Diabetes pharma

• What is the healthy fasting blood glucose range?

  1. 0 – 5.4 mmol/L
• What is the glycated haemoglobin (HbA1c) target for at-risk diabetes?

  Aim below 42 mmol/mol (6%)
• What is the glycated haemoglobin (HbA1c) target for diabetics?

  Aim below 48 mmol/mol (6.5%)
• What are the two peptide chains in proinsulin joined by?

  Disulphide bridges

  
• How is recombinant human insulin administered?

  Parenterally, commonly subcutaneously
• What is the concentration of recombinant human insulin in insulin syringes?

  100 units/ml
• What is a rare allergic reaction associated with recombinant human insulin?

  Reduced immunogenicity
• What is the prescribed dosage of insulin based on?

  Hypoglycaemic activity in rabbits
• What are the main types of insulins used in diabetes treatment?

  • Rapid-acting Insulins
  • Intermediate Insulins
  • Long-acting Insulins

  
• What is the onset action time for soluble insulin?

  30-60 minutes

  
• What is the peak action time for soluble insulin?

  1. 4 hours

  
• What is the duration of action for soluble insulin?

  Up to 8 hours

  
• What is lipodystrophy in relation to insulin injections?

  Varying injection sites
• When should insulin doses be increased?

  During pregnancy
• When should insulin doses be reduced?

  In hepatic/renal impairment
• What is a potential risk of tight control of blood sugar?

  Reduced warning signs of hypoglycaemia
• What are the characteristics of rapidly acting insulins?

  • Avoid insulin dimer/hexamer formation
  • Faster onset, shorter duration
  • Inject directly before a meal
• Name a rapidly acting insulin.

  Insulin lispro
• What is the formulation of intermediate insulins?

  Isophane insulin suspension with protamine

  
• What is the duration of action for insulin glargine?

  18-24 hours

  
• What is the half-life of insulin detemir?

  1. 8 hours
• What is the mechanism of action for insulin glargine?

  Aggregates form at neutral pH
• What is the effect of insulin degludec?

  Ultra-long acting insulin
• What are the major complications of diabetes?

  • Diabetic Neuropathy
  • Diabetic Retinopathy

  
• What is the treatment for diabetic neuropathy?

  Tight control of blood glucose
• What is the role of glucagon in hypoglycaemia?

  Counteracts low blood sugar levels
• What are the drugs that induce insulin release?

  • Sulphonylureas
  • Meglitinides
  • Gliptins
• What is the mechanism of action for sulphonylureas?

  Stimulates insulin release from pancreas
• What is the commonest adverse effect of sulphonylureas?

  Hypoglycaemia
• What is the pharmacokinetics of sulphonylureas?

  Liver metabolism, renal excretion
• What is the role of incretins in glucose homeostasis?

  Increase insulin and decrease glucagon

  
• What do DPP-4 inhibitors do?

  Increase GIP/GLP-1 levels
• What is the mechanism of action for metformin?

  Activates AMPK and inhibits gluconeogenesis

  
• What are the adverse effects of metformin?

  Diarrhoea, vomiting, lactic acidosis

  
• What is the target tissue for pioglitazone?

  Adipose tissue, muscle, liver
• What is the mechanism of action for pioglitazone?

  Increases sensitivity to insulin
• What do gliflozins inhibit?

  SGLT2
• What is the effect of gliflozins on glucose?

  70g glucose loss/day
• What are the adverse effects of gliflozins?

  Dehydration, hypotension, worsened UTI
• What are the important drugs in diabetes treatment?

  1. Insulins (15%)
  2. Insulin release (30%)
  3. Insulin resistance (50%)
  4. Glucose excretion (5%)