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29 Cards in this Set
- Front
- Back
_________ It is used to monitor the plasma glucose concentration over prolonged periods of time (4-6 weeks).
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Glycosylated hemoglobin Hb-A1c
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Insulin secretion is promoted by __________.
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↑ blood glucose levels, amino acids, GI hormones and by β-2 agonist.
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Insulin is referred as the _________as it promotes anabolism and inhibits catabolism of carbohydrates, fatty acids and protein.
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storage hormone
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What is the mechanism of action of insulin?
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Insulin binds to insulin receptors on the plasma membrane and activates tyrosine kinase – primarily in adipose tissue, liver and skeletal muscle.
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The Nerves, RBC’s, Kidney, and Lens of the eye (do/do not) require insulin for glucose transport
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DO NOT
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Insulin increase the storage of glucose as______ in the liver and It inserts the________glucose transport molecule in the cell membrane
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glycogen; GLUT-2
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Insulin inhibits _______– thus significantly ↓ glucose output by the liver
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gluconeogenesis
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(IN MUSCLE) Glucose transport into the cells is facilitated by ______into the cell membrane
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GLUT-4
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(Adipose tissue) Insulin facilitates the storage of _______ by activating plasma lipoprotein lipase and inhibiting intracellular lipolysis
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triglyceride
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(Adipose tissue) Insulin increases the glucose uptake by ______insertion into the cell membrane
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GLUT-4
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Insulin is a _______peptide
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51 AA
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Insulin is inactivated by ______ found mainly in _____ and ______
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insulinase; liver; kidney
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Adverse effects of Insulin
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Hypoglycemia
Allergic reactions Lipodystrophy Others includes Seizures Coma |
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This kind of oral anti-diabetic drug Reduces the bio-synthesis of glucose in liver --
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Biguanides
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This kind of anti-diabetic drug Increases the sensitivity of target cells to insulin --
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Thiazolidinediones
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This kind of oral anti-diabetic drug Retards the absorption of sugars from the GI tract
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Acarbose, Miglitol
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This kind of oral anti-diabetic drug- Stimulation of pancreatic insulin release
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Sulfonylureas, Meglitinide
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Adverse effects of Sulfonylureas?
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Hypoglycemia
Cholestatic jaundice Weight gain Cross placenta – fetal hypoglycemia. Chlorpropamide : It can cause water retention by ↑ release of ADH (SIADH) Disulfiram-like reaction with alcohol. |
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_____ has minimal renal excretion thus useful in patients with DM and impaired renal function
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Repaglinide, Nateglinide
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Who am I?
Increase sugar utilization and inhibits gluconeogenesis Does not promote insulin secretion. It increase the sensitivity of liver and muscle to insulin. It causes modest weight loss |
Metformin (Glucophage)
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Thiazolidinediones
Enhance glucose and lipid metabolism through action on _______________. They enhance sensitivity to insulin in muscle and fat by increasing the ______ glucose transporters. |
Peroxisome Proliferator Activated Receptor (PPAR–γ);
GLUT 4 |
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Troglitazone is associated with _________.
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hepatitis
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Alpha-Glucosidase Inhibitors inhibits alpha-glucosidase which converts dietary starch and complex carbohydrates into ________
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simple sugars
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The following are examples of what?
Acarbose (Glucobay) , Miglitol (Glyset) |
Alpha-Glucosidase Inhibitors
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Glucagon like Peptide : GLP-1 analog : Xenatide : (Byetta) :
GLP is an incretin released from the ________ which increase the glucose dependent insulin secretion |
small intestine
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________ suppress glucagon release and reduce appetite
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Xenatide
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Sitagliptin (Januvia) is an oral anti-diabetic drug.
It inhibits the dipeptidyl peptidase 4 (DPP-4). What is the dipeptidyl peptidase 4 (DPP-4)? |
an enzyme which inactivates the incretins GLP-1 and GIP
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How does Glucagon act?
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It acts by stimulation of glucagon receptors and not through beta 1 receptors.
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What is Pramlintide acetate (Symlin)?
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a relatively new adjunct treatment for diabetes. It is derived from amylin, a hormone that is released into the bloodstream, in a similar pattern as insulin, after a meal. Like insulin, amylin is deficient in individuals with diabetes. By substituting for amylin, pramlintide aids in the absorption of glucose by slowing gastric emptying, promoting satiety, and inhibiting inappropriate secretion of glucagon, a catabolic hormone that opposes the effects of insulin and amylin.
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