endocrine week 2

Question 1

sulphonylureas

Answer 1

inhibit the potassium ATP pump on beta cells > +insulin secretion
may cause weight gain
e.g. glibenclamide, glicazide

Question 2

metformin

Answer 2

biguanide
increase the uptake of glucose by skeletal muscle
acts on the liver to inhibit glucneogenesis
25% develop GI side effects

Question 3

pioglitazone

Answer 3

TF for genes involved in triglyceride storage. Stops deposition of lipids in non-adipose tissue, helping to reduce insulin resistance and the development of ALD.
works over a period of months
Side effects: increased long bone fractures, water retention and bladder cancer

Question 4

DPP-IV inhibitors

Answer 4

DPP-IV normally degrades GLP-1 so inhibiting it allows GLP-1 to act for longer.
Well tolerated - weight neutral, oral tablet and provide a fairly stable glucose level
e.g. sitagliptin

Question 5

GLP-1 agonists

Answer 5

GLP-1 normally secreted upon ingestion of food, causing:
beta: enhanced glucose-dependent secretion of insulin
alpha - decreased secretion of glucagon
liver - decreased hepatic glucose output
brain - promotes satiety and reduced appetite
stomach - slows gastric emptying
Drugs works very well and lead to weight loss as well.
Issue as they must be injected
e.g. exenatide

Question 6

SGLT-2 inhibitors

Answer 6

Channel in the PCT that normally reabsorbs up to 90% of the glucose in the tubule.
have additional benefit of osmotic diuresis which can be beneficial in the context of hypertension.
can have issue where kidneys and pancreasecorr-talk leading to release of glucagon, increasing chances of DKA developing
e.g. empaglifozin

Question 7

type II diabetes

Answer 7

condition of hyperglycaemia caused by insulin resistance - failure of target tissues to respond to glucose

Question 8

metabolic abnormalities in type 2 DM

Answer 8

insulin resistance increased glucose production by the liver and impaired secretion of insulin by the beta cells of the pancreas