Anti-diabetic drugs

Question 1

Type 1 diabetes is known as:

Answer 1

insulin dependent (10% of cases)

Question 2

Type 2 diabetes is known as:

Answer 2

Non-insulin dependent (90% of cases)

Question 3

What are some signs of diabetes mellitus?

Answer 3

PU/PD

Glucosuria, ketouria, weight loss, fatigue

Question 4

What are some chronic effects of hyperglycemia?

Answer 4

Vascular damages in kidneys/limbs

Neural and ocular damage due to sorbital accumulation

Question 5

What is proinsulin?

Answer 5

Insulin + C-peptide

Question 6

What factors regulate insulin secretion?

Answer 6

Glucose, AA, fatty acids are all stimulatiors

Inhibitors: alpha-2 agonists and somatostatin

Question 7

What is the mechanism by which glucose stimulates insulin secretion?

Answer 7

glucose enters beta cells > metabolized to generate ATP > ATP blocks K channels > decreases K efflux > increased K concentration > depolarization > opens Ca channels > increases Ca > increases insulin exocytosis

Question 8

Can insulin be administered orally?

Answer 8

NO; peptide so it’s destroyed by the GI tract

Question 9

What effect does an alpha-2 agonist have on insulin secretion?

Answer 9

Decreases secretion

Question 10

What effects does Beta-2 agonist have on insulin secretion?

Answer 10

Increased secretion

Question 11

What is the general action of insulin?>

Answer 11

Conserve energy amd increase glucose transport into cells

Question 12

What is the action of insulin on carbohydrate metabolism?

Answer 12

Increased glucose transport into striated muscles and adipocytes and increase glycogen synthesis

Question 13

What is the action of insulin on lipid metabolism?

Answer 13

Increased lipid synthesis

Decreased lipolysis

Question 14

What is the action of insulin on protein metabolism?

Answer 14

Increased uptake of amino acids into cells for protein synthesis

Question 15

What is the action of insulin on potassium metabolism? What will you commonly see in diabetic animals?

Answer 15

Increased Na/K ATPase activity

Hyperkalemia because you don’t have insulin so you do not have ATP to pump K into the cells

Question 16

What are the signs associated with insulin overdose?

Answer 16

Rapdi fall: peripheral weakness, sweating, hunger

Slow fall: CNS effects and disturbances (coma or seizures)

Question 17

Describe fast acting insulin preparations:

Question 18

Describe intermediate acting insulin preparations:

Answer 18

Onset is 2 hours

Can mix with regular insulin to make action quicker but duration shorter

Question 19

Describe long acting insulin preparations:

Answer 19

Onset is 7 hours, lasts 36

Question 20

Is human insulin the best choice to control feline diabetes?

Answer 20

NO; bovine would be, but it is off the market

Question 21

What is the only way to treat insulin resistance right now?

Answer 21

Increase the dose of insulin

Question 22

What is somogyi rebound?

Answer 22

Insulin overdose; induces hypoglycemia and then a short hyperglycemia

Question 23

How does Glipizide work as an oral hypoglycemic agent?

Answer 23

It is used to stimulate insulin secretion by blocking K channels

Question 24

What type of diabetes can Glipizide be used against?

Answer 24

Type 1

Question 25

What is the MOA for the anti-hyperglycemic agent Metformin?

Answer 25

Decreases absorption of glucose from gut
Decreases hepatic output of glucose
Increases glucose utilization by increasing sensitivity to insulin

Question 26

What is the MOA for the anti-hyperglycemic agent Thiazolidinediones?

Answer 26

Increases the tissue sensitivity to insulin; used in type 2 patients

Question 27

Why is Metformin referred to as an anti-hyperglycemic agent but is not a hypoglycemic agent?

Answer 27

It does not increase insulin release, so it only alleviates hyperglycemia. Does not cause hypoglycemia

Question 28

What is the structure of canine insulin?

Answer 28

A:21 aa, B:30 aa

These are connected by 2 disulfide bonds 3