Insulin And Hypoglycaemics Flashcards by Alice Caporn | Brainscape

Q

What is the term used to describe elevated serum glucose conc.

A

Hyperglycaemia

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Q

The approximate fasting blood glucose concentration in a healthy individual is:

A

5-7mmol/L

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Q

The approximate fasting blood glucose concentration in a diabetic patient is

A

10mmol/L

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Q

Where are insulin secreting cells found?

A

The pancreas

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Q

What is the disease caused by an absolute loss of insulin secreting cells?

A

Type 1 diabetes

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Q

Give an example of an increasing

A

Glucagon-like peptide

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Q

What is the drug sensitive type of diabetes with early (<20years) onset

A

Maturity-onset diabetes of the young

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Q

Name a class of drugs which changes ion channel properties (diabetes)

A

Sulphonylureas

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Q

Drug(s) which alter the transcriptional profile of insulin-sensitive genes

A

Thiazolindinediones

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Q

What is the disease that arises when tissues become resistant to insulin

A

Type II diabetes

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Q

Where is the location of the principle site of glucose storage

A

Liver

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Q

Which two types of diabetes drugs are insulin sensitisers 
A. SGLT2 inhibitors
B. Biguanides
C. GLP-1 Rs agonists
D. Thiazolidinediones

A

B & D

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Q

Which type of diabetic drug works by promoting glucose loss 
A. DPP4 inhibitors
B. Biguanides
C. SGLT2 inhibitors
D. Alpha-glucose inhibitors

A

SGLT2 inhibitors

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Q

Which of the following types of diabetes drugs are insulin secretagogues 
A. DPP4 inhibtors
B. Alpha-glucosidase inhibitors
C. GLP-1 Rs agonists 
D. Sulphonylureas
E. SGLT2 inhibitors

A

DPP4 inhibitors
GLP-1 Rs agonists
Sulphyonylureas/meglitinides

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Q

Which type of diabetic drug works by delaying glucose absorption?

A

Alpha-glucosidase inhibitors

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Q

What is the approximate blood glucose level of hypoglycaemia

A

<3mmol/L

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Q

What cannot substitute glucose, meaning glucose delivery is critical to function

A

CNS

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Q

Most tissues can utilise non-glucose molecules as substitutes of glucose, like….

A

Fatty acids and amino acids

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Q

What is used as a diagnostic of diabetes mellitus

A

Glucosuria

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Q

A rise in blood sugar is recognised by what

A

Pancreatic B-cells

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Q

The human pancreas has approximately how many islets of langeuhan?

A

1.5 million

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Q

True or false, pancreatic B-cells are not associated with the vasculature

A

False, they are very closely approximated with the blood vessels

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Q

Insulin acts on a number of large tissues;

A

Liver
Muscle
Adipocytes
CNS

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Q

Is the CNS involved in the homeostasis of blood glucose

A

No. Rise in blood sugar is detected by pancreatic B-cells which then release insulin

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Q

How does glucose enter the pancreatic B cells

A

Via glucose transporter

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Q

True or false, glucose has to be metabolised in the pancreatic B cells, this uses energy which acts as a signal

A

True

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Q

When the pancreatic B cell depolarises following the shut down of K channels, which ion floods into the cell pushing insulin out by exocytosis

A

Calcium

Q

Which drugs are molecules which close the K channel, mimicking the actions of glucose and are used to treat type II diabetes

A

Insulin secretagogues

Q

Which drugs work by opening the K channel, inhibiting the actions of glucose and are used to treat congenital hyperinsulinism

A

Hyperglycaemia inducing drugs

Q

Glucose-stimulated insulin release is a 2 stage process. In stage 1 all the insulin stored in pancreatic B cells is released. Stage 2 is the synthesis of new insulin molecules. Which stage do people with type II diabetes lose?

A

Stage 1

Q

A fall in blood glucose is detected by which cells

A

Pancreatic alpha cells

Q

When hypoglycaemia is detected by the pancreatic alpha cells, what substance do they release which principally acts on the liver

A

Glucagon

Q

What substance is used medically to reawaken the unconscious patient

A

Glucagon

Q

Which system has a direct link to the pancreas

A

Digestive system

Q

During digestion the small intestine releases incretin hormones which stimulates pancreatic B cells to release insulin. Which hormones are realised?

