Ozcan 4-11, 4-14 Diabetes

Question 1

3 symptoms of diabetes

Answer 1

high blood glucose, excessive thirst of hunger, glucose in urine, fatigue, blurred vision, frequent urination

Question 2

diagnosis of diabetes that must be confirmed at least twice

Answer 2

fasting plasma glucose(FPG) >126mg/dl, Oral Glucose Tolerance Test (OGTT)>200 mg/dl 2hrs after 75g dose, Random Plasma Glucose (RPG) >200mg/dl,

Question 3

diagnosis of diabetes that can be performed once

Answer 3

HbA1c > 6.5%, insulin levels

Question 4

insulin

Answer 4

discovered in 1912 by Fred Banting and Charles Best, consists of 2 chains (A=21aa & B=30aa) joined by 2 disulfide bridges, synthesized as preproinsulin (24aa signal peptide- B chain- C chain- A chain) processed to mature insulin in ER and Golgi. It is packed into insulin granules.

Question 5

Islets of Langerhans

Answer 5

contain four cell types in the pancreas

Question 6

alpha cells

Answer 6

secrete glucagon- signal the fasting state, make up 20% of the islet cells on the outter ring

Question 7

beta cells

Answer 7

secrete insulin- signal the fed state, make up 70% of islet cells inside the ring of alpha cells

Question 8

glucose-regulated insulin secretion steps

Answer 8

1. Uptake and metabolism of glucose, leading to increased ATP levels, 2. Increased ATP/ADP ratio leads to closure of KATP channels causing 3. depolarization of the membrane, 4. Depolarization activates calcium channels causing calcium influx, 5. Rise in intracellular calcium causes insulin secretion from the granules into the blood stream.

Question 9

defect of T2D

Answer 9

defects in insulin action and secretion

Question 10

requirements for maintaining blood glucose

Answer 10

insulin release, glucose uptake by adipose and muscle cells, glucose output by liver cells

Question 11

4 stages of T2D

Answer 11

insulin resistance, hyperinsulinemia, beta cell failure, hyperglycemia (T2D)

Question 12

what do liver cells do in response to insulin

Answer 12

store glucose as glycogen

Question 13

drug that stimulates insulin secretion, and its mechanism

Answer 13

sulfanylureas, meglitinides - they work by closing KATP channels; Glucagon-like peptide 1 (GLP1) -works on the beta cells directly

Question 14

drugs that decrease insulin resistance

Answer 14

Thiazolidinediones (TZDs) pioglidazone- they activate nuclear hormone receptor PPAR gamma, metformin &biguanides -increase uptake by muscle, decrease gluconeogensis

Question 15

drugs that delay digestion of carbohydrates and absorption of glucose

Answer 15

alpha glucosidase inhibitors- inhibit alpha amylase and alpha glucosidases