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Endocrine 2 > Welch Diabetes > Flashcards

Welch Diabetes Flashcards

1
Q

What is the functional unit of the pancreas?

A

islets of Langerhans

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2
Q

What are the types of cells in the islets of Langerhans? What does each secrete?

A

Alpha cells - glucagon

Beta cells - insulin

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3
Q

Which peptide is cleaved in maturation of insulin?

A

C-peptide

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4
Q

What effect does insulin have on carbohydrate, protein, and fat pools?

A

Carbohydrate:

  • inhibits glycogen synthetase to store glucose as glycogen
  • increases gluco-1-phosphatase to increase energy utilization
  • inhibits gluconeogenesis

Protein
- increases break down of protein to amino acids to be released

Fat
- Decreases lipase activity and allows for storage of fat

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5
Q

What happens if the body lacks insulin in terms of gluconeogenesis and lipase activity?

A

Increased gluconeogenesis means more urea excretion (azoturia)

Increased lipase activity leading to more FFA to be converted to ketones

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6
Q

Can glucose enter cells without insulin? Which cells are found to have them?

A

Yes, if there are GLUT-2 receptors present. Beta cells in the pancreas have them

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7
Q

How does glucose regulate the amount of insulin?

A

If glucose enters the beta cell, ATP is generated which will bind to ATP sensitive K channels that will close it and depolarize the cell by increase intracellular calcium. This will secrete more insulin

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8
Q

Is the ATP sensitive potassium channel on the outside or inside of the cell? SU receptors?

A

ATP: inside
SU: outside

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9
Q

What is the MOA of biguanides? sulfonyl ureas? TZDs?

A

Biguanides - decrease hepatic glucose production (AMPK stimulators)
Sulfonyl urea - increase insulin secretion
TZD - increase insulin sensitivity

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10
Q

What is the MOA of DPP-4 inhibitors? GLP-1 agonists?

A

DPP-4 inhibitors - increases GLP-1 and GIP concentrations

GLP - 1 agonists - increases insulin concentrations by glucose dependent mechanisms, decreases glucagon, decreases gastric emptying

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11
Q

Other than insulin desensitivity, what other aspect contributes to TDM2?

A
  • Reduced beta cell response to high glucose concentrations
  • Elevated glucagon
  • Impaired secretions of incretin hormones
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12
Q

What is IAPP? It’s role in Beta cell function?

A

Islet amyloid polypeptide

- too much of it will damage Beta cell

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13
Q

Why are GLP-1 proteins so short-lived?

A

Degraded by DPP-4

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14
Q

What is Liraglutide?

A

A long-acting GLP-1 analogue (incretin mimetic)

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15
Q

What is Byetta?

A

An incretin mimetic that suppresses glucagon secretion

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16
Q

When prescribing Januvia, what you must consider regarding blood glucose?

A

BG must be elevated in order for this to work

17
Q

Which class of drugs are considered to be a pancreatic secretagogue?

A

Sulfonyl ureas

18
Q

What is the MOA of meglinitides?

A

Same as SU but at a slightly different binding site on SUR

19
Q

What are some 1st generation SUs? 2nd generation?

A

1st generation: Orinase, Tolinase

2nd generation: Diabeta

20
Q

What are some side effects and ADRs associated with metformin?

A

Nausea, cramps, diarrhea, and lactic acidosis

21
Q

What are some side effects of alpha-glucosidase inhibitors?

A

Diarrhea, and flatulence

22
Q

Which receptors does TZDs work on? What is the MOA of TZDs?

A

Peroxisome Proliferator-activated receptors (PPARy)

  • Lowers blood glucose levels by improving target cell response to insulin
  • Lowers levels of FFA
23
Q

What is the MOA of SGLT2 inhibitors?

NEEDS RENAL ADJUSTMENT

A

Decrease hyperosmolar blood (glucose concentration)

24
Q

Describe the components of the insulin receptor. Which part does insulin bind to?

What does the unbound part of the receptor responsible for?

A

The receptor consists of beta and alpha part. Insulin binds to the alpha section.

The beta region activates intrinsic tyrosine kinase activity which autophosphorylates the receptor to activate of cellular

25
Q

What is somatostatin MOA?

A

Somatostatin binds to receptors on pancreatic beta cell that blocks voltage gated Ca++. Blocks insulin secretion

Endocrine 2 (11 decks)

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