Insulin & Hypoglycaemics Flashcards

1
Q

Where is insulin released?

A

Pancreatic beta cells

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2
Q

Where is glucagon released?

A

Pancreatic alpha cells

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3
Q

Delta cells release…

A

Somatostatin

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4
Q

Which influx of ions into the cell causes the release of insulin?

A

Ca2+

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5
Q

Where does insulin act?

A

Liver, muscles cells and fat cells

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6
Q

What does insulin do?

A

Increases glucose uptake, storage and utilisation.
Increases protein synthesis.
Increases triglyceride synthesis

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7
Q

How does insulin act?

A

Binds to receptors and activates receptors to activates Glut4 transporter to transport glucose from the blood to the cells.

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8
Q

What is diabetes mellitus?

A

When the pancreas doesn’t produce enough insulin or the body can’t effectively use the insulin that it produces and leads to hyperglycaemia

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9
Q

Types of therapy for type 1 diabetes mellitus

A
  • Insulin therapy
  • Islet/pancreas transplantation
  • Prevention with immune mediated destruction of beta cells
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10
Q

What are the 3 basic r

prepared insulins for t1 diabetes

A

Short duration rapid onset
Intermediate action
Longer lasting slower onset

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11
Q

What do you know about insulin injections for management of t1 diabetes

A

Injection is subcutaneous 3-4 times daily

Can get insulin pumps that give a continuous basal insulin at mealtimes

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12
Q

When would you use glucagon therapy (GlucaGen for injection) to induce hyperglycaemia?

A

In cases of severe hypoglycaemia when you can’t get oral glucose in.

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13
Q

What does glucagon promote?

A

Glycogenolysis
Gluconeogenesis
Lipolysis

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14
Q

What do secretagogues do in treatment of diabetes?

A

Stimulate the release of insulin by beta cells. They are small molecule antagonists of the K(ATP) channel.

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15
Q

What do sensitizers do for diabetes treatments?

A

Improve the insulin sensitivity

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16
Q

What is Diazoxide what does it treat?

A

Hyperglycaemic therapy. Treats congenital hyperinsulinism in infancy, insulinomas and severe cases of transient hypoglycemia.

17
Q

What do secretagogues 2 do?

A

Boost insulin release by enhancing normal physiology of insulin mediated insulin secretion. They are peptide agonists of GLP1 receptor.

18
Q

Exenatide and Liraglutide are examples of…

A

Secretagogues type 2

19
Q

Gliptins such as sitagliptin and vildagliptin are examples of…

A

Secretagogues type 3

20
Q

How do secretagogues 3 work?

A

Boost insulin release by increasing the normal physiology of incretin mediated insulin secretion. They are inhibitors of DPP4 and raise the half life of serum GLP1

21
Q

What are the 2 types of Insulin sensitizers

A

Thiazolidinediones and Biguanides

22
Q

What are the 2 modes of actions of Biguanides?

A

1 - preventing hepatic production of glucose

2 - overcoming insulin resistance by improving insulin sensitivity

23
Q

What is the most widely prescribed Biguanide/antidiabetic drug in the world?

A

Metformin (glucophage)

24
Q

How do insulin thiazolidinediones work?

A

Activate a protein involved in transcription of insulin sensitive genes which regulate glucose and fat metabolism.

25
Q

Main target of insulin thiazolidinediones

A

Adipocytes

26
Q

Alpha glucosidase inhibitors like acarbose and glucobay work by…

A

Converts oligosaccharides to glucose

27
Q

What do sodium coupled glucose transporters do?

A

Glucose reabsorption