DM general Flashcards
(54 cards)
What happens ketoacidosis?
Diabetic ketoacidosis tends to occur in type 1 diabetics when there is a lack of insulin in the bloodstream that prevents glucose absorption. This causes unchecked ketone body production (through fatty acid metabolism) potentially leading to dangerous glucose and ketone levels in the blood.
What is type 1 diabetes.
- Autoimmune destruction of the insulin-producing beta cells in the pancreas.
- Lack of insulin leads to increased glucose in blood and urine.
What is type 2 diabetes?
•Diabetes mellitus type 2 is ↓insulin production +/- insulin resistance.
What are the ways to diagnose type 2 diabetes?
- Resting blood glucose Lvls > 11.1
- Fasting plasma glucose >7.0mmol/l
- Oral glucose tolerance test → blood sugar test. 75mg oral glucose given. Second blood sugar taken.
- Hba1c →glycoslated haemoglobin
What are the thresholds for fasting plasma glucose?
7 is diabetic
What is the Hba1c threshold for Diabetes?
> 48mmol/l =diabetic
What are symptoms of hyperglycaemia?
Polyuria, polydipsia, unexplained weight loss, visual blurring, genital thrush, lethargy.
What is the diabetic threshold for resting blood glucose?
11.1 mmol/l
What is the threshold for diabetes in a 2hr oral glucose tolerance test?
11.1mmol/l
what kind of drug is metformin? and what does it do?
•Biguanide
•Decrease hepatic gluconeogenesis (primary effect)
Increase peripheral insulin sensitivity (secondary effect)
What is the treatment for type 1 diabetes?
Insulin replacement
What is gliclazide? and what is its method of action?
- It is sulfonyluria.
- It increases insulin production.
- It can cause hypoglycaemia → can cause hypo’s
- they can also cause weightgain
What contraindicates metformin?
renal impairment stop drug when eGFR =/
What is the incretin gap?
- Incretins cause an increase in the amount of insulin released from pancreatic beta cells. they are responsible for ~50-70% of insulin production.
- The incretin gap is the amount of difference incretins make compared to IV insulin.
What does insulin do?
- It promotes the absortion of glucose into fat, liver and muscle cells.
- The pancreatic beta cells are sensitive to the glucose concentration in the blood. When the blood glucose levels are high they secrete insulin into the blood; when they are low they stop.
What does incretins do? and what stimulates their release?
Incretins cause an increase in the amount of insulin released from pancreatic beta cells and inhibit the release of glucagon. their release is stimulated by eating.
Where is glucagon produced and what does it do?
Glucagon produced by alpha cells of the pancreas. It works to raise the concentration of glucose in the bloodstream. Its effect is opposite that of insulin, which lowers the glucose.
What are metaglinides?
Like suphonylurias but faster acting and for a shorter period of time. Pretty much same MOA.
What is the MOA of sufonylurias?
They bind to the SUR1 receptor in the Beta cell causing a calcium influx and the exocytosis of insulin.
What are thiazidinediones?
- pioglitazone is and example.
- Fat in blood damages beta cells so it changes fat from visceral to adipose.
- Issues concerning safety
What are GLP1 + GIP?
They are incretin stimulating drugs.
- Glucagon like peptide 1
- Glucose dependent insulinotropic peptide (GIP)
Name a DPP-4 inhibitor?
sitagliptin
vildagliptin
Name a GLP-1 receptor agonist?
Byetta
Liraglutide
How do Glp-1 agonists work?
•stimulate production of incretin
•excess production of insulin
→
suppression of glucagon production and WEIGHT LOSS
