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Pharmacology > Week 12: Glucose Regulation > Flashcards

Week 12: Glucose Regulation Flashcards

1
Q

which hormones do alpha cells secrete?

A

Glucagon

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2
Q

which hormones do beta cells secrete?

A

insulin

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3
Q

where are alpha and beta cells located in the pancreas?

A

Islets of langerhans

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4
Q

where is the pancreas located?

A

Under the liver

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5
Q

Which hormone does the pancreas release in response to low blood sugar?

A

Glucagon (turns glycogen into glucose which raises blood sugar)

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6
Q

which hormone does the pancreas release in response to high blood sugar

A

Insulin (turns glucose into glycogen and pulls glucose from blood into tissue cells)

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7
Q

what’s the difference between basal rate of insulin and bolus rate?

A

Basal rate is when insulin is being continuously released in the body
bolus rate is a shot of insulin released to manage the food you just consumed

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8
Q

What happens during Ketogenesis?

A

Fat Turns into glucose

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9
Q

what does glucagon do?

A

raises blood sugar

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10
Q

what does insulin do?

A

Lowers blood sugar

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11
Q

what is a state of euglycemia?

A

a state of normal blood sugar (4-6 mol/L)

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12
Q

what are the endocrine functional units of the pancreas?

A

Islets of Langerhans

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13
Q

how are Diabetes Mellitus and Diabetes insidious similar?

A

they both make you super thirsty and pee a lot

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14
Q

What are the 3 causes of diabetes mellitus?

A
  1. inadequate/absent production of insulin
  2. insulin resistance
  3. stress levels (cortisol)
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15
Q

what would cause an inadequate production of insulin

A

Destruction of beta cells (autoimmune) or overproduction of insulin which overworks beta cells causing them to be destroyed over time

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16
Q

what happens during insulin resistance?

A

target cells are less able to metabolise the glucose available to them
this will cause hyperglycemia and hyperinsulinemia

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17
Q

how does an elevated cortisol level cause Diabetes Mellitus?

A
  • cortisol levels are increased
  • cortisol is a glucocorticoid that encourages the production of glucose
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18
Q

What are the four types of diabetes mellitus?

A
  1. Autoimmune destruction
  2. insulin resistance
  3. Maturity-onset diabetes of the young
  4. gestational diabetes mellitus
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19
Q

Explain the thrifty gene hypothesis

A
  • indigenous individuals have a hard time processing glucose, and one hypothesis is that it is an outcome of the malnourishment of residential schools
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20
Q

what are the four major clinical manifestations indicating high blood sugar

A
  • polyuria
  • polydipsia (constant thirst)
  • cellular dehydration (makes you super sleepy)
  • blurred vision
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21
Q

hoe does hyperglycemia affect fluid shift in the cells?

A

It causes increased osmosis and increased serum osmolality

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22
Q

how does high blood sugar result in increased gluosuria, polyuria, and polydipsia?

(in the kidneys)

A

-kidneys pump out glucose in the proximal tubule
-during hyperglycemia, pumps cannot keep up because there is too much
-glucose will escape and go further down the nephron
-it will pull more water into the urine which will increase urination and thirst

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23
Q

which method of diagnosis would determine gestational diabetes?

A

oral glucose tolerance test (the one where the patient drinks 75g of glucose and the blood glucose is measured 30, 60, and 120 mins after

So you can see how good the body is at regulating it

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24
Q

how many positive tests ranged across the 4 diagnostic studies do you need to be diagnosed with diabetes?

A

2 positive tests

25
Q

how does Hemoglobin A1C test blood glucose?

A

it determines glycemic control over time over 120 days

shows the amount of glucose that has been attached to HgB molecules

26
Q

is water ok during fasting blood glucose? which values indicate DM?

A

Yes, anything over 7mmol/L indicates DM

27
Q

what levels of random plasma blood glucose indicate DM?

A

anything over 11.1mmol/L

28
Q

What is Hyperosmolar Hyperglycemic state?

