Therapeutic Approaches to Diabetes Flashcards
primary energy source for all tissues?
Glucose
Uptake of blood glucose for energy utilization is in which two tissues?
Skeletal muscle
Brain
Uptake of blood glucose for energy storage is in which tissues?
Liver
Adipose
Blood glucose excretion is in which tissue?
Kidney
What happens to glucose in a calorie deficit? (2)
Glycogen breakdown (glycogenolysis) Glucose synthesis (gluconeogenesis)
Blood glucose:
variable or non-variable?
wide or narrow range?
Variable
Narrow range
What tissue is critical for glucose homeostasis?
Pancreas
The pancreatic islet of langerhans contains which two cells? They release which hormone/substance and under what condition (high or low glucose)
alpha : glucagon at low blood glucose levels
beta : insulin at high blood glucose levels
Primary target or alpha cells? (1)
hepatocytes
Primary target for beta cells? (3)
Liver
Fat
Skeletal muscle
Insulin is what type of hormone?
Anabolic polypeptide
Insulin is cleaved by intracellular ______ to generate which two chains? They remain linked by what?
proteases
A chain and B chain
Linked by 2 disulfide bridges
4 steps leading to glucose-stimulated insulin secretion (GSIS)
- Glucose enters via GLUT2 and is metabolized, elevates [ATP]
- Elevated ATP inhibits ATP-sensitive K+ channels
- Depolarization and opening and voltage-gated Ca2+ channel
- Increased intracellular Ca2+ results in exocytic secretion of insulin from storage vesicles into the blood
GLUT2 only transports glucose under what condition?
low affinity
>6mM
Blood insulin levels parallel _______ levels
blood glucose
Diabetes Mellitus causes what? (2)
What does DIABETES and MELLITUS reference to in this disease?
Rapid weight loss
Excessive urination
Diabetes : copious amounts of urine production
Mellitus: sweet taste or smell of urine produced
Diabetes Mellitus disorders are all characterized by what?
high blood glucose
Two primary causes of diabetes mellitus?
Inadequate insulin secretion
Impairment of insulin action
type I diabetes is the most or least common type of diabetes?
It is the destruction of what?
there is reduced/absence of ________
Least common
Pancreatic beta cells
insulin secretion
Type II diabetes is the most or least common type of diabetes?
The tissues are ______ to insulin
Advanced stages associated with __________ insulin secretion
Most common
resistant
insufficient
Type I diabetes is the loss of insulin production and GSIS : \_\_\_\_\_\_ glucose uptake \_\_\_\_\_\_ glucose storage Failure to inhibit \_\_\_\_\_ production Low or high levels of blood glucose?
Reduced
Reduced
Glucose production
Elevated blood glucose
Acute effects of Type I and Type II diabetes? (5)
Excessive urine production Extreme thirst/hunger Rapid HR Nausea, dizziness, confusion Weakness, shaking, fainting
Chronic Complications of Type I and Type II diabetes? (8)
- Weight loss
- Damage to blood vessels in eyes
- Damage to blood vessels in extremities
- Kidney damage
- Peripheral nerve damage
- Hyperlipidemia
- Hypertension
- CV disease
Treatments of Type I diabetes? (2)
Even with good management of hyperglycemia, is there still risk of chronic complications?
Diet
Insulin replacement
Yes
Type II diabetes is characterized by insulin resistance by the tissues:
____ glucose uptake and energy storage
____ liver glucose synthesis and release
Chronic _______
Reduced
Increased
Hyperglycemia
Lifestyle changes to treat Type II diabetes? (3)
Diet
Exercise
Weight loss
6 drugs to treat type II diabetes?
Metformin Insulin secretagogues Incretin agents Gliflozins Thiazolidinediones Insulin
4 types of insulin/insulin analogues?
Regular insulin
Insulin ispro
NPH insulin
Insulin Glargine
2 insulin secretagogues?
Glyburide (sulfonylurea)
Rapaglinide (meglitinide)