Endo

Question 1

aspart

Answer 1

Short acting insulin 
Type 1 DM, type 2 DM,
GDM (postprandial glucose
control).
Binds insulin receptor (tyrosine
kinase activity).
Liver: increase glucose stored as
glycogen.
Muscle: increase glycogen, protein
synthesis; increase K+ uptake.
Fat: increase TG storage.

Question 2

glulisine

Answer 2

Short acting insulin 
Type 1 DM, type 2 DM,
GDM (postprandial glucose
control).
Binds insulin receptor (tyrosine
kinase activity).
Liver: increase glucose stored as
glycogen.
Muscle: increase glycogen, protein
synthesis; increase K+ uptake.
Fat: increase TG storage.

Question 3

tolbutamide

Answer 3

Sulfonylurea 
Stimulate release of
endogenous insulin in
type 2 DM. Require some
islet function, so useless in
type 1 DM.
Close K+ channel in β cell
membrane > cell depolarizes
> insulin release via increased Ca2+
influx.
Risk of hypoglycemia increased in renal
failure, weight gain.
First generation: disulfiram-like
effects.
Second generation:
hypoglycemia.

Question 4

chlorpropamide,

Answer 4

1st gen Sulfonylurea 
Stimulate release of
endogenous insulin in
type 2 DM. Require some
islet function, so useless in
type 1 DM.
Close K+ channel in β cell
membrane > cell depolarizes
> insulin release via increased Ca2+
influx.
Risk of hypoglycemia increased in renal
failure, weight gain.
First generation: disulfiram-like
effects.
Second generation:
hypoglycemia.

Question 5

glipizide,

Answer 5

Sulfonylurea 
Stimulate release of
endogenous insulin in
type 2 DM. Require some
islet function, so useless in
type 1 DM.
Close K+ channel in β cell
membrane > cell depolarizes
> insulin release via increased Ca2+
influx.
Risk of hypoglycemia increased in renal
failure, weight gain.
First generation: disulfiram-like
effects.
Second generation:
hypoglycemia.

Question 6

repaglinide

Answer 6

meglitinide 
Used as monotherapy in
type 2 DM or combined with
metformin.
Stimulate postprandial
insulin release by binding
to K+ channels on β cell
membranes (site differs from
sulfonylureas).
Hypoglycemia (increased risk with
renal failure), weight gain