Insulin and Glucose Lowering Drugs Flashcards

Vocabulary flashcards for reviewing key terms and definitions from the lecture notes on Insulin and Glucose Lowering Drugs.

Diabetes Mellitus

Syndrome of disordered metabolism and inappropriate hyperglycemia secondary to an absolute/relative deficiency of insulin, or a reduction in biological effectiveness of insulin, or both. A chronic systemic progressive disorder characterized by hyperglycemia associated with abnormalities in the metabolism of carbohydrate, protein and fat.

Type 1 Diabetes (IDDM)

10% of diabetes population; autoimmune disease; Beta cell destruction –insulin deficiency; Usually less than 30 years old at onset; Often thin at diagnosis; Ketosis prone; Genetic predisposition

Type II Diabetes (NIDDM)

90% of diabetes population; Multi-factorial in pathogenesis; Usually >30 years at onset of disease; Insulin deficiency/ insulin resistance; Strong family history link; Obesity often present

Polyuria

Frequent urination; a common sign/symptom of Diabetes Mellitus

Polydipsia

Increased thirst; a common sign/symptom of Diabetes Mellitus

Polyphagia

Increased hunger; a common sign/symptom of Diabetes Mellitus

FBS (Fasting Blood Sugar) for Diabetes Diagnosis

≥126mg/dL

PPS (Postprandial Blood Sugar) for Diabetes Diagnosis

≥200mg/dL

HbA1C for Diabetes Diagnosis

≥6.5%

Sulfonylureas MOA

Stimulate release of insulin from pancreatic beta cells by blocking ATP- sensitive K+ channels resulting depolarization and Ca2+ influx; Sensitize beta cells to glucose; Inhibit hepatic glucose production; Reduce peripheral insulin resistance ( increase insulin sensitivity)

Biguanide (Metformin) MOA

Decrease production of hepatic glucose (hepatic gluconeogenesis); decrease intestinal absorption of glucose; improves peripheral insulin sensitivity

Alpha-Glucosidase Inhibitors MOA

Inhibits hydrolysis of dietary di-saccharides, tri-saccharide, and complex carbohydrates, resulting in delayed glucose absorption

Thiazolidinedione MOA

Improve target cell response to insulin; mechanism is dependent on the presence of insulin for activity

Meglitinides MOA

Stimulate insulin release from beta cells in a glucose-dependent manner

Dipeptidyl Peptidase IV (DPP-4) Inhibitors MOA

Blocks enzyme dipeptidyl peptidase IV or DPP-4, the enzyme responsible for breaking down Incretin hormones such as Glucogon-like peptide-1 (GLP-1) that stimulate insulin producing cells after a meal; It prolongs stimulation of insulin production.

Glucagon-like Peptide (GLP) -1 Agonist Mechanisms of Action

Stimulate glucose-dependent insulin secretion; Decrease glucagon secretion; Slow gastric emptying; Promote satiety and decrease body weight; Improve beta cell function

Amylinomimetic Agent Pramlintide Mechanism of action

Slows the rate at which food is released from the stomach (slows gastric emptying); Prevents postprandial rise of plasma glucagon; Decrease appetite leading to decreased caloric intake and potential weight loss