Week 6 Part 3

Front 1

The pancreas functions as an exocrine gland, the pancreas excretes ______ to break down ?

Back 1

enzymes

proteins, lipids, carbohydrates, and nucleic acids in food.

Front 2

The pancreas functions as an endocrine gland, the pancreas secretes the ______________ to control blood sugar levels throughout the day.

Back 2

hormones insulin and glucagon

Front 3

Hormones which increase blood glucose include

Back 3

Glucagon

Adrenaline

Cortisol

Growth hormone

Front 4

Hormones which decrease blood glucose include

Back 4

Insulin

Front 5

Insulin does more than just________________.

Back 5

decrease blood glucose levels

Front 6

Insulin increases thee entry of glucose into ____________________.

Back 6

muscles & adipose tissue.

Front 7

Insulin ↑ conversion of glucose to glycogen in ________.

Back 7

the liver.

Front 8

Insulin ↑ conversion of spare glucose to _____.

Back 8

fat

Front 9

Insulin ↑__________ uptake by cells

Back 9

amino acid

Front 10

Insulin ↓_________ in adipose tissue

Back 10

lipolysis

Front 11

Effects of insulin is overall ________ in action

Back 11

anabolic

Front 12

Insulin binds to _________ to __________ glucose

Back 12

receptors

uptake

Front 13

Insulin receptors on _________,________,_________.

Back 13

skeletal muscle, adipose tissue and liver

heart? brain? nil receptor but uses it ?

Front 14

Diabetes Type I (juvenile) involves

Back 14

Lack of insulin

Front 15

Type II Diabetes involves

Back 15

Insulin resistance

Front 16

If no insulin adipose tissue depots _________ into muscle and causes liver liver to produce

Back 16

fatty acids

cholesterol

triglycerides

acetoacetic acid

Front 17

Diabetic metabolism - lack of insulin causes

Back 17

decreased glucose uptake by tissues

Increased proteinbreakdown

Increased lipolysis

Front 18

Lack of insulin - > decreased glucoseuptake by tissues -> ________,__________,_________ - > ________,________ -> Coma, Death

Back 18

HyperglycaemiaGlycosuriaOsmotic diuresis

DehydrationAcidosis

Front 19

Lack of insulin - > Increased proteinbreakdown - > _________________,

- > Hyperglycaemia Glycosuria Osmotic diuresis

- > Dehydration Acidosis - > Coma, Death

Back 19

Increased plasmaamino acids

Front 20

Lack of insulin - > _______________ - > ___________________ - > Dehydration, Acidosis

- > Coma Death

Back 20

Increased lipolysis

Increased plasmafree fatty acids

Ketogenesis

Ketonuria

Front 21

Long term consequences of poorlycontrolled blood glucose levels

Back 21

Diabetic retinopathy

Diabeticnephropathy

Diabetic neuropathy

Stroke Risk

Cardiovascular events

Front 22

Diabetic retinopathyleading cause of________ in adults

Back 22

blindness

Front 23

Diabeticnephropathy leadingcause of ___________.

Back 23

end-stage renal disease

Front 24

Diabetic neuropathyleading cause of ____________.

Back 24

nontraumatic foot amputations

Front 25

Long term consequences of poorlycontrolled blood glucose levels increased stroke risk ______

Back 25

2-4x

Front 26

Long term consequences of poorly controlled blood glucose levels _% of suffers die from cardiovascular events

Back 26

80%

Front 27

Diabetic control - Normal HBA1c ____

Back 27

3.5 - 6.5%

Front 28

Diabetic control - Low risk = ____ Hba1% and _____ fast plasma glucose (mmol)

Back 28

<6.5

<5.5

Front 29

Diabetic control - Macrovascular risk = ____ Hba1% and _____ fast plasma glucose (mmol)

Back 29

>6.5

>5.5

Front 30

Diabetic control - Microvascular risk = ____ Hba1% and _____ fast plasma glucose (mmol)

Back 30

>7.5

>6.0

Front 31

Why can’t people take natural insulin orally?

Back 31

Stomach acid

Front 32

Insulin needed at _______, and also longer acting insulin to provide _______________.

Back 32

mealtimes

background cover

Front 33

Need to minimise number of insulin _________ required

Back 33

injections

Front 34

Short acting insulin

Back 34

Lispro (humalog)

Aspart (NovoRapid)

Front 35

Regular insulin

Back 35

(Actrapid, humanlin R, NPH)

Front 36

Long acting insulin

Back 36

Glargine (Lantus)
Detemir (Levemir)

Front 37

Short acting insulin onset(mins), time to peak(hr) and duration (hrs)

Back 37

10-20

1-3

3-5

Front 38

Regular insulin onset(mins), time to peak(hr) and duration (hrs)

Back 38

30

2.5-5

6-8

Front 39

Long acting insulin duration (hrs)

Back 39

20-24

Front 40

_________ insulin currently in phase II trials

Back 40

Oral

Front 41

Inhaled insulin approved for use a few years ago & withdrawn in _________ due to poor sales. New inhaled formulation approved this year.

