Endo

Question 1

GLP-1 stimulated by

Answer 1

oral glucose load

Question 2

GLP-1 secreted by

Answer 2

small intestine L cells

Question 3

example of a GLP-1 mimetic

Answer 3

exenetide, Liraglutide

s/c injection 60mins before morning and evening meals

Consider adding exenatide to metformin and a sulfonylurea if:
BMI >= 35 kg/m² in people of European descent and there are problems associated with high weight, or
BMI < 35 kg/m² and insulin is unacceptable because of occupational implications or weight loss would benefit other comorbidities.

Question 4

side effect of GLP-1: Exenetide

Answer 4

linked to severe pancreatitis

increased risk of hypoglycaemia

Nausea, vomiting

Question 5

What is the Incretin Effect?

Answer 5

a higher insulin spike is seen with oral glucose than IV glucose

Mediated by GLP-1, decreased in T2DM

Question 6

example of Dipeptidyl peptidase-4 (DPP-4) inhibitors

Answer 6

Vildagliptin

sitagliptin

Question 7

DPP-4

Answer 7

DPP-4 inactivates GLP-1, therefore potentiating the effect of GLP-1 (increase insulin release, inhibit glucagon)