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Flashcards in Diabetes Deck (20)
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1
Q

What is the half life of insulin?

A

3-5 mins

2
Q

How does an increase in glucose lead to insulin release?

A

Increase of glucose increases ATP, which leads to a slight depolarization and influx of Ca, causing insulin to be released

3
Q

What type of receptor is the insulin receptor?

A

Tyrosine protein kinase, phosphorylates IRS (insulin receptor substrates) leading to downstream pathways

4
Q

What happens in type 1 diabetes?

A

Beta cells are selectively destroyed resulting in insulin deficiency

5
Q

What happens in type 2 diabetes?

A

Tissue resistance is build against insulin resulting in no insulin action

6
Q

What are the 2 diagnostic criteria for diabetes?

A

Elevated glucose -> fasting plasma glucose, oral glucose tolerance test
Increased Hemoglobin A1C (glycosylated hemoglobinm more long term snapshot)

7
Q

What is the first line treatment of diabetes?

A

Well balanced diet
Exercise for weight loss
Education: rationale behind controlling glucose intake

8
Q

Why can’t you take an insulin pill?

A

1st pass metabolism

9
Q

What are the different types of insulin, and what do they do?

A

Regular: dimerizes, but needs to be monomeric to act
Rapid acting: unable to dimerize
Regular short acting: can’t dimerize
NPH: protamine makes it soluble (lower peak but lasts longer)
Long acting: Low peak but constant action

10
Q

What drugs can you take for Type 2 diabetes?

A
Metformin (biguanides) - goto for type2
sulfonylureas
GLP1 receptor agonists
DDP4 inhibitors
Thiazolidinediones 
SGLUT2 inhibitors
Alpha-glucosidase inhibitors
11
Q

What does Metformin do?

A

Supresses hepatic glucose production (increases AMPK activation)
inactivating glucagon receptor

12
Q

What do sulfonylureas, GLP1 receptor agonistsm and DDP4 inhibitors do?

A

Promote insulin secretion

13
Q

How do sulfonylureas such as Glyburide work?

A

Blocks the ATP-sensitive K channel

Side effects: loss of efficacy, hypoglycemia, weight gain

14
Q

How do GLP1 receptor agonists such as Liraglutide work?

A

Increases cAMP to promote insulin secretion and growth of beta cells, impairs glucagon secretion

15
Q

How do DDP4 inhibitors such as Sitagliptin work?

A

Inhibits enzyme that inactivates endogenous incretins

16
Q

How do Thialidinediones and Amyin analogues work?

A

Decrease insulin resistance

17
Q

How do Thiazolidinediones such as Rosiglitazone and Pioglitazone work?

A

Act on different tissues to increase insulin sensitivity
Side effects weight gain, heart failure, bladder tumor
Binds to TFs for lipid/glucose enzymes

18
Q

How do amylin analogues such as pramlintide work?

A

Affects neural transmission to inhibit glucagon secretion

19
Q

How do SGLUT2 inhibitors such as Canaglifozin work?

A

Inhibits renal reabsorption of glucose to increase its excretion
Side effects: UTIs (glucose rich urine), orthostatic hypotension (diuretic effect, RAAS_

20
Q

How do alpha glucosidase inhibitors such as acarbose work?

A

Blocks intestinal glucose absorption
delays ingestion/digestion of starch
doesn’t cause hypoglycemia because doesn’t touch insulin
Side effects: gastrointestinal