Hellekant Pancreas

Question 1

Insulin inhibits breakdown of fat/adipose by inhibiting what enzyme?

Answer 1

Intracellular lipases that hydrolyze TGs

Question 2

What are the effects of sympathetics on beta islet cells?

Answer 2

Inhibit insulin and amylin secretion

Question 3

Parasympathetic nerves via the vagus n. Are involved in what phase of insulin secretion?

Answer 3

Cephalic phase

Question 4

What cells secrete glucagon?

Answer 4

Alpha islet cells

Question 5

What cells of the pancreas secrete somatostatin?

Answer 5

Delta cells

Question 6

What is amylin?

Answer 6

Amino acid that is Co-packaged and co-secreted with insulin in beta cells

Question 7

What is the function of amylin?

Answer 7

Inhibits glucagon secretion (at alpha cell); induces satiety, delays gastric emptying, inhibits secretion of digestive enzymes

Question 8

Glucagon increases in response to what?

Answer 8

Hypoglycemia, amino acids, and sympathetics

Question 9

What triggers the release of somatostatin in regards to pancreatic hormones?

Answer 9

Insulin

Question 10

What inhibits release of somatostatin in regards to pancreatic hormones?

Answer 10

Ghrelin

Question 11

What cells release ghrelin?

Answer 11

Epsilon

Question 12

What is the function of somatostatin in regards to pancreatic functions?

Answer 12

Inhibits release of insulin, glucagon, and ghrelin.

Question 13

What are examples of incretins? What is their broad function?

Answer 13

GIP, and GLP-1; promote beta cell insulin release after eating

Question 14

What cells produce GLP-1?

Answer 14

L cells

Question 15

What is the function of GLP-1?

Answer 15

Stimulates insulin in high glucose situation and inhibits glucagon secretion euglycemia or hypoglycemia

Question 16

What degrades glp-1?

Answer 16

Dipeptidyl peptidase -4

Question 17

What cells produce GIP?

Answer 17

K cells

Question 18

What is the function of GIP?

Answer 18

Stimulates insulin in high glucose situation and promotes glucagon secretion following a meal

Question 19

How is GLP-1 formed?

Answer 19

Alternative splicing from glucagon gene

Question 20

What is the function of dipeptidyl-peptidase 4?

Answer 20

Degradation of GLP-1

Question 21

What is a big difference in the effects of GLP-1 vs. GIP?

Answer 21

GLP-1 decreases PP glucagon, while GIP increases PP glucagon

Question 22

During what phase are the incretins released? What causes the release?

Answer 22

GI phase; released due to hyperosmolarity due to glucose in gut

Question 23

Why is there a larger insulin response from oral vs. IV glucose?

Answer 23

Due to oral (carbs stimulate sweet receptors) and intestinal (incretins released) phases of insulin secretion

Question 24

Where are SGLT1 transporters found?

Answer 24

Mostly small intestine; if in kidney fond in late proximal straight tubule

Question 25

Where are SGLT2 transporters found?

Answer 25

Kidney - early PCT

Question 26

What cells are GLUT1 found on?

Answer 26

Most cells

Question 27

What cells are GLUT2 found on?

Answer 27

Liver, beta cells, kidney, hypothalamus, basolateral membrane of small intestine

Question 28

Where are GLUT3 transporters found?

Answer 28

Brain, placenta, testes

Question 29

Where are GLUT4 transporters found?

Answer 29

Skeletal and cardiac muscle; fat

Question 30

Where are GLUT5 transporters found?

Answer 30

Mucosal surface in small intestine; sperm

Question 31

What glucose transporter is activated by insulin?

Answer 31

GLUT4

Question 32

What GLUT is the sensor for beta pancreatic cells?

Answer 32

GLUT2

Question 33

What is the function of GLUT7?

Answer 33

Transports glucose in endoplasmic reticulum

Question 34

What drug for DM impairs gluconeogenesis?

