Insulin & Hypoglycaemics Flashcards
Where is insulin released?
Pancreatic beta cells
Where is glucagon released?
Pancreatic alpha cells
Delta cells release…
Somatostatin
Which influx of ions into the cell causes the release of insulin?
Ca2+
Where does insulin act?
Liver, muscles cells and fat cells
What does insulin do?
Increases glucose uptake, storage and utilisation.
Increases protein synthesis.
Increases triglyceride synthesis
How does insulin act?
Binds to receptors and activates receptors to activates Glut4 transporter to transport glucose from the blood to the cells.
What is diabetes mellitus?
When the pancreas doesn’t produce enough insulin or the body can’t effectively use the insulin that it produces and leads to hyperglycaemia
Types of therapy for type 1 diabetes mellitus
- Insulin therapy
- Islet/pancreas transplantation
- Prevention with immune mediated destruction of beta cells
What are the 3 basic r
prepared insulins for t1 diabetes
Short duration rapid onset
Intermediate action
Longer lasting slower onset
What do you know about insulin injections for management of t1 diabetes
Injection is subcutaneous 3-4 times daily
Can get insulin pumps that give a continuous basal insulin at mealtimes
When would you use glucagon therapy (GlucaGen for injection) to induce hyperglycaemia?
In cases of severe hypoglycaemia when you can’t get oral glucose in.
What does glucagon promote?
Glycogenolysis
Gluconeogenesis
Lipolysis
What do secretagogues do in treatment of diabetes?
Stimulate the release of insulin by beta cells. They are small molecule antagonists of the K(ATP) channel.
What do sensitizers do for diabetes treatments?
Improve the insulin sensitivity
What is Diazoxide what does it treat?
Hyperglycaemic therapy. Treats congenital hyperinsulinism in infancy, insulinomas and severe cases of transient hypoglycemia.
What do secretagogues 2 do?
Boost insulin release by enhancing normal physiology of insulin mediated insulin secretion. They are peptide agonists of GLP1 receptor.
Exenatide and Liraglutide are examples of…
Secretagogues type 2
Gliptins such as sitagliptin and vildagliptin are examples of…
Secretagogues type 3
How do secretagogues 3 work?
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
What are the 2 types of Insulin sensitizers
Thiazolidinediones and Biguanides
What are the 2 modes of actions of Biguanides?
1 - preventing hepatic production of glucose
2 - overcoming insulin resistance by improving insulin sensitivity
What is the most widely prescribed Biguanide/antidiabetic drug in the world?
Metformin (glucophage)
How do insulin thiazolidinediones work?
Activate a protein involved in transcription of insulin sensitive genes which regulate glucose and fat metabolism.
Main target of insulin thiazolidinediones
Adipocytes
Alpha glucosidase inhibitors like acarbose and glucobay work by…
Converts oligosaccharides to glucose
What do sodium coupled glucose transporters do?
Glucose reabsorption
