Diabetes Therapies SD

Question 1

What is the difference between type 1 and type 2 diabetes?

Answer 1

Type 1- insulin deficient
Type 2- Insulin resistant

Question 2

How many ATP molecules does one molecule of glucose generate?

Answer 2

30

Question 3

What is glycolysis?

Answer 3

Break down of glucose

Question 4

Briefly explain how insulin is released following glucose intake

Answer 4

Glucose is eaten and detected by GLUT-2 in the pancreas once inside a pancreatic cell. Metabolism occurs in mitochondria and produces ATP.
ATP is detected by sulfonylurea receptor & ATP switches off this receptor therefore potassium is no longer pumped out —> calcium channels open and calcium is pumped in which causes insulin to be released.

Question 5

What tissues does insulin effect metabolism in?

Answer 5

Liver
Fat cell
Muscle cell

Question 6

Explain insulin action on glucose levels

Answer 6

Insulin binds to receptor
Receptor is phosphorylated \
This activates cell signalling
This releases GLUT-4
GLUT-4 imports glucose
Hence lowering blood glucose

Question 7

Where is GLUT-4 found?

Answer 7

Muscles

Question 8

Where is GLUT-2 found?

Answer 8

Pancreas

Question 9

What does an insulin molecule consist of?

Answer 9

2 peptide chains of 21 and 30 amino acids linked by 2 disulphide bonds

Question 10

Define ‘insulin resistance’

Answer 10

The failure of target tissues to respond normally to insulin

Question 11

What are the outcomes of insulin resistance on the body?

Answer 11

Decreased uptake of glucose in muscle cells
Reduced glycolysis & fatty acid oxidation
Continuing of gluconeogenosis
=Blood glucose increase

Question 12

What is the half-life of naturally occurring insulin?

Answer 12

3-5 mins

Question 13

What organ(s) remove insulin from the body and state a %

Answer 13

Liver 60%
Kidneys 35-40%
(Artificial insulin the numbers are reversed)

Question 14

What is added to insulin to make it last longer?

Answer 14

Zinc or Protamine

Question 15

How does zinc increase the duration of insulin?

Answer 15

Increases the stability of insulin
Delays site absorption

Question 16

How does protamine increase duration in insulin?

Answer 16

Forms an insoluble complex with insulin so wont dissolve/ break down straight away when it gets into the blood hence produces prolonged release when administered

Question 17

Why prolonged insulin?

Answer 17

To avoid very frequent injections (as normal insulin HL is 3-5mins)

Question 18

What is meant by “endogenous”?

Answer 18

Naturally occuring

Question 19

Briefly explain how to make recombinant insulin

Answer 19

Add human DNA to bacterial plasmid
Introduce plasmid back into bacterium
Plasmid replicates inside bacterium and bacterium divide to produce a colony
Purify protein culture
(Anything in a bacterial plasmid will produce huge amounts hence why it is used)

Question 20

What are the 3 commercially rapid acting insulins?

Answer 20

Lispro
Aspart
Glulisine

Question 21

When would you take rapid acting insulin and why?

Answer 21

5-15 mins before food
To minimise elevated blood glucose

Question 22

When should short acting insulin be injected?

Answer 22

30-45 mins before a meal

Question 23

What kind of insulin is bound to protamine?

Answer 23

Intermediate acting

Question 24

What is an example of long acting insulin?

Answer 24

Insulin Detemir
Levemir

Question 25

What happens if you have too much insulin?

Answer 25

Severe hypoglycaemia —> brain damage—> cardiac arrest