Podcast Beta
Questions and Answers
What is the primary hormone released by the pancreas that regulates blood glucose levels?
What characterizes Diabetes Mellitus?
Which of the following is NOT a common acute metabolic symptom of Diabetes Mellitus?
What type of complications are associated with Diabetes Mellitus?
Signup and view all the answers
In what way does the endocrine system mainly differ from the nervous system?
Signup and view all the answers
What is primarily considered a microvascular complication of Diabetes Mellitus?
Signup and view all the answers
What is the role of incretins concerning insulin release?
Signup and view all the answers
Which statement about symptoms of Diabetes Mellitus is accurate?
Signup and view all the answers
What is a benefit of using Insulin Lispro for diabetes management?
Signup and view all the answers
Which class of hypoglycemic drugs includes thiazolidinediones?
Signup and view all the answers
What is unique about Insulin Degludec compared to other insulins?
Signup and view all the answers
Why is insulin not suitable for oral administration?
Signup and view all the answers
Insulin NPH is classified as which type of insulin?
Signup and view all the answers
Which of the following is NOT a route for insulin administration?
Signup and view all the answers
What is the principal source of insulin currently used for production?
Signup and view all the answers
Which insulin type is characterized by a cloudy appearance?
Signup and view all the answers
What is the mechanism of Incretin Mimetics?
Signup and view all the answers
Which drug is the first oral glucagon-like peptide-1 (GLP-1) receptor agonist available in Canada?
Signup and view all the answers
What is the initial dose for Ozempic® in terms of subcutaneous injection?
Signup and view all the answers
Which adverse effect is most commonly associated with Incretin Mimetics?
Signup and view all the answers
What is the purpose of tapering up the dose of Rybelsus®?
Signup and view all the answers
Which condition is a contraindication for using Incretin Mimetics?
Signup and view all the answers
What is the dosing frequency for Trulicity®?
Signup and view all the answers
How may Incretin Mimetics affect the absorption of oral medications?
Signup and view all the answers
What is the primary mechanism of action of metformin?
Signup and view all the answers
Which of the following medications is classified as a sulfonylurea?
Signup and view all the answers
Which of the following factors could effectively contraindicate the use of metformin?
Signup and view all the answers
What is a common adverse reaction associated with sulfonylureas?
Signup and view all the answers
Which of the following statements about meglitinides is true?
Signup and view all the answers
Which antihyperglycemic agent should be taken with food to minimize gastrointestinal side effects?
Signup and view all the answers
What is a significant risk when using sulfonylureas in patients with kidney impairment?
Signup and view all the answers
What is a common therapeutic use of DPP-4 inhibitors?
Signup and view all the answers
What should SGLT2 inhibitors not be used in conjunction with?
Signup and view all the answers
Which of the following SGLT2 inhibitors is marketed under the name Jardiance?
Signup and view all the answers
What is the effect of elevated levels of thyroid hormones on TSH levels?
Signup and view all the answers
What is a common adverse reaction associated with SGLT2 inhibitors?
Signup and view all the answers
What is the primary role of calcitonin in the body?
Signup and view all the answers
Which thyroid hormone is more potent?
Signup and view all the answers
What does a low TSH level indicate?
Signup and view all the answers
What is the function of SGLT2 inhibitors in diabetes management?
Signup and view all the answers
Study Notes
Homeostasis
- The endocrine system works with the nervous system to maintain homeostasis in the body.
- The nervous system uses neurotransmitters to send signals over short distances (synapses), resulting in rapid effects.
- The endocrine system uses hormones to send signals over long distances, resulting in slower but longer-lasting effects.
Endocrine System
- The endocrine system includes several glands: hypothalamus, pituitary gland, pineal gland, thyroid, parathyroid, thymus, pancreas, adrenal glands, testes, and ovaries.
Diabetes
- Diabetes is a chronic condition that results from abnormal insulin production or impaired insulin sensitivity.
- Insulin and glucagon are released by the pancreas and are involved in blood glucose regulation.
- Diabetes is characterized by hyperglycemia, which can lead to microvascular and macrovascular complications.
- Microvascular complications include neuropathy, nephropathy, and retinopathy.
- Macrovascular complications include hypertension, angina, and myocardial infarction.
- Symptoms of diabetes include polyuria, polydipsia, weight loss, fatigue, blurred vision, and slow wound healing.
Insulin
- Insulin is a hormone that plays a crucial role in carbohydrate, fat, and protein metabolism by regulating blood glucose levels.
- Insulin is produced by the pancreas and helps cells absorb glucose for energy.
- Insulin can be administered by syringe, pen, or continuous subcutaneous insulin infusion (CSII) using an insulin pump.
- Insulin is available in various forms with different durations of action: rapid-acting, short-acting, intermediate-acting, long-acting, and ultra long-acting.
- The type and dose of insulin are adjusted based on individual needs, and insulin can be used to treat both type 1 and type 2 diabetes.
