S5.1 The Pharmacology Of Insulin Flashcards
What is the difference between type 1 and type 2 diabetes?
Type 1 diabetes is insulin deficiency, type 2 is insulin resistance.
What are the main symptoms of diabetes mellitus?
Polyuria, polydipsia and unexplained weight loss
Describe the plasma glucose concentrations between a healthy patient and a diabetic patient
Normal range 3.3-6mmol/L plasma glucose
Fasting ≥7.0mM, random ≥11.1mM both indicate DM
What lab tests are done to diagnose diabetes?
HbA1c
Glucose in the blood reacts with Hb to produce HbA1c.
Poorly controlled diabetics can have HbA1c value >6.5%.
What is the role of insulin?
Stimulates uptake of glucose into liver, muscle and adipose tissue.
Decreases hepatic glucose output via inhibition of gluconeogenesis. Inhibits glycogenolysis.
List the 6 types of insulin treatments in type 1 diabetes
Ultrafast acting - aspart Rapid acting - novorapid Short acting - actrapid Intermediate acting - isophane Long/very long acting - glargine
What are the ADRs of insulin?
Hypo (too much) and hyperglycaemia (too little), lipodystrophy (death of fat cells), Insulin allergies
What is the mechanism of metformin?
Reduces Insulin resistance leading to increased glucose uptake by tissues.
Reduces hepatic glucose production (gluconeogenesis)
What are the ADRs of metformin?
GI symptoms such as abdominal pain or diarrhoea
What is the mechanism of sulphonylureas (gliclazide)?
Stimulate beta cells to release insulin
What are the ADRs of sulphonylureas?
Weight gain
Hypoglycaemia
What is the mechanism of acarbose (α glucosidase inhibitor)?
Inhibits breakdown of carbohydrates to glucose by blocking action of the enzyme α Glucosidase.
What are the ADRs of acarbose?
Flatulence
What is the mechanism of glitazones?
Eg pioglitazone, rosiglitazone
Increase insulin sensitivity in muscle and adipose tissue and decrease hepatic glucose output by binding PPARs
What is the mechanism of Glucagon Like Peptide 1 Therapies?
Eg exenatide, liraglutide
Increase insulin secretion from the beta cells
Decreases Glucagon production from alpha cells