Back 41

2007

Front 42

Another drugs that act on endocrine function are _______________.

Back 42

oral hypoglycaemics

Front 43

Actions of oral hypoglycaemics 1-5.

Back 43

1. Decrease absorption of glucose

2. Increase insulin secretion

3. Decrease glucose production

4. Increase glucose uptake & utilisation

5.Decrease lipolysis

Front 44

Name the available oral hypoglycaemics

Back 44

Metformin

Sulphonylureas

Glitazones

Meglitinides

Acarbose

Front 45

Metformin actions

Back 45

1. Decrease absorption of glucose

3. Decrease glucose production

4. Increase glucose uptake & utilisation

5.Decrease lipolysis

Front 46

Metformin preferred for obese people because

Back 46

it does not stimulate appetite

Front 47

Metformin very low risk of _____________.

Back 47

accidental hypoglycaemia

Front 48

Metformin drawbacks

Back 48

Anorexia, GI disturbances

Lactic acidosis (rare but serious)

Should not be given to anyone who already has a pre-disposition to lactic acidosis, e.g. pulmonary disease, heart failure, shock, or anyone who with hepatic or renal failure.

Front 49

Sulphonylureas actions

Back 49

2. Increase insulin secretion

Front 50

Sulphonylureas include ___________,___________,___________.

Back 50

Tolbutamide, Glibenclamide, Gliclazide.

Front 51

Sulphonylureas Hypoglycaemia can be _____ & _________.

Back 51

severe

prolonged

Front 52

Sulphonylureas - Glibenclamide has _______ active metabolites

Back 52

several

Front 53

Sulphonylureas cause _________.

Back 53

weight gain

Front 54

Glitazones actions

Back 54

4. Increase glucose uptake & utilisation

5.Decrease lipolysis

Front 55

Glitazones (Thiazodinediones) include _________,_________.

Back 55

Rosiglitazone, Pioglitazone.

Front 56

Glitazones (Thiazodinediones) _________ hypoglycaemic effect.

Back 56

very slow onset

Front 57

Glitazones (Thiazodinediones) reduce levels of ________ and __________.

Back 57

fatty acids and triglycerides.

Front 58

Glitazones (Thiazodinediones) insulin sensitivity ________, requirement for exogenous insulin __________.

Back 58

increases

decreases

Front 59

Glitazones (Thiazodinediones) may cause _________(may be less with newerglitazones), _______ & ________.

Back 59

hepatotoxicity

weight gain

fluid retention.

Front 60

Glitazones are contraindicated in patients with congestive heart failure why?

Back 60

fluid retention.

Front 61

Meglitinides actions

Back 61

2. Increase insulin secretion

Front 62

Meglitinides include ________,_________.

Back 62

repaglinide(Prandin)

nateglinide(Starlix)

Front 63

Meglitinides stimulate _____________.

Back 63

pancreatic βcells.

Front 64

Meglitinides __________ so they can be taken just before a meal.

Back 64

act rapidly

Front 65

Acarbose inhibits ____________ and ____________.

Back 65

brush border glucosidase

pancreatic amylase

Front 66

Acarbose reduces digestion of ___________.

Back 66

complex carbohydrates

Front 67

Acarbose can cause _______ & _________.

Back 67

Flatulence

Diarrhoea

Front 68

If a person taking acarboseoverdoses and gets hypoglycaemic, how should they correct this?

Back 68

Give glucose in absorb-able form because complex carbs won't be digested

Front 69

Oncreased body weight increases _____________.

Back 69

insulin resistance

Front 70

Insulin is “anabolic” and will increase ______________.

Back 70

body weight

Front 71

Diabetics on insulin, sulphonylureas or meglitinides will ___________. Which could make diabetes worse

Back 71

put on weight

Front 72

Treatment of overweight diabetics involves

Back 72

–weight loss (decrease 13.5Kg and decrease HBA1c 8.1% to 5.8%)

–Drugs that reduce insulin resistance

Front 73

Glibenclamideis a sulphonylurea, this drug increases insulin secretion from the pancreas

It is eliminated via the kidney, hence can accumulate in the _______ or ________

Accumulation of glibenclamide and its active metabolites causes __________.

Back 73

elderly or in renal failure

hypoglycaemia