Lec 16 part 2 - type 2 diabetes Flashcards
T2D: how is beta cell dysfunction linked
not direct effect
but increases the risk
T2D: why increased adiposity can be risk factor
adipocytes are key insulin sensing tissues
3 other risk factors for type 2 diab
- envornmental chemicals
- unbalanced microbiome
- intrauterine development
T2D: what initially happens when insluin sensitive tissues not responsing correctly OR if unhealthy lifestyle
beta cells increase the release of insluin
islets need to work harder to exocytose more insulin
an adaptative response
what is level of treatment determined by
severity of disease
patient lifestyle
patient compliance/side effects
basically the same as any other treatment
5 groups of treatment of T2D
- promoting insulin release from beta cells
- insulin sensitisers = aid insulin signalling
- promotion of glucose loss from kidneys
- modifiying glucose/nutrient absorption from GI tract = affects incretins
- appetite regulation
main insulin sensitiser
metformin
what does metformin do
- increases hepatic insulin sensitivity
- increase uptake of glucose into peripheral cells
- decreased hepatic glucose production by inhibiting gluconeogenesis
- triggers AMP Kinase signalling pathway
How do thiazolidinediones work
- act on liver, muscle and adipocytes
- activate their receptors
- improves insulin sensitivity
- alternative sources of energy are suppressed so the glucose can be used (via changes in gene transcription
K+ channel inhibitors
- mimic action of glucose on beta cells
- triggers depolarisation
sulfonylureas
closes the K+ channels
which again depolarises the cell
allowing Ca to enter
stim insulin release
what is an inretin memetic
agents that act like incretin hormones
2 types of incretin mimetics
- agonists of GLP-1
- DPP4 inhibitors
name a GLP 1 agonist
semaglutide
aka ozempic omg plot twist (acts on glp receptors in the brain as well so at high doses can be used for weight management)
