Week 11 - Endocrine - Diabetes

Question 1

Insulin decreases blood glucose by?

Answer 1

• Increasing glucose uptake into muscle and fat via GLUT-4 receptors
• Increasing glycogen synthesis
• Decreasing gluconeogenesis
• Decreasing glycogen breakdown

Question 2

How is insulin released?

Answer 2

• B-Cell
• ATP blocks K-channel
• Depolarised cell opens Ca channel
• Ca influx contracts myosin filaments
• Insulin released

Question 3

What is the percentage cause, onset and requirement of Type I diabetes?

Answer 3

• 5-10%
• early loss of insulin-producing pancreatic B-Cells
• Juvenille onset
• Requires insulin replacement (insulin dependant)

Question 4

What is the percentage, cause, onset and requirement of Type II diabetes?

Answer 4

• 90-95%
• Mainly from lifestyle factors
• Adult onset
• Cellular insulin resistance
• Impaired insulin secretion

Question 5

What are some Secondary Complications of Diabetes?

Answer 5

• Vascular disease
• Altered cardiac metabolism
• Nerve damage
• Renal Failure
• Blindness

Question 6

Why are hypoglycaemic drugs usefuly for Type II and not Type I diabetes?

Answer 6

-Because they enhance insulin production and Type I don’t produce insulin at all.

Question 7

What are some types of Hypoglycaemic drugs?

Answer 7

Biguanides
Sulfonylureas
Thiazolidinediones

Question 8

What are the effects of Biguanides and an example?

Answer 8

-Increase glucose uptake in skeletal muscle
-Inhibit hepatic glucose output
-Inhibit intestinal glucose absorption
Eg Metformin

Question 9

What are the effects of Sulfonylureas and an example?

Answer 9

Stimulate insulin secretion
-K/ATP channels contain receptors for sulfonylureas
-Only effective if pancreatic β cells are functional
Eg Tolbutamide

Question 10

What are the effects of Thiazolidinediones and an example?

Answer 10

-Enhance effectiveness of endogenous insulin -Increase insulin sensitivity
Eg. Rosiglitazone

Question 11

What are the indications for Insulin?

Answer 11

• Type 1 diabetes
• Type 2 - poorly managed or under stress from injury or illness
• Emergency treatment of diabetic ketoacidosis and hyperkalaemia (K moves into cell with glucose)
• Pregnancy if diet not working.

Question 12

What are the uses of Glucagon?

Answer 12

Injection to treat hypoglaecemic episodes

Treat cardiac failure from B-adrenoceptor agonists