Insulin and Oral Anti-Diabetic Agents

Question 1

What is Type 1 Diabetes also known as?

Answer 1

Insulin dependent diabetes

Question 2

What is Type 2 Diabetes also known as?

Answer 2

Insulin non-dependent diabetes

Question 3

What are the three established treatments of Anti-hyperglycaemic agents?

Answer 3

Metformin
Sulphonylureas
Glitzones

Question 4

Describe mechanism of action Metformin

Answer 4

It is a biguanide

Improves insulin resistance in skeletal muscles and liver through cAMP mechanism

Inhibits intestinal glucose absorption
Inhibits gluconeogenesis
Enhances glucose uptake in skeletal muscle

Question 5

Describe the mechanism of Sulphonylureas

Answer 5

Are an insulin secretogogue, and reduces HbA1c

Question 6

Give two examples of Sulphonylureas

Answer 6

Gliclazide

Glimepirid

Question 7

Describe the mechanism of Glitzones

Answer 7

PPARy agonist
Modulates transcription of insulin sensitising genes
Reduces HbA1c

Question 8

What are the four classes of modern anti-hyperglycaemic agents?

Answer 8

GLP-1 analogues
DPP-4 inhibitors
SGLT-2 inhibitors
Insulin analogues

Question 9

Describe the Incretin Effect

Answer 9

When normal healthy people were given a glucose load orally, the insulin response was high, yet when administered intravenously, the insulin response was low. The Incretin effect is diminished in Type 2 Diabetes

Question 10

State two Incretin Hormones and what intestinal cells they are derived from

Answer 10

Glucagon-like Peptide-1 (GLP-1) from Intestinal L cells

Glucose-Dependent Insulinotropic Peptide (GIP) from Intestinal K cells