Insulin Analogues and Anti-Obesity Agents Flashcards
What are the five main insulin categories?
Short acting Rapid acting Intermediate acting Long acting Very long acting
Give time scale of short acting insulin
- when it starts to work
- when to inject
- peak
- duration of action
Works in 30-60 minutes Inject 15-30 minutes before eating Peaks at 2-3 hours Duration of 8-10 hours Injected several times a day to cover meals
Give time scale of rapid acting insulin
- onset of action
- when to inject
- peak
- duration
Onset within 5-15 minutes
Inject just before eating
Peaks at 30-90 minutes
Duration of 4-6 hours
Give timings of intermediate acting insulin
- onset
- peak
- duration
- when to inject
Onset of 2-4 hours
Peaks at 4-8 hours
Duration of 12-20 hours
Twice a day, before breakfast and dinner
Give time scale of long and very long acting
- onset
- duration
Onset of 2-6 hours (slow)
Duration of up to 24 hours
Give benefits of long and very long acting insulin
Keeps blood glucose at a more steady state
Reduced chance of nocturnal hypos
Less need for snacking between meals and before bed because there is less of a peak of insulin concentration
Adverse effects of insulin?
Hypoglycaemia
Hyperglycaemia
Lipodystrophy from injecting in the same spot (hypertrophy or atrophy)
Painful injections due to acidic solutions
Insulin allergies due to preservatives
What are the different types of insulin?
Porcine and bovine
Recombinant DNA technology
- human short-acting
- human rapid-acting
- isophane intermediate acting
- long-acting basal analogue insulins
- very long-acting basal analogue insulins
What causes elevation of HbA1c?
Glucose non-enzymatically irreversibly glycosylates haemoglobin - rate is proportional to glucose
What is the normal baseline HbA1c?
6%
What damage can a HbA1c above 7% cause?
Damage of function to -renal -hepatic -CVS -neurological Due to onset of microvascular disease
Name the two main anti-obesity agents
Orlistat
Sibutramine
How does orlistat work?
A gastric and pancreatic lipase inhibitor
-reduces dietary fat conversion to fatty acids and glycerol
Major limitations of orlistat?
GI disturbance
-includes fatty stools increasing risk of flatus with unpleasant discharge or faecal incontinence
How does sibutramine work?
Noradrenaline and serotonin re-uptake inhibitor
- suppresses appetite
- reduces hyperglycaemia
- reduces rate of glucose metabolism
- may increase thermogenesis