Term
| What protein can be measured to determine how much insulin the body is making? |
|
Definition
|
|
Term
| What do each cells in the Pancreas secrete? |
|
Definition
Alpha -> Glucagon
Beta -> Insulin
Delta -> Somatostatin |
|
|
Term
| What can stimulate the beta cells to secrete insulin? |
|
Definition
Glucose, mannose
Leucine
Vagal stimulation
Sulfonylureas |
|
|
Term
| What can amplify insulin release? |
|
Definition
Enteric hormones:
cholecystokinin
secretin
gastrin
Neural stimulation (beta-adrenergic) |
|
|
Term
| What can Inhibit Insulin release? |
|
Definition
Somatostatin
Diazoxide
Catecholamines |
|
|
Term
| How does insulin affect GLUT4 receptors on Adipose and smooth muscle cells? |
|
Definition
| Increases synthesis and insertion on membranes |
|
|
Term
| What are the most important actions of insulin in the Liver and Adipose tissue? |
|
Definition
Liver:
Stimulates Glucose conversion -> Glycogen and fatty acids
Adipose Tissue: Inhibits Lipolysis |
|
|
Term
| How often should blood sugar measurements be made? |
|
Definition
| 4 times daily, before each meal |
|
|
Term
| What is the test for long-term control of blood glucose? How does it work? |
|
Definition
Hemoglobin A1C
Red blood cells live and average of 3-4 months -> allows long term glycocylation of RBC to be tested
The higher the average blood glucose the more extensive the glycosylation |
|
|
Term
| What are the Sulfonylureas? |
|
Definition
1st Generation:
Tolbutamide
Acetohexamide
2nd Generation:
Glipizide |
|
|
Term
| How do the Sulfonylureas promote hypoglycemia? |
|
Definition
Increase insulin sensitivity
(Initially increases insulin release) |
|
|
Term
| How do Sulfonylureas Trigger insulin release? |
|
Definition
| Close K+ channels in B-cells -> depolarizes cell -> triggers insulin release |
|
|
Term
| What are the Meglitinides? |
|
Definition
|
|
Term
| How do the Meglitinides promote hypoglycemia? |
|
Definition
(Repaglinide)
Increase insulin secretion
Binds to K+ channels in B-cells -> increased intracellular K+ -> depolarizes cell -> Releases insulin
(Note - This is the same mechanism as the sulfonylureas) |
|
|
Term
|
Definition
|
|
Term
| How do the Biguanides promote hypoglycemia? |
|
Definition
Metformin
Decrease hepatic glucose production
Decrease glucose absorption form GI
Decrease Plasma glucagon levels |
|
|
Term
| What are the Thiazolidindiones? How do they promote hypoglycemia? |
|
Definition
Pioglitazone
(end in "-azone")
Bind PPAR receptor -> increases insulin sensitivity -> increase glucose uptake in muscles and adipose tissues |
|
|
Term
| What are the alpha-Glucosidase Inhibitors? How do the promote hypoglycemia? |
|
Definition
Acarbose
Inhibit alpha-glucosidase in epithelial brush borders -> decreases carbohydrate absorption |
|
|
Term
| What is GLP-1? What does it do? |
|
Definition
Endogenous Incretin that decreases post-prandial blood glucose
Increase Insulin secretion
Decrease glycogenolysis
Decrease Gastric Emptying
Decrease Appetite
Decrease glucagon secretion |
|
|
Term
| What is the Incretin drugs? |
|
Definition
|
|
Term
| What Incretin drug acts on GLP-1 receptors but is more potent then it? |
|
Definition
|
|
Term
| What drug can enhance the hypoglycemic actions of sulfonylureas? |
|
Definition
|
|
Term
| What drug is a long acting somatostatin analogue? |
|
Definition
|
|
Term
| What drug is used to treat insulinomas, glucagonomas, and acromegally? |
|
Definition
Octreotide
(somatostatin analogue) |
|
|
Term
| What does Octreotide inhibit? |
|
Definition
| insulin, glucagon, GH, & TSH |
|
|
Term
| Why can't Metformin cause hypoglycemia? |
|
Definition
| No effect on insulin secretion |
|
|
