Questions and Answers
What is a characteristic side effect of Thiazolidinediones like Rosiglitazone?
Which mechanism is primarily associated with the action of Amylin?
Which of the following is a contraindication for the use of Rosiglitazone?
What effect does the incretin Exenatide have on the pancreas?
Signup and view all the answers
What is a primary action of Metformin in glycemic control?
Signup and view all the answers
Which statement accurately describes a feature of DPP-4 inhibitors like Sitagliptin and Vildagliptin?
Signup and view all the answers
What is the primary mechanism of action of sulfonylureas?
Signup and view all the answers
Which of the following statements about the action of acarbose is true?
Signup and view all the answers
Which of the following may be a secondary effect of sulfonylurea therapy?
Signup and view all the answers
What is a commonly noted gastrointestinal side effect of acarbose?
Signup and view all the answers
At what plasma glucose levels do neuroglycopenic symptoms typically occur?
Signup and view all the answers
Which of the following inhibitors can be used in combination with sulfonylureas for an additive effect?
Signup and view all the answers
Which mechanism is primarily associated with sulfonylureas in the treatment of diabetes?
Signup and view all the answers
What is the primary action of biguanides, such as Metformin, in diabetes management?
Signup and view all the answers
How do insulin secretagogues function in diabetes treatment?
Signup and view all the answers
What is a major contraindication for the use of Metformin?
Signup and view all the answers
Which strategy is most effective for glycemic control in type 2 diabetes?
Signup and view all the answers
What is a common risk of insulin therapy without sufficient carbohydrate intake?
Signup and view all the answers
Which of the following medications primarily acts to enhance insulin sensitivity?
Signup and view all the answers
Which factor is associated with the development of Type 2 diabetes?
Signup and view all the answers
What is a key characteristic that differentiates Type 1 diabetes from Type 2 diabetes?
Signup and view all the answers
What is the most common chronic complication of diabetes?
Signup and view all the answers
Study Notes
Types of Diabetes
- Diabetes Mellitus Type 1: Insulin Dependent (IDDM); caused by destruction of pancreatic β cells.
- Diabetes Mellitus Type 2: Non-insulin Dependent (NIDDM); characterized by insulin resistance.
- Type I diabetes leads to low or absent insulin levels, while Type II diabetes typically exhibits high-normal to very high insulin levels.
- Type I often presents between ages 1-20, whereas Type II onset is usually 12 years and older, commonly associated with obesity (60-90% of cases).
- Gestational diabetes and family history are risk factors in Type II.
- Both types can lead to serious complications, including the risk of diabetic coma and ketosis.
Consequences of Diabetes
- Acute: Hyperglycemia, diabetic ketoacidosis, or diabetic coma.
-
Chronic Complications:
- Retinopathy: Leading cause of blindness in individuals of working age.
- Coronary and Cerebrovascular Disease: 2-4 fold increased risk of coronary heart disease and stroke; 75% have hypertension.
- Nephropathy: 16% of new patients require renal replacement therapy.
- Foot Problems: 15% risk of foot ulcers with a significant amputation requirement among those affected.
- Erectile Dysfunction: Affects up to 50% of men with long-standing diabetes.
Insulin
- Insulin is a peptide hormone that reduces blood glucose levels, produced by β cells in the islets of Langerhans.
- Insulin secretion is influenced by glucose levels leading to processes like glucokinase activation and ATP production.
- Other hormones raising blood glucose include cortisol, glucagon, growth hormone, epinephrine, estrogen, and progesterone.
Treatment of Type 1 Diabetes
- Treatment primarily involves insulin replacement therapy.
- Various insulin preparations, categorized by onset, peak, and duration, are commonly used:
- Rapid: Lispro, Aspart, and Glulisine; onset 0.2-0.5 hrs, duration 3-4 hrs; used for meals and acute events.
- Short Acting: Regular insulin, onset 0.25-1 hr, duration 5-8 hrs; also for meals.
- Intermediate: NPH, onset 1.5-2 hrs, duration 18-24 hrs; used for basal coverage.
- Long-Acting: Glargine and Detimir; Glargine has up to 24 hrs coverage.
Insulin Delivery Systems
- Inhaled Insulin: Example is Exubera; alternative to injections.
Adverse Effects of Insulin Therapy
- Can cause severe hypoglycemia if insulin is administered without carbohydrate intake.
- Additional side effects include edema and decreased hematocrit.
Thiazolidinediones: Rosiglitazone
- Linked to hepatotoxicity and fatal ischemic heart disease.
- Not recommended for patients with class 3 or 4 heart failure; may worsen heart failure and cause edema.
New Classes of Hypoglycemic Drugs
- Amylin: A peptide that suppresses glucagon, delays gastric emptying, and suppresses appetite; Pramlintide is a modified form used with insulin.
-
Incretin: GLP-1 released from the gut increases glucose-dependent insulin secretion; quickly broken down by DPP-4.
- Exenatide: Incretin mimetic (injected).
- Sitagliptin & Vildagliptin: DPP-4 inhibitors (oral).
Symptoms of Hypoglycemia
- Early symptoms include sweating, hunger, and tremors, typically at plasma glucose levels of 60-80 mg/dl.
- At levels below 60 mg/dl, symptoms may escalate to confusion, weakness, and loss of consciousness.
Treatment of Type 2 Diabetes
-
Inhibitors of Intestinal Glucose Absorption: Acarbose and Miglitol act as α-glucosidase inhibitors, delaying carbohydrate absorption and reducing postprandial glucose.
- Side effects include significant gastrointestinal discomfort.
- Sulfonylureas: Historically the first class of oral antidiabetic drugs; they promote insulin secretion from β cells, improving blood glucose levels and possibly enhancing insulin sensitivity.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
This quiz covers essential information regarding the types of diabetes, including Type 1 (IDDM) and Type 2 (NIDDM), as well as their treatments involving insulin and oral hypoglycemic drugs. Enhance your understanding of the causes and characteristics of each diabetes type. Test your knowledge on this important health topic.
