Pharm lectures Flashcards
what are the four functions of glucago-like peptide-1 (GLP-1) and where is it secreted?
- causes pancreatic Beta cells to release insulin in response to oral glucose load
- supresses hepatic glucagon release
- slows gastric emptying
- decreases appetite
Released into the ileum by L cells!!
what is the function of glucose-dependent insulinotrophic peptide (GIP)? where is it released?
released by K cells in the jejunum
- causes Beta cells in the pancreas to release insulin in response to oral glucose load
what is the enzyme that inactivates GIP and GLP-1?
DDP-4
explain how carbohydrates are absorped? where do they go? where are they stored?
ABSORBED IN THE SI
- digested by amylase in the saliva
- digested by pancreatic amylase
- broken down from disacchrides to monosacchrides and absorbed via brush border enzymes
- portal circulation
- liver
- stored as glycogen
the liver synthesizes carbohydrates to what? what are they stored and released by?
synthesize glucose (gluconeogenisis) stores/release glycogen (glycogenolysis)
the liver metabolizes fats to what?
ketones to fatty acids, converts carbs and proteins to fats
what does the liver convert proteints to?
converts proteins and carbohydrates to fat
islet of langerhans cells in pancreas: alpha cell function?
release GLUCAGON causes HEPATIC GLYCOGENOLYSIS leading to GLUCOES RELEASE INTO BLOOD BETEWEEN MEANS
islet of langerhans cells in pancreas: beta cell function?
release INSULIN causing GLUCOSE ENTRY INTO CELLS and release of AMYLIN which INHIBITS GASTRIC EMPTYING AND GLUCAGON RELEASE
explain the two phases of insulin release?
first phase: release of PREFORMED insulin and peaks within minutes
second phase: newly synthesized insulin peaks 2-3 hours after food ingestion
what does insulin do? what is it released by?
released by beta cells
released in response to increased blood sugar
what is glucagon and what does it do? what is it released by?
alpha cells in the pancreas, maintains blood glucose between meals through…
- glycogenolysis (breakdown of glycogen to glucose and release into blood)
- glyconeogensis (glucose formation)
what is the function of amylin and what is it released by?
released by beta cells in repsonse to increased blood glucose
- inhibits gastric emptying
- inhibits glucagon release
what is the function of somatostatin?
inhibits the release of insulin and glucagon
what is the functio nof the gut dervied hormoens? what are they?
incretin effect with GIP and GLP-1…increase the insulin release
what are the three counter regulatory hormones that are released during hypoglycemia naturally by the body to keep the BS levels stable?
- catecholamines (epi)
- growth hormone (GH)
- glucocorticoids (cortisol)
what are the two strange effects or phenomena that happen with BS and the counter-regulatory hormones?
- somogyi effect
2. dawn phenomena
what is the somogyi effect?
cycle of hypoglycemia, hyperglycemia, and then hypoglycemia that occurs during the night in response fluctuating insulin and courter-regulatory hormones
ultimately leads to hypoglycemia
what is the dawn phenomena?
increased blood glucose beweetn 5-9 am without preceeding low glucose
happens in Type 1 and type 2 leads to mild hyperglycemia but when with somogyi effecting get MARKED HYPERGLYCEMIA
what does the current evidence suggest to keep the A1c below to prevent the risk of micro and macro complications?
below 7
what are the 3 evidence based drugs that have been aprpovde to keep the aic below 7?
- metformin
- sulfonylurea
- insulin
what is the goal A1c for T1DM? 2
below 7
if young between 6-6.5
what is the goal A1c if you have T2DM?
less than 7
if you are over 80 years old what is the acceptable A1c?
8-8.5
