Insulin And Hypoglycaemics

Question 0

What do SGLT2 Inhibitors promote?

Answer 0

Glucose loss

Question 1

Name two insulin sensitisers?

Answer 1

Thiazolidinediones

Biguanides

Question 2

What do alpha glucosidase inhibitors delay?

Answer 2

Glucose absorption

Question 3

What are three insulin secretagogues?

Answer 3

DPP4 inhibitors, GLP-1 receptor agonists, sulphonylureas/megtinides.

Question 4

What are the 7 stages of cellular insulin release?

Answer 4

Glucose uptake
Glucose metabolism
Potassium channel opening
Depolarisation 
Calcium channel opening
Calcium influx
Insulin release

Question 5

What are six functional effects of insulin?

Answer 5

Increase conversion of glucose to glycogen
Increases the break down of amino acids to protein
Increases the breakdown of glucose to fat
Decreases gluconeogenesis
Decreases glycogen break down
Increases glucose and amino acid transport into cells

Question 6

Where is glucagon released from?

Answer 6

Pancreatic alpha cells

Question 7

Which hormones in the small intestine stimulate insulin release?

Answer 7

GLP 1

GIP

Question 8

Which nerves in the small intestine stimulate insulin release?

Answer 8

Enteric

NS

Question 9

Which is more effective oral or IV glucose?

Answer 9

Oral

Question 10

What is impaired glucose regulation?

Answer 10

Pre diabetes (type 2)

Question 11

Name 6 less common types of diabetes

Answer 11

Gestational diabetes
Transient neonatal diabetes
Permanent neonatal diabetes
Maturity onset diabetes of the young
Maternally inherited diabetes and deafness
Associated with syndromes - wolfram, alstrom…

Question 12

What type of disease is DM Type 1?

Answer 12

An auto immune disease

Question 13

What causes DM type 1?

Answer 13

Destruction and damage of beta cells

Question 14

What are four risk factors of DM Type 2?

Answer 14

Obesity, family history, ageing, ethnicity

Question 15

What are the two main complications of type 1 DM

?

Answer 15

Decreased insulin signalling

Elevated glucose

Question 16

What are the three main complications of type 2 DM?

Answer 16

Elevated glucose
Elevated lipids
Insulin resistance

Question 17

What are the broad treatment plans for type 1 DM?

Answer 17

Lifelong insulin, healthy diet, regular exercise.

Question 18

What are the broad treatment palms for type 2 DM?

Answer 18

Lifestyle changes - weight, diet, activity.

Hypoglycaemic therapy and/or insulin.

Question 19

Give three examples of short acting insulin

Answer 19

Insulin aspart
Insulin glulisine
Insulin lispro

Question 20

When should you inject short acting insulin and how long does it take to work?

Answer 20

Before, with or just after food.

30-60 mins. Lasts 8 hours (peak 2-4)

Question 21

Give five examples of intermediate/longer duration insulin

Answer 21

Insulin detemir
Insulin glargine
Insulin zinc suspension
Isophane insulin
Protamine zinc insulin

Question 22

Where is zinc found?

Answer 22

Pamcreatic B cells

Question 23

How often should insulin be injected?

Answer 23

Subcutaneous 3-4 times daily

Question 24

Which insulin is a mixture of intermediate and fast acting drug and has a rapid onset with long - lasting actions?

Answer 24

Biphasic insulin preparations eg biphasic insulin aspart

Question 25

When would you give glucagon therapy?

Answer 25

First aid treatment for severe hypoglycaemia when oral glucose is not possible

Question 26

How do secretagogues work?

Answer 26

Close the potassium channel - boost insulin release by enhancing aspects of normal physiology of glucose stimulated insulin secretion.

Question 27

Name two short acting sulphonylureas

Answer 27

Gliclazide and tolbutamide

Question 28

Name two long acting sulphonylureas

Answer 28

Chlorpropamide | Gibenclamide

Question 29

What do long acting sulphonylureas increase the risk of especially in the elderly?

Answer 29

Hypoglycaemia

Question 30

What are the three types of secretagogues?

Answer 30

Sulphonylureas Meglitinides Diazoxides

Question 31

Name two short acting megnitilides

Answer 31

Repaglinide | Nateglinide

Question 32

What is diazoxide used to treat?

Answer 32

Congenital hyperinsulnism, insulinomas, transient hypoglycaemia.

Question 33

What are the side effects of diazoxide?

Answer 33

Anorexia, nausea, vomiting, hyperuricaemia, hypotension, oedema, tachycardia, arrhythmias, extrapyramidal effects.

Question 34

Name two GLP1 receptor agonists?

Answer 34

Exenatide | Liraglutide

Question 35

Which enzyme rapidly breaks down GLP 1?

Answer 35

DPP4

Question 36

What do DPP4 inhibitors do?

Answer 36

Preserve GLP 1 levels

Question 37

Gilptins are a type of what?

Answer 37

DDP4 inhibitor

Question 38

Name 3 gilptins

Answer 38

Sitagliptin Vildagliptin Saxagliptan

Question 39

How do insulin sensitisers work?

Answer 39

Improve the sensitivity of target organs to insulin

Question 40

How do biguanides work?

Answer 40

Activate enzymes - agonist of AMPK

Question 41

Name a biguanide

Answer 41

Metformin

Question 42

Metformin is also available in...

Answer 42

Combination

Question 43

Give an example of a thiazolidnedione?

Answer 43

Rosiglitizone

Question 44

Name an alpha glucosidase inhibitor

Answer 44

Acarbose