Thiazolidinediones and Incretin Mimetics Overview
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Questions and Answers

What was the percentage reduction in body weight produced by orlistat compared to the control group in the meta-analysis?

  • 5.5%
  • 2.9% (correct)
  • 10%
  • 12%
  • What main effect does sibutramine have on food intake?

  • Increases food intake
  • Limits calorie absorption
  • Causes loss of appetite
  • Reduces food intake (correct)
  • Which hormone levels does orlistat reportedly reduce?

  • Leptin (correct)
  • Insulin
  • Cortisol
  • Ghrelin
  • For what reason was sibutramine withdrawn in most countries?

    <p>Increased cardiovascular risk</p> Signup and view all the answers

    How does orlistat affect the release or action of thyroid hormones?

    <p>No interference with thyroid hormones</p> Signup and view all the answers

    Which metabolic parameter is improved by orlistat?

    <p>Reduced waist circumference</p> Signup and view all the answers

    What is a common adverse effect associated with the drug class that includes pioglitazone?

    <p>Flatulence and loose stools</p> Signup and view all the answers

    What was the effect of sibutramine combined with lifestyle modification?

    <p>More effective than when alone</p> Signup and view all the answers

    Which parameter does sibutramine NOT affect according to the findings?

    <p>Energy expenditure</p> Signup and view all the answers

    What therapy is pioglitazone typically combined with to improve outcomes in type 2 diabetes?

    <p>Metformin</p> Signup and view all the answers

    Which drug continues to be in clinical use among the thiazolidinediones?

    <p>Pioglitazone</p> Signup and view all the answers

    What is a characteristic effect of GLP-1 agonists after they are administered?

    <p>Suppression of glucagon secretion</p> Signup and view all the answers

    Which of the following events has NOT been associated with earlier thiazolidinedione drugs?

    <p>Diabetes-related weight loss</p> Signup and view all the answers

    What is the typical time frame within which thiazolidinediones achieve their maximum effect?

    <p>1-2 months</p> Signup and view all the answers

    How do GLP-1 agonists contribute to weight management in patients?

    <p>By affecting satiety</p> Signup and view all the answers

    Which statement about the efficacy of incretin mimetics is correct?

    <p>They showed uncertain clinical significance on A1c levels.</p> Signup and view all the answers

    What condition is liraglutide primarily used to treat?

    <p>Type 2 diabetes</p> Signup and view all the answers

    Which hormone's levels are not suppressed by food in obese individuals?

    <p>Ghrelin</p> Signup and view all the answers

    What does the research by Colditz et al. in 1995 link to diabetes risk?

    <p>Weight gain</p> Signup and view all the answers

    Which of the following describes the role of leptin according to the studies mentioned?

    <p>It regulates appetite and fat storage.</p> Signup and view all the answers

    What does the neuroendocrine regulation of metabolism involve?

    <p>A network of hormones and neural circuits</p> Signup and view all the answers

    Which publication is considered a classic on the role of leptin?

    <p>Effects of recombinant leptin therapy</p> Signup and view all the answers

    What is a major conclusion drawn from the research by Barsh et al. in 2000?

    <p>There is a genetic basis to body weight regulation.</p> Signup and view all the answers

    What aspect of body fat regulation does the hypothesis by Kennedy et al. highlight?

    <p>The hypothalamic control mechanism for food intake</p> Signup and view all the answers

    What effect does pioglitazone have on hemoglobin A1C?

    <p>Decreases hemoglobin A1C levels</p> Signup and view all the answers

    What is a potential adverse effect associated with pioglitazone?

    <p>Heart failure</p> Signup and view all the answers

    What is a consideration regarding the long-term use of SGLT2 inhibitors?

    <p>Long-term outcomes and safety data are still emerging</p> Signup and view all the answers

    Which of the following is NOT true concerning the effects of pioglitazone?

    <p>It reduces the risk of developing cardiovascular disease</p> Signup and view all the answers

    What is the main concern associated with the cardiovascular risk when comparing SGLT2 inhibitors to metformin?

    <p>SGLT2 inhibitors may present a higher cardiovascular risk</p> Signup and view all the answers

    Which of the following studies is considered a landmark clinical trial related to diabetes control?

    <p>American Diabetes Association, 1993</p> Signup and view all the answers

    What is a potential benefit of SGLT2 inhibitors in the treatment of type 2 diabetes?

    <p>Lowering of hemoglobin A1C</p> Signup and view all the answers

    What does the acronym IRS refer to in the context of diabetes complications?

    <p>Insulin Receptor Signaling</p> Signup and view all the answers

    What percentage of obesity cases is primarily caused by single gene mutations, according to the review mentioned?

    <p>Over 30%</p> Signup and view all the answers

    Which gene mutations are indicated as contributing factors to obesity?

    <p>POMC and leptin receptor</p> Signup and view all the answers

    Which mutation is most commonly found in obese patients?

    <p>Melanocortin MC4 receptor mutation</p> Signup and view all the answers

    What is the primary characteristic of polygenic obesity?

    <p>Results from the interaction of many genes with small effects.</p> Signup and view all the answers

    Which of the following is NOT listed as a cause of obesity?

    <p>Exposure to extreme temperatures</p> Signup and view all the answers

    Which receptor mutations are associated with the central processing of appetite and energy expenditure?

    <p>CB1 and D2 receptors</p> Signup and view all the answers

    What conditions are significantly increased by having a BMI over 30 kg/m2?

    <p>Type 2 diabetes and hypertension</p> Signup and view all the answers

    Which of these issues is a potential defect leading to obesity?

    <p>Malfunctions in energy expenditure control systems</p> Signup and view all the answers

    Study Notes

    Thiazolidinediones

    • Drugs in this class, despite commercial success, have had adverse effects, especially cardiovascular problems
    • No clinical trials have shown a benefit on mortality
    • Licensed on the basis of effects on HbA1c, a surrogate marker for long-term diabetes status, whose clinical significance is uncertain
    • Pioglitazone is the only drug remaining in clinical use after rosiglitazone and troglitazone faced regulatory action
      • Rosiglitazone was shown to increase heart attack risk, and troglitazone was shown to cause liver damage
    • The effects of thiazolidinediones on blood glucose are slow, with maximum effects being achieved only after 1-2 months of treatment
    • They enhance the effectiveness of endogenous insulin, which reduces hepatic glucose output, and increases glucose uptake into muscle
    • Pioglitazone improves control, but increases weight, causes heart failure and fluid retention

    Incretin Mimetics

    • Exenatide is a synthetic version of exendin-4, a peptide found in the saliva of the Gila monster
    • GLP-1 agonists increase insulin secretion, suppress glucagon secretion and slow gastric emptying
    • They reduce food intake by affecting satiety, which is associated with modest weight loss
    • They are administered by subcutaneous injection once daily or weekly
    • GLP-1 agonists are associated with increased cardiovascular risk

    Sodium Glucose Co-transporter (SGLT)2 Inhibitors

    • Improve control, but long term outcomes and safety data are still emerging

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    Description

    This quiz covers the key aspects of thiazolidinediones and incretin mimetics in diabetes treatment. It discusses the implications of thiazolidinediones on cardiovascular health, regulatory actions, and their effects on glucose management. Additionally, it touches on the synthetic nature of incretin mimetics and their potential benefits.

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