Insulin & Anti Diabetics [15] Flashcards
Cause of type 1 diabetes
Insulin deficiency
Needs insulin therapy
Cause of type 2 diabetes
Insulin insensitivity & inadequate insulin secretion
What is diabetes
Chronic hyperglycaemia
Disturbances of carbohydrate, fat and protein metabolism
Preventative management of diabetes includes
Blood pressure
Blood lipids
Anti thrombotic agents
Inc insulin resistance could be due to
Genetics
Lack of exercise
High calorie diet
What lifestyle changes must be made to manage type 2 diabetes
Reduce calorie load
Reduce sugar load
Physical exercise
Glycated haemoglobin concentration is a measure of
Glucose control
What medications of considered first
Metformin to decrease glucose conc
Metformin adv
Inhibits liver gluconeogenesis
Metformin disadv
Diarrhoea
Lactic acidosis - renal impairment
How do sulfonylureas increase insulin supply
Bind to SU receptor
Open K+ channel
Depolarise islet B cell
What do DPP-4 inhibitors do
Inhibit degradation of natural GLP-1
What is GLP-1
Hormone
Stimulates insulin secretion
Inhibits glucagon secretion
What do SGLT2 inhibitors do
Cause urinary glucose loss
Inhibit renal tubular reabsorption
Which insulin is rapid acting
Meal time insulin for basal insulin
Meal time
Which insulin is soluble and which is NPH
Meal time is soluble
Basal is NPH
What’s in an insulin mix
Soluble + NPH insulins
Technical problem with insulin therapy
High variability in subcutaneous insulin absorption profile
Personal problems with insulin therapy
Needle
Repetitive
Compliance
Metformin MOA
Activates AMPK
Decreases cAMP
Decreases gluconeogenesis
Thiazolidinediones MOA
PPAR-ay agonist
Increase lipogenesis
Decreases plasma fatty acids
What insulin therapies increase glucose loss
SGLT2 inhibitors
What insulin therapies decrease glucose entry to blood
Metformin
Alpha glucosidase inhibitors
What insulin therapies increase insulin supply
Sulfonylureas
GLP-1 receptor agonist + DDP-4 inhibitor
Insulin administration
What insulin therapies increase improve insulin sensitivity
Thiazolidinediones
Alpha glucosidase inhibitors MOA
Inhibit absorption of carbohydrates from small intestine
Can’t synthesis glucose
