8 Week Handout
TA: Manely Leilah Yafeh
1. List the main symptoms of Type 1 Diabetes. What are the main differences between Type 1 and
Type 2 Diabetes?
2. What treatment options are available for Type 1 and Type 2 Diabetes? What is the purpose of
testing for glycated hemoglobin levels?
Drug Class
Effect
Sulfonylureas and Meglitinides
Stimulate insulin
secretion
Decrease intestinal
glucose uptake
Decrease hepatic
gluconeogenesis
Adiponectin, Resistin
plasma glucose and
weightloss
insulin secretion and
gastric delay
-Glucosidase Inhibitors
Biguanides (e.g. Metformin)
PPAR Activators ("Glitazones")
Incretin (GIP, GLP-1) Analogs
Dipeptidyl peptidase-4 (DPP-4)
Inhibitors
Mechanism of
Action
Block KATP
channels
Inhibit
disaccharidases
Activate protein
kinase
Activate PPAR
Insulin
Glucagon
Half-life of
incretins
Glycated hemoglobin levels give long-term measure of blood glucose levels in a period of six months.
Therefore, tests the effectiveness of drug treatment.
3. What is Metabolic Syndrome? Why is there a link between central obesity and the development
of Type 2 Diabetes?
Metabolic Syndrome is a state of pre-type II diabetes. When visceral fat increases, the synthesis of TNF-
increases. TNF- causes insulin receptor desensitization. Also, increased visceral fat leads to altered
adipokine in secretion that theres increased resistin and decreased adiponectin secretion.
4. Compare the Glucose Tolerance Test results of a normal subject, a Metabolic Syndrome patient,
and a diabetic patient. Can you differentiate between Type 1 and 2 Diabetes based on the results
from a Glucose Tolerance Test?
No, you cant differentiate between type 1 and type 2 diabetes based on the results of the glucose
tolerance test.
5. How does glucagon protect against hypoglycemia? What are the symptoms of hypoglycemia?
Glucagon works via a Gs receptor on heptocytes to increase glycogenolysis; PKA activates
phosphorylase kinase, which activates glycogen phosphorylase, which hydrolyzes glycogen, and results
in glucose -1-phosphate, which is isomerized to glucose 6 phosphate via hexokinase. Glucose 6
phosphate is the first substrate for glycolysis; The liver has glucose 6 phosphatase, which produces pure
glucose, which can diffuse out of GLUT2 channels into the circulatory system
Symptoms of hypoglycemia:
1) Increased Sympathetic Activity: Tachycardia/Palpitations, sweating, subcutaneous
vasoconstriction (pale)
2) Sleepiness/Irritability
3) Headache
4) Nausea/Vomiting
5) Depression of the Nervous System:Confusion/Abnormal Behavior
6) Blood glucose less than 40 mg/dL leads to seizures, coma, death