Pharmacology of Diabetes

Question 1

What are the 4 strategies for Type 2 diabetes pharmaceutics?

Answer 1

1. Increase insulin secretion (SU, GLP-1 agonists, DPP-4 inhibitors)
2. Decrease insulin resistance (glitazones)
3. Slow glucose absorption

4 enhance glucose excretion (SGLT2 inhibitors)

Question 2

Where is GLUT2 expressed?

Answer 2

Cell membrane of pancreatic beta cells

-glucose transporter

Question 3

What is responsible for the closure of the Katp potassium channels in the beta cells?

Answer 3

Increased ATP/ADP ratio

Question 4

The activity of Sulfonylureas is dependent of plasma glucose concentration (T/F)

Answer 4

False

• induce insulin secretion independently of glucose levels
• risk of hypos

Question 5

What patients are more prone to hypoglycaemia?

Answer 5

the elderly

patients with
reduced hepatic function

Chronic renal disease

Question 6

What is the action of Glinides, such as Repaglinide?

Answer 6

Insulin secretogogues

-Bind to SUR1 subunit on Katp channels, closing them

Question 7

What are the functions of the incretin GLP-1?

Answer 7

1. beta cells: induces insulin secretion
2. alpha cells: decrease glucagon secretion
3. peripheries: enhance glucose uptake (due to insulin)
4. liver: decrease glucose production
5. stomach: slow down gastric emptying

Question 8

What are Gliptins? How do they work?

Answer 8

DPP-4 inhibitors

Inhibit DPP-4, prolonging actions of incretins GLP-1 and GIP.

Question 9

How does Extenatide, a GLP-1 analogue, act on beta cells?

Answer 9

Binds to GLP-1 receptors, driving intracellular cAMP levels up.