Diabetes Meds Flashcards
(29 cards)
Where is insulin secreted from and in what amount?
- synthesized and stored bound to zinc in granules in the B-islet cells of the pancreas
- 60 units/day (25% total content)
- continuously released + additional increases following carbohydrate ingestion
Describe how high blood glucose stimulates insulin release:
- glucose enters B-cell via GLUT-2 transporter
- converted to ATP via oxidation
- closes ATP-sensitive K+ channel causing depolarization
- Ca2+ enters cell
- insulin is secreted
GLP-1 stands for…
glucagon-like peptide-1
GIP stands for…
glucose-dependent insulinotropic peptide
DPP-4 stands for…
dipeptidyl peptidase
Describe the incretin effect:
GLP-1 and GIP are released from specialized neuroendocrine cells of the small bowel –> stimulate insulin release
What is the function of DPP-4?
rapidly inactivates GLP-1 and GIP
How is the incretin response affected by type 2 DM?
type 2 DM blunts the incretin response and GIP becomes ineffective in stimulating insulin release
List the 4 hormones that increase serum glucose:
1) cortisol
2) catecholamines
3) glucagon
4) growth hormone
List the 4 peptides that stimulate insulin release:
1) glucagon-like peptide-1 (GLP-1)
2) glucose-dependent insulinotropic peptide (GIP)
3) pituitary adenylate cyclase-activating polypeptide (PACAP)
4) vasoactive intestinal peptide (VIP)
Action of insulin on muscle:
- anabolic hormone enhancing protein synthesis and decreasing protein breakdown
- glucose transport into muscle using GLUT-4 transporter
- glycogen synthesis and storage
Action of insulin on fat:
- increases fatty acid and triglyceride uptake into adipose tissues (lowers plasma FA levels)
- increased glucose transport into fat cells using GLUT-4 transporter
- inhibits fat breakdown
- increased clearance of ketone bodies
Which 3 types of tissues do not require insulin for transportation of glucose?
- brain
- liver
- kidney
Action of insulin on liver:
- increased synthesis of glycogen in liver
- inhibited gluconeogenesis, glycogenolysis, and ketogenesis
- excess glucose converted to FFA
- synthesis of FFA and glycerol into triglycerides for fat storage
- increased protein synthesis from amino acids
Action of insulin on electrolytes:
- increases K+ uptake into cells
- increase renal Na+ retention
Action of insulin on brain:
- stimulates memory
- controls appetite
Action of insulin on cardiovascular system:
vasodilatory properties
Summary of insulin effects on the body:
- increase glucose update
- increase glycolysis
- increase protein synthesis
- increase lipogenesis
- decrease gluconeogenesis
- decrease lipolysis
- decrease proteolysis
Diabetes diagnosis A1C, fasting BG test, and GTT:
A1C = 6.5%+
FBG = 126 mg/dL+
GTT = 200 mg/dL+
Prediabetes diagnosis A1C, FBGT, and GTT:
- A1C = 5.7-6.4%
- FBG = 100-125 mg/dL
- GTT = 140-199 mg/dL
Normal A1C, FBGT, and GTT:
- A1C = <5.7%
- FBG = <99 mg/dL
- GTT = <140 mg/dL
Lifestyle r/f type 2 DM:
- high carbohydrate intake
- metabolic syndrome
- inactivity
- obesity
- HTN
- high cholesterol
What is a HgA1C?
- glycosylated hemoglobin
- amount of glucose combined with Hgb is directly proportion to the total amount of sugar in the body
- useful tool in measuring long-term glucose control d/t life span of rbc = 8-12 weeks
- goal is <6.5%
Diabetic complications:
- Alzheimer’s dz
- nerve damage
- eye damage
- hearing impairment
- dental problems
- cardio/cerebro/vascular dz
- kidney damage
- extremity damage
- skin conditions r/t poor wound healing
