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endocrine > Diabetes > Flashcards

Diabetes Flashcards

1
Q

what is glycosylation

A

accumulation of trapped plasma proteins and cross linked basal lamina proteins

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2
Q

what is intermediate diabetes

A

those people who are at future risk of developing diabetes

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3
Q

what are the diagnostic values for intermediate diabetes

A

fasting glc 6.1-7 (also known as impaired fasting glucose)
resting glucose between 7.8 and 11.1
HbA1C between 42-47

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4
Q

what is MODY

A

maturity onset diabetes in the young

autosomal dominant condition

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5
Q

what mutations do you get in MODY

A

glucokinase mutations

trasncription factor mutations

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6
Q

what drugs can cause secondary diabetes

A

corticosteroids

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7
Q

what is gestational diabetes

A

increasing insulin resistance in pregnancy

higher chance of getting diabetes type 2 in later life

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8
Q

how does metformin work

A

improves insulin action - acts on the liver and muscle to have a similar effect as exercise

affects glc transport and decreases fatty acid synthesis
improves receptor function
inhibits gluconeogenic pathways

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9
Q

how long is the half life of metformin

A

6 hours

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10
Q

advantages of metformin

A 
improves CV outcome 
Efficcaeous 
well tolerated 
not associated with weight gain 
can be used in pregnancy 
cheap
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11
Q

disadvantages of metformin

A

GI side effects
risk of lactic acidosis
risk of Vit B12 malabsorption

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12
Q

what are sulphpnylureas usually called

A

gli…ides

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13
Q

how do sulphonylureas work

A

act on the pancreas increasing insulin secretion

bind to sulphonylureas receptors which closes ATP K binding channels

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14
Q

how long do sulphoyluyreas work

A

12 hours

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15
Q

advantages of sulphoylureas

A

work with metformin
rapid improvement in control
cheap
well tolerated

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16
Q

disadvantages of sulphponylureas

A 
risk of hypos 
weight gain 
caution in renal and hepatic disease 
can't be used in pregnancy 
hypersensitivity and photosensitivity reactions
17
Q

Thiazolidinediones- what are they usually called

A

….glitazones

18
Q

How do Thiazolidinediones work

A

improve insulin action
by selectively stimulating PRAR nuclear receptors causing. change in transcription

reduced insulin resistance
reduced withdrawal of glc from the liver
reduced quantity of glc insulin and glycated haem in the blood

19
Q

advantages for Thiazolidinediones

A

good for those with significant insulin resistance
cheap
safe for CV

20
Q

disadvantages of Thiazolidinediones

A

can increase the risk of bladder cancer
fluid retention
weight gain
increased risk of fractures in females

21
Q

what are DDP 4 inhibitors called

A

…..gliptans

22
Q

how do DDP 4 inhibitors work

A

increase insulin release

inhibit DPP4 so delay the breakdown of incretins leading to an increase in insulin and glucagon production

23
Q

advantages of DPP4 inhibitors

A

well tolerated, can be used in renal impairment
no risk of hypos
weight neutral

24
Q

disadvantages of DPP 4 inhibitors

A

small effect on glycemic control
cant be used in pregnancy
side effects include nausea

25
Q

what are GPL1 analogues called

A

end in tides

26
Q

how do GPL1 analogues work

A

increase insulin resistance

incretic mimetic

27
Q

advantages of GPL1 analogeus

A

weight loss
no risk of hypos
can be used with basal insulin

28
Q

what are disadvantages of GPL1 analogues

A

v expensive
injection
cant be used in pregnancy
nausea

29
Q

what are SGL2 inhibitors called

A

….glifozin

30
Q

how do SGL2 inhibitorsrs work

A

increase the excretion of glucose by the kidneys

31
Q

advantages of SGLT2 inhibitora

A

weight loss
no risk of hypos
good effect on glycemic control
can add to insulin regiments

32
Q

disadvantages of SGLT2 inhibitors

A 
expensive 
side effects: 
UTI fungal infections, osmotic symptoms 
risk of DKA 
cant be used in breast feeding

endocrine (3 decks)

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