antidiabetics Flashcards
1
Q
What are the positive regularors of insulin release
A
glucose (substrate)
amino acids (substrate)
incretins (hormones)
Epi/Beta2-adrenergic stimulation (hormones)
vagus stimulation (neuronal)
2
Q
negative regulation of insulin release
A
NE/alpha2-adrenergic stimulation (neuronal)
amylin (hormone)
3
Q
describe the Glucose transporters (GLUT)
A
- GLUT4 –> muscle, adipose tissue –> INSULIN MEDIATED UPTAKE OF GLUCOSE
- GLUT 1 –> all tissues, especially RBCs and brain –> basal glucose uptake, transport across BBB
4
Q
INsulin action on cellular targets
A
5
Q
Less insulin causes
A
- Gluconeogenesis
- amino acids/glycerol/lactate to glucose
- glycogenolysis
- glycogen to glucose
- Ketogenesis
- mobilization of fat for energy
6
Q
Type I DM
A
- Immune mediated Beta-cell destruction
- leads to ABSOLUTE INSULIN deficiency
- genetic predisposition
- SYMPTOMS
- polyuria/nocturnal enuresis, thirst (hyperosmolar state), blurred vision
- weight loss/polyphagia
- paresthesia (temporay peripheral sensory nerve dysfunction
- level of consciousness
7
Q
Type II DM
A
- Insulin resistance and insulin secretory defect
- genetic predispoistion
- obesity, nutrition and physical activity plays a role in developing DM
- SYMTPOMS:
- Neuropathy, classic severe insulin deficiency signs (polyuria, thirst, blurred vission, fatigue
- obesity and metabolic syndrome (dyslipidemia, HTN, coronary artery disease)
8
Q
adverse effects of insulin therapy
A
- Hypoglycemia (insulin theray too effective
- Hypersensitivity
- Resistance
- Lipohypertrophy –> fat deposition at injection site
- lipoatrophy –> fat loss at injection site
9
Q
Hypoglycemia
A
- Treatment = Glucose or glucagon
- Symptoms prodcued by autonomic symptoms
- tachycardia, sweating, tremors, nausea, hunger
- neuroglycopenic symptoms
- irritability, fonusion, headache, speech difficulty
- loss of consciousness, seizure, coma, death
