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DEN 2026 - Pharmacology > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Name 3 main target organs of insulin

A
  1. Liver
  2. Muscle
  3. Fat
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2
Q

Describe 2 reactions which insulin increases in the liver

A
  1. Glycolysis increased generation of ATP by oxidation of glucose
  2. Glycogen synthesis (increase in the storage form of glucose)
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3
Q

Describe 2 reactions which insulin decreases in the liver

A
  1. Gluconeogenesis from pyruvate or lactate

2. Glycogenolysis (break down of glycogen)

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4
Q

What is the overall effect of insulin on the liver?

A

Increased storage of glycogen in the liver

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5
Q

Describe 3 reactions which insulin increases in skeletal muscle

A
  1. Glut4 translocation
  2. Glycogen synthesis
  3. Glycolysis
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6
Q

Name 2 anabolic effects of insulin on skeletal muscle

A
  1. Increased amino acid uptake

2. Increased protein synthesis

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7
Q

Describe 2 reactions which insulin increases on adipose tissues

A
  1. Glut4 membrane translocation

2. Glycerol concentration

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8
Q

Describe the overall metabolic effect of insulin on the body

A

Fuel storage in the form of glycogen for situations where there is no food present

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9
Q

Name 2 types of Diabetes Mellitus

A
  1. Type 1 (insulin-dependent)

2. Type 2 (non-insulin dependent)

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10
Q

Describe Type 1 diabetes

A
  • β cells in pancreas destroyed
  • No insulin produced
  • Early age onset
  • Moderate genetic predisposition
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11
Q

Describe Type 2 diabetes

A
  • Insulin stops working at target tissues
  • 35+ years old onset
  • Very strong genetic predisposition
  • Frequently obese
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12
Q

How is insulin manufactured for therapy of Type 1 diabetes

A

Recombinant human protein in bacteria

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13
Q

Name 3 ways insulin can be administered

A
  1. Subcutaneously (most common)
  2. Intravenously
  3. Intramuscularly
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14
Q

Why is insulin not administered orally?

A

Insulin is degraded by GIT

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15
Q

What is the principle of insulin preparations?

A

Alter rate of absorption by increasing particle size e.g. crystallisation or complexing with zinc

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16
Q

What is a short acting insulin preparation?

A

Novorapid

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17
Q

Name a modified insulin preparation

A

Insulin Glargine (Lantus)

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18
Q

Describe Lantus

A
  • Long acting insulin analogue
  • Provides constant basal insulin supply
  • Prolonged absorption from site of injection
  • Reduces risk of night-time hypoglycaemia
19
Q

Name 3 side effects of insulin therapy

A
  1. Hypoglycaemia
  2. Coma
  3. Brain damage
20
Q

How is hypoglycaemia with insulin therapy reversed?

A

Sweet drinks or IV glucagon if person is unconscious

21
Q

Name 4 factors which contribute to causation of Type 2 diabetes

A
  1. Genetic predisposition
  2. Obesity
  3. Glucocorticoids
  4. HIV protease inhibitors
22
Q

Describe insulin resistance

A
  • Failure of insulin to trigger its effects at target tissues
  • High blood glucose levels and high insulin levels
  • Can exhaust pancreas and lead to decreased insulin production
23
Q

What is the pharmacological strategy in the treatment of Type 2 diabetes?

A

Improve sensitivity of target tissues to insulin with drugs and other factors

24
Q

Describe 4 components of the therapy of Type 2 diabetes

A
  1. Reduce weight by exercise and diet
  2. Lower blood pressure
  3. Reduce cholesterol by reducing fat intake
  4. Oral hypoglycaemic agents
25
Q

Name 6 types of drugs used for Type 2 diabetes

A
  1. Biguanides
  2. Sulfonylureas
  3. Thiazolidinediones
  4. Incretin drugs
  5. SGLT2 inhibitors
  6. Insulin
26
Q

Name an example of a biguanides drug

A

Metforin

27
Q

Describe the mechanism of action of metformin

A

Lower blood glucose levels by increasing uptake into striated muscle and inhibiting gluconeogenesis in the liver and intestinal glucose absorption

28
Q

Name 4 side effects of metformin

A
  1. Nausea
  2. Anorexia
  3. Diarrhoea
  4. Lactic acidosis
29
Q

Name 3 contra indications of metformin

A
  1. Renal disease
  2. Heart failure
  3. Pregnancy
30
Q

Name an example of a sulfonylureas drug

A

Gliclazide

31
Q

Describe the mechanism of action of sulfonylureas drugs

A
  • Bind to K ATP receptor on β cells to mimic ATP by blocking channel
  • Trigger membrane depolarisation and calcium ions to enter the cell
  • Release of insulin by exocytosis
32
Q

Name 1 drawback of sulfonylureas drugs

A

They only work if the β cells in the pancreas are still functional

33
Q

Name an example of a thiazolidindione drug

A

Rosiglitazone

34
Q

Describe the mechanism of action of thiazolidindiones

A
  • Lower blood glucose and increase insulin sensitivity
  • Decrease gluconeogenesis in the liver
  • Increase glucose uptake in muscle
35
Q

Name 2 types of incretin drugs

A
  1. Incretin analogues

2. Incretin enhancers

36
Q

Name an example of an incretin analogue

A

Byetta

37
Q

Name an example of an incretin enhancer

A

Sitagliptin

38
Q

What is the overall mechanism of action for incretin drugs?

A

Bind to GLP-1 receptors on pancreatic β cells to increase insulin release

39
Q

Name an example of an SGLT2 inhibitor

A

Dapagliflozin

40
Q

What is the mechanism of action of dapagliflozin?

A

Reversibly inhibit SGLT2 in the kidney PCT decreasing glucose reabsorption and increasing urinary glucose excretion

41
Q

What is the main challenge with dental problems and diabetes?

A

Dental treatment may interrupt normal daily routine e.g. diet / injections

42
Q

Describe the relationship between diabetes and periodontal disease

A
  • Poorly controlled T1DM patients with nephropathy most at risk
  • Caused by poor white blood cell chemotaxis or vascular damage to gums
43
Q

Describe the relationship between diabetes and increased risk of caries

A
  • Decreased salivary function

- Resolved when patients have low carb diet

44
Q

Describe the relationship between diabetes and xerostomia

A
  • Reduced salivary function
  • Increase in salivary gland size to compensate
  • Could lead to infection e.g. candidiasis

DEN 2026 - Pharmacology (22 decks)

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