Daonil)
Glicazide (Diamicron)
Glipizide (Minidiab)

Question 21

MOA of glitazone (thiazolidinedione)

Answer 21

Agonist of PPAR

Binds to PPAR leading to transcription of genes involved in insulin signalling

Question 22

Example of glitazone

Answer 22

Pioglitazone (Actos)

Question 23

Effects of inhibitor of alpha-glucosidase in the GIT (4)

Answer 23

1) Reduce degradation of di- and polysaccharides
2) Reduce absorbable monosaccharides
3) Reduce carbohydrate absorption
4) Reduce postprandial hyperglycaemia

Question 24

Example of alpha-glucosidase

Answer 24

Acarbose (Glucobay)

Question 25

What are incretins + 2 examples

Answer 25

Intestinal hormones released in response to glucose and lipids
GIP and GLP-1

Question 26

What drugs that modulate the incretins and the incretin effect (2)

Answer 26

GLP-1 analogues

DPP-4 inhibitors [Sitagliptin (Januvia)]

Question 27

How do SGLT2 inhibitors work

Answer 27

Loss of glucose through urine and reduction in fasting glucose levels

Question 28

Examples of SGLT2 inhibitors

Answer 28

Dapaglifozin (Forxiga)
Canaglifozin (Invokana)
Empaglifozin (Jardiance)