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25 Cards in this Set
- Front
- Back
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Explain the components of the metabolic syndrome
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Three or more of the following components:
1. Elevated waist circumference 2. Elevated triglyerides 3. Reduced HDL cholesterol 4. Elevated blood pressure 5. Elevated fasting glucose |
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Lipoatrophic diabetes: gene defect?
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Lamin A
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Lipoatrophic diabetes: treatment
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Leptin (very effective)
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What percentage of women with gestational diabetes will develop it later in life?
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30-50%
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How can you measure insulin sensitivity?
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Euglycemic Insulin Clamp
HOMA modelling |
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Which leads to adverse outcomes more: visceral or peripheral fat?
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Visceral
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Development of type 2 DM: Role of free fatty acids?
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FFA compete with glucose for substrate oxidation in muscle. Thus elevated FFAs might cause insulin resistance
Intracellular FFAs alters the phosphorylation of insulin |
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Development of type 2 DM: role of inflammation
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Pro-inflammatory cytokines are elevated
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Sulfonylureas: what do they do?
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Stimulate insulin release
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Thiazolidinediones: what do they do?
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Improve insulin sensitivity
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Biguanides: what do they do?
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Decrease hepatic gluconeogenesis
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Alpha-glucosidase inhibitors: what do they do?
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Delay absorption of carbohydrates
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List three sulfonylurea drugs
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Glyburide
Glipizide Glimepiride |
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Sulfonylureas: M of A
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Inhibition of beta cell ATP-sensitive K channels --> cell depolarization --> Ca influx --> insulin release
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Sulfonylureas: AE
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Drug allergy (may cross over with sulfa allergies)
Hypoglycemia |
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Rapid-acting insulin secretagogues: name two
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Class Meglitinide ( e.g. Repaglinide (Prandin))
Class D-phenylalanine (e.g. Nateglinide (Starlix)) |
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Rapid-acting insulin secretagogues: M of A
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Regulate KATP --> insulin up
rapid onset, short half-life, so must be taken immediately before a meal |
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Biguanides: name three
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Phenformin
Metformin Buformin |
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Biguanides: M of A
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Unknown, but decreases hepatic glucose production. First line therapy for type 2 DM
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Metformin: potential AE
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Lactic acidosis
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Metformin: Contraindicated in?
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Kidney disease
Liver disease Hypoxemia |
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Metformin: should be discontinued for 48 hours after what procedure?
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After contrast dye administration
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Metformin: AE?
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Metallic taste
Diarrhea Nausea and vomiting |
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Thiazolidinediones: name three
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Rosiglitazone (Avania)
Pioglitazone (Actos) Troglitazone (Rezulin) |
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Thiazolidinediones: M of A
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Bind to the peroxisome proliferation activation receptor (PPAR-gamma) and enhances transcription of insulin responsive genes.
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