Diabetics

Question 1

List the classes of Oral anti diabetics (GI3DA)

Answer 1

Glucosidase Inhibitors
Insulin Secretagogues
Insulin sensitizers
Dipeptidyl peptidase IV inhibitor
Amylin analogues

Question 2

Examples of Glucosidase inhibitors?

Answer 2

(MiA)

Acarbose
Miglitol

Question 3

Insulin Secretagogues are classified into two ______ and ______?

List 3 examples under each

Answer 3

Sulfonylurea
Examples: Tolbutamide, Chlorpropamide, Glyburide

Meglitinides
Ex: Rapaglinide, Nateglinide

Question 4

Insulin sensitizers are classified into two ______ and ______?

List examples under each

Answer 4

Biguanides
Ex: Metformin

Thiazolidinediones/Glitazone
Ex: Troglitazone, Rosiglitazone, Pioglitazone

Question 5

Examples of Incretin Mimetics

Answer 5

Exenatide

Question 6

Examples of Dipeptidyl peptidase IV inhibitors?

Answer 6

Sitagliptin
Saxagliptin

Question 7

Examples of Amylin analogue?

Answer 7

Pramlintide

Question 8

MAO and Adverse Effects of Sulfonylureas?

Answer 8

MAO
- Binds and blocks ATP-sensitive K+ channels of the pancreatic beta cells
- This causes depolarization and influx of Ca+
- Eventually causing Insulin secretion

Side Effects
- Steven Johnson syndrome
- Disulfiram like reactions or Alcohol intolerance
- Hypoglycemia
- Weight gain
- Allergic reactions

Question 9

MAO and Adverse Effects of Meglitinides?

Answer 9

MAO
- Binds and blocks ATP-sensitive K+ channels of the pancreatic beta cells
- This causes depolarization and influx of Ca+
- Eventually causing Insulin secretion

Side Effects
- Hypoglycemia
- Weight gain
- Hepatotoxicity

Question 10

MAO and Adverse Effects of **Incretin Mimetics **?

Answer 10

MAO
- Binds to Glucagon Like Peptide-1 (GLP-1) receptor
- Leads to increased Insulin secretion and decreased Glucagon secretion

Side Effects
- Pancreatitis
- Weight loss

Question 11

MAO and Adverse Effects of **Dipeptidyl Peptidase IV inhibitors **?

Answer 11

MAO
- Binds and inhibits the DPP-4 enzyme that breaks down Glucagon Like Peptide-1 (GLP-1) or Incretin
- Leads to accumulation of Incretin
- Leads to increased Insulin secretion

Side Effects
- Pancreatitis
- Urinary Infection

Question 12

MAO and Adverse Effects of Amylin Analogue?

Answer 12

MAO
- Acts as an Amylinomimetic
- Amylin is a peptide hormone co-secreted with Insulin

Side Effects
- Anorexia
- Nausea
- Vomiting

Question 13

MAO and Adverse Effects of Biguanides?

Answer 13

MAO
Improves glucose tolerance by:
- Activating AMP-activated Protein Kinase (AMPK)
- Reduce hepatic gluconeogenesis
- Increases peripheral utilization of glucose
- Direct stimulation of tissue glycolysis

Side Effects
- Lactic Acidosis
- Vit B12 deficiency
- weight loss

Question 14

MAO and Adverse Effects of Thiazolidinedione?

Answer 14

MAO
- Binds and activates the transcription factor PPARy
- Leads to increased glucose utilization

Side Effects
- Increased risk of Heart Failure
- Increased risk of bone fracture
- Edema

Question 15

MAO and Adverse Effects of **Glucosidase inhibitors **?

Answer 15

MAO

• Bind and inhibit alpha-Glucosidase (a brush border enzyme expressed by intestinal epithelial cells)
• this causes delayed and decreased intestinal glucose absorption
• hence reduces hyperglycemia after food ingestion

Side Effects
- Flatulence
- Bloating
- Abdominal discomfort
- Diarrhea