A

having super sweet blood and being dehydrated, this is commonly seen in people with type 2 DM who have the ability to produce some insulin

29
Q

What glucose levels will indicate Hyperosmolar hyperglycemic state ?

A

blood glucose above 34 mmol/L

30
Q

how would you treat Hyperosmolar Hyperglycemic state?

A

fluid replacement
0.9%NS

31
Q

Explain Diabetic Ketoacidosis

A

in the absence of insulin, lipolysis increases, which accumunates ketones in the body
ketones are very acidic so you go into metabolic acidosis
can also result in polyuria

32
Q

which DM complication can cause fruity breath?

A

Ketoacidosis

33
Q

how can DM affect the eye?

A

high blood glucose and blood pressure can damage eye blood vessels, causing retinopathy, cataracts and glaucoma

34
Q

how can DM affect the kidney?

A

High blood pressure damages small blood vessel (which is the vascular system to kidneys) , and excess blood glucose can overwork the kidneys resulting in neuropathy

35
Q

how does DM result in neuropathy?

A

high blood sugar damages peripheral nerves, which can result in pain or numbness

36
Q

how does DM affect the heart? (which things)

A

high blood pressure and insulin resistance increase risk of coronary heart disease (arteries cannot deliver enough O2 rich blood to heart)

37
Q

what are symptoms of low blood sugar similar to?

A

symptoms of low blood sugar

38
Q

how does DM affect extremities?

A

It causes Peripheral Vascular disease which results form narrowing of blood vessels, increasing the risk for reduced blood flow in legs

39
Q

what is angiopathy?

A

Destruction of blood vessels

40
Q

what is critically high blood sugar?

A

33mmol/L

41
Q

what is critically low blood sugar?

A

2.8 mol/L8

42
Q

what is the overall standard of care for a person with DM?

A

Create a person-centred goal and approach

43
Q

true or false: injected insulin has a lot of side effects

A

False, it will have low side effects because its a natural hormone that were replacing

44
Q

what drug class is metformin?

A

biguanides

45
Q

what is the first drug of choice for most patients after an initial diagnosis of DM?

A

Metformin

46
Q

what are the 3 ways Metformin lowers blood glucose and improves glucose tolerance?

A
  1. inhibits glucose production in the liver
  2. it sensitises insulin receptors in target tissues
  3. it slightly reduces glucose absorption in the gut
47
Q

which organ is metformin hard on?

A

the kidneys

48
Q

what is the MOA for Gliclazide?

A

it stimulates the release of insulin from the pancreatic beta cels, and may increase target cell sensitivity to insulin

49
Q

what are secretagogues

A

drugs that increase insulin secretion

50
Q

how could gliclazide cause hypoglycemia? which drug would be a better alternative?

A

if someone is fasting the drug could be working too hard to release insulin.
Metformin does not cause hypoglycemias

51
Q

what is the science behind hypoglycaemia?

A

Blood sugar under 4 mmcl/L caused by too much insulin in relation to available glucose

52
Q

what causes the neurogenic clinical manifestations with hypoglycemias?

A

low blood sugar triggers the release of neuroendocrine hormones (like epinephrine) which activates the autonomic nervous system which will cause the neurogenic things.

53
Q

What are neuroglycopenic clinical manifestations?

A

if BS levels continue to drop a lack of BS in the brain will cause loss of consciousness, seizures, coma, and death

54
Q

which drugs can interfere with the recognition of hypoglycaemic symptoms?

A

Beta blockers

55
Q

which would symptoms of hypoglycaemia look like?

A

Fight or flight symptoms basically

56
Q

where in the kidneys does glucose get pumped out?

A

Proximal tubule

57
Q

true or false: people with hyperosmolar hyperglycaemic state produce some insulin

A

true,

58
Q

what happens when increased blood sugar overworks the kidney?

A

neuropathy

Pharmacology (8 decks)

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