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Pharmacology Test #5 > Insulin and Diabetes > Flashcards

Flashcards in Insulin and Diabetes Deck (116)
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1

Criteria for the Diagnosis of Diabetes

1. A1C greater than or equal to 6.5%
2. Fasting plasma glucose greater than or equal to 126 mg/dL
3. 2-h plasma glucose greater than 200 mg/dL during an OGTT
4. A random plasma glucose greater than 200 mg/dL

2

Glucose intolerance in type 1 diabetes characterized by

no functioning insulin-secreting pancreatic beta cells, dependency on exogenous insulin and a tendency towards ketoacidosis

3

Type 1 diabetes is thought to be caused by

antibodies that destroy pancreatic beta cells that may be triggered by viruses, chemicals etc. in genetically predisposed individuals

4

Role of glucagon

increased glucagon levels in the presence of increased blood glucose levels

5

Hyperlipidemia in diabetes

increased fatty acid mobilization from fat cells; increased fatty acid oxidation - ketoacidosis

6

What happens in hyperglucemia (due to lack of insulin)

1. decreased glucose uptake in cells where glucose uptake is insulin-dependent
2. decreased glycogen synthesis
3. increased conversion of amino acids to glucose

7

Cardiovascular complications from diabetes

micro and macro angiopathies

8

Neuropathy complications from diabetes

increased blood glucose levels lead to increased utilization of the polyol pathway (Aldose Reductase); increased cytosolic water in neural cells

9

Nephropathy complications from diabetes

renal vascular changes and changes in the glomerular basement membrane

10

Ocular complications from diabetes

cataracts, retinal microaneurysms and hemorrhage

11

Increased susceptibility to what? with diabetes

increased susceptibility to infections

12

Conventional therapy goals of insulin therapy and monitoring

reduce acute symptoms - polyuria, dehydration and ketoacidosis

13

Intensive therapy goals of insulin therapy and monitoring

keep blood glucose levels below 150 mg/dL; prevent/delay onset of complications; increased risk of hypoglycemia

14

Oxidation products of glucose react irreversibly with proteins to form

Advanced glycation end-products (AGE)

15

Advanced glycation end-products (AGE) results in

loss of normal protein function; acceleration of aging process; theorized to account for many long-term complications of diabetes

16

AGE precursor, methylglyoxal, inhibits

vasorelaxation stimulated by acetylcholine/NO

17

Role of the alpha subunits in the insulin receptor

regulatory unit of the receptor; represses the catalytic activity of the beta subunit; repression is relieved by insulin binding

18

Role of the beta subunits in the insulin receptor

contain the tyrosine kinase catalytic domains (autophosphorylation)

19

Insulin effects on the liver

inhibits: glycogenolysis; ketogenesis; and gluconeogenesis
stimulates: glycogen synthesis and triglyceride synthesis

20

Insulin effects on the skeletal muscle

glucose transport; amino acid transport

21

Insulin effects of the adipose tissue

triglyceride storage and glucose transport

22

Glucose disposal in a fasting state

75% is non-insulin dependent (Liver, GI, brain)
25% is insulin-dependent (skeletal muscle)

23

Glucagon is secreted in a fasting state to prevent

hypoglycemia

24

Glucose disposal in a fed state

80-85% is insulin-dependent (skeletal muscle)
4-5% is insulin-dependent in adipose tissue
Glucagon secretion is inhibited

25

In a fed state, insulin inhibits the release of what?

inhibits release of FFA from adipose tissue

26

What does decreased serum FFA regulate?

enhances insulin action of skeletal muscle; reduces hepatic glucose production

27

GLUT1

constitutive; widely expressed

28

GLUT2

constitutive; beta-cells and liver

29

GLUT3

constitutive; neurons

30

GLUT4

insulin-induced; skeletal muscle and adipocytes