- Insulin cannot be taken orally because it is broken down by stomach acid.
- Insulin is now primarily produced using recombinant DNA technology in bacteria or yeast to match human insulin (insulin analogues).
Incretin Mimetics
- Incretin mimetics act as GLP-1 receptor agonists, promoting insulin secretion and reducing glucagon secretion, resulting in lower blood glucose levels.
- They are used as add-on therapy to metformin, sulfonylureas, or basal insulin.
- Incretin mimetics can be administered via injection or orally:
- Injectable forms include Ozempic (semaglutide), Trulicity (dulaglutide), Victoza (liraglutide), Byetta (exenatide), and Adlyxine (lixisenatide).
- Oral forms include Rybelsus (semaglutide).
- Common side effects of incretin mimetics include nausea, vomiting, hypoglycemia, weight loss, arrhythmia, and pancreatitis.
- They may reduce the absorption rate of some oral medications.
- Incretin mimetics are contraindicated in pregnancy and those with personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2.
Oral Anti-diabetic Agents
- Oral antidiabetic agents are used to manage type 2 diabetes by lowering blood glucose levels.
- They are available in various classes: Biguanides, Sulfonylureas, Meglitinides, Glitazones, α-glucosidase inhibitors, DPP-4 inhibitors, SGLT2 inhibitors, and combinations.
Metformin
- Metformin is a biguanide medication that enhances insulin sensitivity in liver, muscle, and fat cells, reducing hepatic glucose production.
- It is often the first-line treatment for type 2 diabetes and can be used in combination with insulin.
- Metformin does not cause hypoglycemia.
- It is available in immediate-release and extended-release formulations, with a recommended daily dose of 500mg to 2g.
- Metformin has potential non-diabetic benefits.
- Metformin is contraindicated in patients with type 1 diabetes, kidney or liver dysfunction, and history of lactic acidosis.
- Common side effects include gastrointestinal issues like nausea, vomiting, diarrhea, metallic taste, and flatulence.
- It is important to start with a low dose and gradually increase as tolerated to minimize gastrointestinal side effects.
Sulfonylureas
- Sulfonylureas are insulin secretagogues that stimulate insulin release from the pancreas, increasing both prandial (meal-related) and basal (between meals) insulin release.
- Sulfonylureas are contraindicated in patients allergic to sulfa drugs, type 1 diabetes, liver or kidney impairment, and thyroid impairment.
- Sulfonylureas are typically taken with meals.
- They are generally not the first-line treatment and can worsen glycemic control if used as the sole agent.
- Sulfonylureas can be associated with weight gain, hypoglycemia, photosensitivity, and various gastrointestinal and skin adverse effects.
- Interactions can occur with alcohol, enzyme inducers, and inhibitors.
Meglitinides
- Meglitinides are rapid-acting insulin secretagogues that primarily increase postprandial insulin release.
- They are taken with meals within 15 minutes to improve postprandial glucose control.
- They are not recommended for patients with type 1 diabetes or those requiring basal insulin.
- Meglitinides can be associated with hypoglycemia, especially if meals are missed.
SGLT2 Inhibitors
- SGLT2 inhibitors lower blood glucose by inhibiting the reabsorption of glucose in the kidneys, leading to increased urinary glucose excretion.
- They are used as monotherapy or in combination with other antidiabetic agents but require good kidney function.
- They should not be used with diuretics and are typically given once daily with the first meal.
- They are associated with adverse effects like hypotension, orthostatic hypotension, syncope, dehydration, electrolyte disturbances, increased LDL, weight loss, urinary tract infections, vaginal infections, and increased urination frequency and volume.
Thyroid Gland
- The thyroid gland produces hormones T4 (thyroxine) and T3 (triiodothyronine) that regulate metabolism and calcium homeostasis.
- These hormones affect almost all body cells and rely on iodine for their synthesis.
- The thyroid gland is regulated by a negative feedback loop involving TRH, TSH, and thyroid hormones.
- Calcitonin is a hormone produced by the thyroid gland that regulates calcium homeostasis by increasing bone formation and inhibiting bone breakdown.
- Thyroid disorders can involve overactivity (hyperthyroidism) or underactivity (hypothyroidism).
- Thyroid disorders are more common in women than men.
- Diagnosis of thyroid disorders involves laboratory tests of TSH and free T4 (FT4), as well as thyroid antibody tests, which can indicate autoimmune thyroid disease.
- Low TSH with high FT4 indicates hyperthyroidism.
- High TSH with low FT4 indicates hypothyroidism.
Thyroid Hormone Synthesis
- The thyroid gland selectively takes up iodine to synthesize T4 and T3.
- T3 is about 4 times more potent than T4.
- T4 is converted to T3 by deiodination.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Test your knowledge on the endocrine system and its role in maintaining homeostasis, particularly concerning diabetes management. This quiz covers the various glands involved, insulin function, and the implications of diabetes on health. Challenge yourself on these critical concepts in human physiology.
