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23 Cards in this Set
- Front
- Back
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Differentiate between Type 1 and Type 2 Diabetes. How is each treated.
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Type 1 is the body's inability to make insulin. Type 1 treatment involves supplementation of insulin.
Type II is the body's inability to recognize insulin. Treatment for Type II invovles (1) Insulin replaceent or (2) drugs that will alter insulin's resistance. |
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What is insulin's structure?
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Insulin's structure involves two peptide chains that are joined by two bisulfide bridges.
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How is insulin released from the beta cell?
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(1) Glucose is transported into the Beta cell and is utilized for energy, and when increased amounts of glucose are present, there is increased amount of ATP production
(2) with the increase of ATP, the ATP binds to the normal efflux of the potassium channel, causing the cell to depolarize. (3) Upon depolariztion, the calcium channels rush in and fuse with the membrane bound vesicles of insulin and force insulin release. |
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What are some other triggers of insulin release (besides the glucose chain of reactions)?
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(1) Vagal innervation of the Muscarinic cells - IP3 process.
(2) Gastric peptides in a meal increase cAMP levels which force insulin release also. |
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What is the main job of insulin?
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To regulate blood glucose levels.
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What are two methods in which insulin regulates blood glucose levels?
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(1) Increases the GLUT1 transporter into cells.
(2) Regulates glucose metabolism by increasing the enzymes responseible for glucose metabolsim and inhibiting those that try to synthesize glucose. |
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What are the effects of insufficient amounts of insulin?
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(1) Ketogenesis
(2) Polyuria (3) Polydypsia (4) Weight loss |
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What is the problem with the glucose meter and what is the most recent solution?
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The problem with the glucose meter is that it monitors glucose but only gets a snapshot reading. Now, Hba1c readings are more useful because it measures the amount of red blood cells glycosylated (gives you an estimation of 120 days - this is the halflife of red blood cells).
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What are the normal readings for Hba1c?
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Normal = 5%
Diabetic = 10% |
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What are some complications of increased glucose levels?
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(1) Blindness
(2) Kidney damage It is believed that these complications result from other proteins. |
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What is the strategy in treating Type I Diabetics?
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To use insulin replacements to MAINTAIN THE GLUCOSE CONCENTRATIONS IN THE BLOOD.
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What sort of treatment do Type I diabetics use? How?
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Type I diabetics use insulin replacement drugs. There are several available - short-acting, intermediate-acting, and long-acting. It is best when these drugs can be combined - like have long-acting drugs plus short subcutaneous acting drugs that are given after eating a meal.
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What do long-acting insulin replacement drugs do?
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Long-acting insuling replacement drugs tend to form aggregates of the insulin molecules. These aggregates have a depositional effect.
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Wha is anther treatmentfor Type I diabetics?
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Having an insulin Pump.
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How is Type II diabetes controlled, specifically what drugs?
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(1) Metformin
(2) Secretagogues: Glimepiride (3) Non-sulfonylurea: Repaglinide (4) Glitazones (5) Alpha-glucosidase inhibitor: acarbose |
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Explain the mechanism of Metformin. What are its side effects?
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Metformin has an unknonw mechanism but probably works by (1) effecting gluconeogenesis (2) decreasing lipolysis (3) effect on the hormone - glucagon.
Side effects include - GI problems and metallic taste in the mouth. |
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What are secretagogues? An example?
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Secretagogues work on the beta cell. An example is glimepiride.
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How does glimepiride work?
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Glimepiride binds to a receptor associated with the Beta cell ATP - sensitive potassium channel to inhibit the efflux of potassium ions. This results in depolarization which opens a voltage-gated calcium channel. The calcium influx favors release of insulin.
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What are some problems associated with glimepiride?
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(1) cause hypoglycemia
(2) increased body weight (3) can cause tachyphylaxis |
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What is the mechanism for repaglinide? How is it used?
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Repaglinide is a non-sulfonylurea. It stimulates as a secretogue and causes the release of insulin. It sometimes combined with metformin.
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Explain the use of glitazones.
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Act to decrease insulin resistance mainly by regulating genes involved in glucose and lipid metabolism, insulin signal transduction as well as adipocyte differentiation. Control gene expression by binding to the peroxisome proliferators- activated receptor- gamma.
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What are some problems of glitazones?
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(1) Liver toxicity
(2) Weight Gain (3) Congestive Heart Failure (4) Can be toxic to fetus |
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What is an alpha-glusocidase inhibitor? What is an example?
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Inhibits the enzyme, alpha-glucosidase (Alpha-glucosidase is on the brush border of the small intestine and hydrolyses carbohydrates)
By inhibiting the enzyme, absorption of glucose and other carbohydrates is delayed and less glucose is absorbed. Acarbose is an example. |
