PBL

Question 1

what type of transporter is used to retain glucose

what is the transport maximum

Answer 1

Sodium-Glucose transporters, know as SGLTs (sodium-glucose linked transporters

Tm = 15mM glucose

Question 2

three types of rapid acting insulin

Answer 2

All taken before a meal

insulin lispro
insulin aspart
insulin glulisine

Question 3

pearls of short acting insulin

Answer 3

Onset of action: 30 minutes
Clinical consequence: blood glucose rises faster than insulin —> early postprandial hyperglycemia (and increased risk of late hypoglycemia)
Regular insulin should be injected 30-45 min before a meal to minimize this effect

Question 4

intermediate acting insulin`

Answer 4

NPH (neural protamine Hagedorn, or isophase)

Onset: 2-5 hours
Duration: 4-12 hours
Usually mixed with regular or short-acting insulin and given 2-4 times/day
Unpredictable action, variability of absorption >50% —> Used less often clinicall

Question 5

long-acting insulin

Answer 5

glargine (once daily), detemir

Question 6

Sx of DKA

Answer 6

Kussmaul respirations (rapid/deep breathing), N/V, abdominal pain, psychosis/delirium, dehydration, fruity breath (exhaled acetone

Question 7

signaling and transduction pathway when insulin binds to insulin receptors

Answer 7

recepotrs is a member of growth factor receptor family. span the membrane only once and activate tyrosine kinases

activate PIP-3 kinase

activates serine/threonine kinase Akt (also known as Protein Kinase B, PKB)

Akt makes GLUT 4 containing vessicles fuse with the membrane