Anti-Diabetic Agents Flashcards
(46 cards)
alpha secretes:
glucagon
beta secretes:
insulin and amylin
delta secretes:
somatostatin
G-cell secretes:
gastrin
F-cell secretes:
pancreatic polypeptide
Insulin
- type of hormone?
- process to make?
- peptide hormone
- made as pre-pro-inslin –> cleaved to pro-insulin –> maturation that cleaves C-peptide leaving just insulin
*positive regulation of insulin release:
- glucose (substrate)
- amino acids (substrate)
- incretins (hormones)
- Epi/Beta2 stim (hormone)
- vagus stim (neuronal)
*Negative regulation of insulin release:
- NE/alpha2 stim (neuronal)
- amylin (hormone feedback)
Insulin secretion is dependent on? Process?
- Calcium - vesicles and docking and stuff
- ATP sensitive K channel closes when ratio of ATP/ADP is high bc of high glucose levels=making ATP –> depolarization –> CA influx)
Insulin receptor and effect on cell upon binding:
bunch of stuff but upreg of GLUT4 transporter on membrane (MUSCLE AND ADIPOSE TISSUE)
GLUT4 is on what tissue? regulated by what?
Muscle and adipose - insulin mediated uptake of glucose
Insulin effects on Liver, muscle and adipose.
1) liver = mediates storage of glucose as glycogen (NOT HEPATIC UPTAKE OF GLUCOSE)
2) adipose= stimulates uptake of glucose (GLUT4)
- uptake and conversion of fatty acids into storage triglycerides
3) Muscle=stimulates uptake of glucose (GLUT4)
- uptake and storage of amino acids into proteins
Type 1 Diabetes
- insulin-dependent diabetes mellitus
- juvenile-onset
- 1a=immune mediated (most)
- 1b=idiopathic
-beta cell destruction = absolute deficiency
Type 2 diabetes
- adult-onset
- non-insulin dependent diabetes
- resistance to insulin and then get insulin secretory deficiency (body tries to inc insulin production to keep up with sugar levels)
-obesity/genetics/nutrition/physical activity
Gestational diabetes
- glucose intolerance in 2nd or 3rd trimester
- 4% get this
- return to normal immediately post delivery
- 40% who get will develop diabetes in next 10 years
type 1 diabetes - signs and symptoms:
1) polyuria/nocturnal enuresis- osmotic diuresis:loss of glucose, electrolytes and water
2) Thirst- hyperosmolar state
3) blurred vision-hyperosmolar state
4) WL/polyphagia
- acute=depletion of water, glycogen, triglyc stores
- chronic=loss of muscle mass as amino acids are used for gucose and ketone bodies
5) Weakness/Dizziness-postural hypertension, potassium loss and muscle catabolism
6) Paresthesias - temporary Periph sensory nerve dysf
7) level of consciousness - depends on level of hyperosmolarity
- slow insulin def = minimal signs but fast deficiency shows fruity breath, ketoacidosis, dehydration, coma,…
Type 2 diabetes- signs and symptoms
1) asymptomatic initially
2) infections - glucose available as E source for microorganisms - skin and candidal vag
3) neuropathy - retinopathy and peripheral neuropathy
4) classic severe insulin deficiency signs - polyuria,thrirst, blurred vision, fatigue, weakness
5) obesity & metabolic syndrome - dyslipidemia, HTN, CAD
Fasting blood glucose levels should be around?
100mg/dL
insulin therapy is required for whcih diabetes?
- type 1
- also used for type2 with declining insulin production/secretion
Whats the point of synthetic insulins pharmakokinetics wise?
We change around a few amino acids of the sequence = different kinetics = how much the insulin sticks to itself (determines length of action)
Rapid acting insulin drugs & duration*
- insulin lispro
- insulin aspart
- insulin glulisine
- inhaled insulin
-3-5 hrs
short acting insulin drugs & duration*
- regular insulin
- 4-12 hrs
Intermediate acting insulin drugs & duration*
- NPH
- 10-20hrs
Long acting insulin drugs & duration*
- insulin Glargine 12-20 hrs
- insulin detemir 22-24hrs