A

GLP-1 (glucagon like peptide-1)

GIP (gastric inhibitory peptide)

Q

What stimulates the release of GLP-1 and GIP from the small intestine which stimulates pancreatic beta cells to release insulin

A

Sugars and fats

Q

Which type of diabetes is where insulin-producing cells are failing and/or tissues are insensitive to insulin

A

Type 2 DM

Q

Which type of diabetes is where insulin-producing cells are destroyed and insulin must be provided

A

Type 1 DM

Q

True or false, T1DM is an autoimmune disease

A

True

Q

T1DM accounts for what percentage os DM cases

A

5-15%

Q

What are some risk factors for T2DM

A

Ageing
Obesity
Ethnicity
Family history

Q

Which type of diabetes is a polygenic disorder

A

T2DM

Q

What is the common feature of T1DM and T2DM
A. Decreased insulin signalling
B. Elevated glucose
C. Elevated lipids
D. Insulin resistance

A

B. Elevated glucose

Q

What are the 3 basic insulin preparations of insulin therapy for T1DM

A

Short duration (rapid onset)
Intermediate action
Longer lasting

Q

Insulin therapy often contains what - which helps bind to the insulin

A

Zinc

Q

Insulin aspart, insulin glulisine and insulin lispro are all what type of insulin therapy

A

Rapid action, short duration

Q

How can the rapid action insulin therapies insulin aspart, insulin glulisine and insulin lispro be administered

A

IV

Subcut

Q

What type of insulin therapy is isophane insulin

A

Intermediate action

Q

What type of insulin therapy do the following drugs belong to; protamine zinc insulin, insulin zinc suspension, insulin detemir and insulin glargine

A

Longer lasting. Slow onset and lasts for long periods

Q

Short duration insulin therapies such as, insulin aspart, insulin glulisine and insulin lispro have an onset of what time?

A

30-60 mins

Q

Short duration insulin therapies such as, insulin aspart, insulin glulisine and insulin lispro have a peak action of what time?

A

2-4 hours

Q

What is the duration of Short duration insulin therapies such as, insulin aspart, insulin glulisine and insulin lispro

A

8 hours

Q

Short duration insulin therapies such as, insulin aspart, insulin glulisine and insulin lispro are injected when?

A

Just before, with or just after food. Only lasts long enough for that mean

Q

Intermediate/longer duration insulin therapy such as; isophane insulin, insulin detemir, insulin glargine, insulin zinc suspension and protamine zinc insulin have of onset of what time?

A

1-2 hours

Q

What is the peak action of Intermediate/longer duration insulin therapy such as; isophane insulin, insulin detemir, insulin glargine, insulin zinc suspension and protamine zinc insulin?

A

4-12 hours

Q

What is the duration of Intermediate/longer duration insulin therapy such as; isophane insulin, insulin detemir, insulin glargine, insulin zinc suspension and protamine zinc insulin

A

16-35 hours

Q

Biphasic insulin aspart, biphasic insulin lispro and biphasic isophane insulin are all what rules of insulin therapy?

A

Mixture of intermediate and fast acting

Q

What is the onset and duration of the following insulin therapies; Biphasic insulin aspart, biphasic insulin lispro and biphasic isophane insulin

A

Rapid onset

Long-lasting

Q

Why is insulin injected?

A

It is a peptide and would be ingested in the stomach

Q

How do portable insulin infusion pumps work?

A

Give a continuous short acting insulin and a patient activated bolus dose at meal times

Q

What are 3 common side effects of hyperglycaemia-inducing glucagon therapy

A

Headache
Nausea
Rapid heart rate

Q

DPP4 inhibitors, GLP-1 receptor agonists and sulphonylureas/meglitinides are all what type of hypoglycaemic therapy

A

Insulin secretagogues

Q

Which hypoglycaemic therapy works by boosting insulin release by enhancing aspects of the normal physiology of glucose-stimulated insulin secretion

A

Sulphonylureas

Q

Gliclazide and tolbutamide are what kind of short acting hypoglycaemic therapy

A

Sulphonylureas

Q

Chlorpropamide, glibenclamide, glipizide and glimepiride are all what type of long acting hypoglycaemic therapy

A

Sulphonylureas

Q

What is the administration regime of the hypoglycaemic therapy sulphonylureas eg. Gliclazide?

A

OD or BD with or shortly before a meal