diabetes mellitus

• Type 1 diabetes is an autoimmune disease that occurs when the body's immune system mistakenly attacks and destroys insulin-producing cells in the pancreas.
• The mechanism of action of SGLT2 inhibitors is to inhibit the reabsorption of glucose in the kidney, making them antidiabetic and altering the physiology of the nephron.
• Vildagliptin is orally administered and increases the risk of heart failure.
• Alogliptin is orally administered.
• Liptin1 is not given to patients with renal problems.
• Linagliptin is orally administered.
• Dulaglutide consists of two GLP-1 analog and DPP4 (dipeptidyl peptidase 4).
• SGLT2 inhibitors have cardiovascular benefit and their side effects include weight loss.
• Albiglutide is a dimer fused to human albumin.
• Sodium Glucose Cotransporter 2 (SGLT2) inhibitors, also known as -Flozin, include Canagliflozin, Empagliflozin, Dapagliflozin, Ertugliflozin, Luseogliflozin, and Tofogliflozin.
• Sitagliptin is orally administered and increases the risk of heart failure.
• Biguanide is used as the first line treatment for Type II DM and its adverse effects are lactic acidosis and diarrhea.
• Phenformin, an older biguanide, has been discontinued due to lactic acidosis and is not used in the market.
• Alpha-glucosidase inhibitors, also known as enzyme inhibitors, inhibit the breakdown of polysaccharides to disaccharides.
• Thiazolidinediones enhance receptor sensitivity to insulin and increase total cholesterol, HDL and LDL without increasing total cholesterol and LDL.
• Rosiglitazone and Pioglitazone are thiazolidinediones.
• For patients with renal impairment or geriatric patients, a lower dose of Mitiglinide is recommended.
• Exenatide, an analog of GLP-1, is an incretin-acting drug.
• Liraglitide, a soluble fatty acid acylated GLP-1 analog, is an incretin-acting drug.
• Mitiglinide is used in Japan and its adverse effect is hypoglycemia which is dose related.
• Incretin-acting drugs, which are secreted in the GI tract, provoke a higher insulin response compared with an equivalent dose given intravenously and stimulate insulin release.
• Alpha glucosidase inhibitors compete with glucose for the intestinal alpha glucosidase enzyme, delaying digestion and absorption of starch, which is a polysaccharide and disaccharide.
• Mitiglinide is not available in the USA and binds to the sulfonylurea receptor same as repaglinide.
• Pharmacology of drugs used in endocrinologic disorders (diabetes mellitus) is discussed in the first semester of the academic year 2022-2023.
• Insulin is violet in color.
• Insulin secretagogues work by inhibiting K+ conductance, leading to an increase in depolarization and stimulation of ATP sensitive K+ channels.
• Mixed insulin contains 70% NPH, 60% NPH, 30% ultra rapid acting (bolus), and 40% RA.
• Sulfonylurea (2nd generation) has greater affinity and is metabolized in the liver.
• The goals of insulin management in glucagonoma are to maintain blood glucose levels between 90-130 mg/dL postprandial and less than 180 mg/dL fasting, and to maintain HbA1C levels below 7%.
• Glucose in the blood undergoes glycolysis, producing pyruvic acid which in turn produces ATP.
• ATP stimulates ATP sensitive K+ channels, preventing potassium from going out of the cell and leading to excitation.
• Oral hypoglycemic agents include sulfonylurea (1st generation), chlorpropamide, tolazamide, acetohexamide, tolbutamide, and acetohydroxamide.
• Sulfonylurea (2nd generation
• Side effects of insulin in glucagonoma include hypoglycemia, diaphoresis, and tachycardia.
• Side effects of insulin include hypoglycemia, diaphoresis, and tachycardia.
• Glucagonoma is characterized by high levels of insulin and glucagon.
• The goals of insulin management are to maintain blood glucose levels between 90-130 mg/dL postprandial and less than 180 mg/dL fasting, and to maintain HbA1C levels below 7%.
• An insulin pen is used for single dose insulin administration in glucagonoma.
• Depolarization, or excitation of cells, occurs when calcium release promotes contraction, squeezing out insulin into the body.
• Sulfonylurea (1st generation) has a long half life, is metabolized in the liver, and its active metabolite is hydroxyhexamide.