Insulin & Oral Anti-diabetics

Question 1

What is insulin?

Answer 1

pancreatic, anabolic hormone that promotes nutrient storage

Question 2

What is diabetes mellitus?

Answer 2

decrease in insulin production or increase in insulin resistance; metabolic disorder similar to fasting

Question 3

type 1 DM

Answer 3

autoimmune destruction of beta cells; low insulin levels; insulin secretion can’t be stimulated

Question 4

type 2 DM

Answer 4

decreased response of peripheral tissues to insulin; low insulin levels; blunted insulin response upon stimulation

Question 5

gestational diabetes

Answer 5

steroid (progestin, estrogen) -induced insulin resistance; often resolves after delivery; treated like type 2

Question 6

fast-acting insulins

Answer 6

lispro, aspart, glulisine

don’t need to dissociate; promotes absorption by preventing self-association

Question 7

intermediate insulin

Answer 7

all protamine and insulin are in a complex

Question 8

long-acting insulins

Answer 8

modification of amino acid sequence makes insulin soluble at acidic pH but precipitate at neutral pH thus slowing absorption
OR
increases self-aggregation and binding to albumin

Question 9

insulin dosing therapies

Answer 9

intensive (variable doses, type 1)

conventional (constant doses, type 2

Question 10

pathway from glucose to insulin release

Answer 10

glucose in blood taken up by beta cells; increases ATP; decreases K efflux; increases Ca influx to signal exocytosis; insulin released

Question 11

mechanism of action of metformin

Answer 11

inactivate mitochondrial glycerophosphate dehydrogenase; antagonize the actions of glucagon and/or activate the AMP-activated protein kinase; takes place in the liver; reduction of gluconeogenesis and hepatic glucose output