Diabetes mellitus Flashcards
Which conditions are a contraindication for alpha-glucosidase inhibitors?
Cirrhosis or IBD
What is the molecular target of metformin?
AMP kinase
Is more insulin released after IV or oral administration of glucose?
Oral
What are the side effects of sulphonylureas?
Weight gain and hypoglycaemia
How do sulphonamides work at an organ level when treating diabetes?
Increase insulin release from the beta cells of the pancreas
Which cells have receptors for AGEs?
Macrophages, endothelial, vascular smooth muscle, T cells
What is exenatide?
A GLP-1R agonist
Which hormone is released with a fall in BSL?
Glucagon
What class of drug is metformin?
Biguanide
What class of drug are the -liptins
DPP-IV inhibitors (prevents breakdown of GLP-1 to treat diabetes)
What does ‘diabetes’ mean?
Production of abundant urine
What is the tissue level effect of alpha-glucosidase inhibitors?
Reduce digestion and absorption of CHOs from small intestine
What are the main side effects of alpha-glucosidase inhibitors?
Flatulence, abdominal discomfort, loose stools
What is insulin lispro?
Short acting insulin
What is HbA1c?
Glycosylated haemoglobin - a marker for diabetes control
Which three tissue are particularly vulnerable to complications in diabetes mellitus?
Kidneys, retina, nerves
What type of cells kill beta islet cells in T1DM
Cytotoxic T cells
Name 2 main effects of GLP-1
Delays gastric emptying Stimulates pro-insulin syntheis
How doe DPP-4 drugs treat diabetes on a tissue level?
Inhibit breakdown of incretins, thus increasing insulin:glucagon ratios
What are the 4 main actions of metformin at a tissue level?
GAIL Gluconeogenesis in liver is inhibited Absorption of carbohydrates is reduced Insulin-mediated glucose uptake is enhanced LDL and TAG levels are decreased
What is the cascade for insulin release from beta cells?
Glucose enters through GLUT-2 Glycolysis and TCA cycle yields ATP ATP displaces ADP from K+ ATP channel K+ influx depolarises cell Depolarisation opens voltage gated Ca2+ channel Ca2+ enters cell and causes vesicles to exocytose insulin
How does diabetes cause peripheral neuropathy?
Ischaemic damage AGEs damage axons and schwann cells
What type of drug is exenatide?
Glucagon-like peptide-1 agonist
Which country has the highest prevalence of Type 1 diabetes?
Finland
How long does the second phase of insulin release last for?
As long as the stimulus is present
What do fructosamine levels tell you in a diabetic patient?
How good BSL control has been over the past 6 to 8 weeks
Why is there polyuria in DM?
Hyperglycaemia => glucosurea => osmotic diuresis => polyurea
Which is the most potent incretin?
GLP-1
Which conditions are a contraindication for metformin?
Renal impairment