Answer 34

Metformin

Question 35

What is a common side effect of biguanides (metformin)?

Answer 35

Diarrhea - reduce by gradually increasing the dose

Question 36

What is the most serious SE of metformin?

Answer 36

Lactic acidosis

Question 37

What is the MOA of sulfonylureas?

Answer 37

Promote insulin secretion by binding SUR1 subunit of ATP-sensitive K channel, closing the K channel, activating Ca++ channels, and thus fusing/release of insulin containing vesicles

Question 38

What are the primary SEs of sulfonylureas?

Answer 38

Hypoglycemia (esp in renal failure) and weight gain

Question 39

What class of drug does glimepiride belong to?

Answer 39

Sulfonylureas

Question 40

What are the first gen sulfonylureas? What is a SE of them?

Answer 40

Chlorpropamide and tolbutamide; disulfiram-like

Question 41

What is the MOA of meglitinides?

Answer 41

Bind the K+ channel at site different than sulfonylureas; same MOA - stimulate insulin release

Question 42

What drugs are in the meglitinide class?

Answer 42

Nateglinide, repaglinide

Question 43

What are the second generation sulfonylureas?

Answer 43

Glimepiride, glyburide, glipizide

Question 44

What is exanitide?

Answer 44

GLP-1 analog

Question 45

What is the MOA of GLP-1 analogs?

Answer 45

Stimulate insulin and inhibit glucagon release; early satiety, delay gastric emptying

Question 46

What drugs are in the GLP-1 analog class?

Answer 46

Exenatide and liraglutide

Question 47

What drugs are in the dipeptidyl peptidase IV inhibitor class?

Answer 47

Linagliptin, saxagliptin, sitagliptin

Question 48

What is the MOA of sitagliptin?

Answer 48

Inhibits dipeptidyl peptidase IV, therefore enhancing the activity of incretins (GLP-1 and GIP)

Question 49

What is the MOA of repaglinide?

Answer 49

Binds K+ channel at site different than sulfonylureas; promotes release of insulin from beta cells

Question 50

What are examples of drugs in the alpha-glucosidase inhibitor class?

Answer 50

Acarbose and miglitol

Question 51

What are the primary side effects of nataglinide?

Answer 51

Nataglinide = meglitinides; SEs hypoglycemia and weight gain; other: tremor, GI and dizziness

Question 52

What is the MOA of acarbose?

Answer 52

Inhibits glucosidases (enzymes that hydrolyze carbs to monosaccharides), therefore decreasing the ability to absorb sugars

Question 53

What are the side effects of alpha-glucosidase inhibitors?

Answer 53

Predominantly GI

Question 54

What is the MOA of amylin analogs?

Answer 54

Bind amylin receptor and inhibit glucagon synthesis, glucose synthesis in liver, and delays gastric emptying and increases satiety

Question 55

What class does pramlintide belong to?

Answer 55

Amylin analog

Question 56

What drug class increases uptake and storage of glucose in skeletal muscle and adipose tissue?

Answer 56

Thiazolidinediones

Question 57

What is the MOA of thiazolidinediones?

Answer 57

Binds and activates PPAR gamma receptor; results in increasing synthesis and transport of GLUT transporters in muscle, adipose and liver; therefore increases insulin sensitivity in peripheral tissue

Question 58

What drugs are in the thiazolidinedione class?

Answer 58

Rosiglitazone and pioglitazone

Question 59

What are the SEs of thiazolidinediones?

Answer 59

Weight gain; edema, heart failure/cv events, URI, HA, hepatotoxic

Question 60

What diabetes drug increases risk for bladder cancer?

Answer 60

Pioglitazone

Question 61

What are the rapid acting insulin preparations?

Answer 61

Lispro, aspart, glulisine

Question 62

What insulin is short acting?

Answer 62

Regular insulin

Question 63

What insulin preparation is considered intermediate acting?

Answer 63

NPH insulin

Question 64

What insulin preparations are considered long acting?

Answer 64

Glargine an detemir