pancreas hormones Flashcards
drugs and hormones
insulin
produced by B cells in the islet of Langerhans
dominates in fed state
increases;
- glucose oxidation
- glycogen synthesis
- fat synthesis
- protein synthesis
glucagon
produced by the A cells
dominates in fasted state
increases
- glycogenolysis
- gluconeogenesis
- ketogenesis
somatostatin
produced by D cells
inhibits A and B cells
glucogenesis
glucose > glycogen
glycogenolysis
glycogen > glucose
gluconeogenesis
synthesis of glucose by;
- glucose breakdown of products
- amino acids
- glycerol
insulin release
by increase of ca2+ concentration or increase of cAMP
inhibition of ATP sensitive channels by ATP, activating Gq, Gs and inhibiting Gi channels
insulin hexamer
3 insulin dimers, with zn2+ form a hexamer, not soluble
GLUT-4
expressed in the membrane (by insulin), facilitates glucose uptake, stimulates glycogen synthesis, glycolysis
insulin injections
short;
- aspart
- lispro
- glulisine
intermediate;
- isophane
- NPH (protamine)
long;
- detemir
- glargine
conventional treatment
2x intermediate acting + short-acting drugs
intensive treatment
1x long-acting insulin
short-acting insulin when needed
fewer complication
increased risk hypoglyceamias
biguanides
oral antidiabetic drug; metformin
reduced peripheral insulin resistance
reduced gluconeogenesis in liver
no hypoglyceamias
sulfonylurea derivatives
oral antidiabetic drug
stimulate insuling release by B cells, block the ATP sensitive K channel > depolarization of membrane > increase in [Ca2+] > insulin release
short acting; tolbutamide, gliclazide
long-acting; glibenclamide, glipizide
risk of hypoglycaemias
metglitinides
oral antidiabetic drug
stimulate insuling release by B cells, block the ATP sensitive K channel > depolarization of membrane > increase in [Ca2+] > insulin release
lower risk of hypoglycaemias
