PHAR 441 Lecture Notes - Lecture 13: Weight Loss, Repaglinide, Bariatric Surgery
10 Dec 2016
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Nutrition 3-5% weight loss significantly improves glycemic control. 30 mins of brisk walking 5 times a week. Benefits = increased insulin sensitivity, increased glucose uptake in muscle and other tissues. Cdc: initiate antihyperglycemic drug therapy if a1c >8. 5% or after 2-3 months of unsuccessful lifestyle management. 1st gen (tolbutamide) = less potent and increased risk of cv events caution in pts with cvd. 2nd gen sus (gliclazide, glyburide, and glimepride) are preferred increased efficacy, decreased side effects. Sus bind to the sur k+-atp channel closes depolarization of the membrane voltage-gated ca2+ channels open = ca2+ triggers movement of insulin granules to the cell surface insulin is released to circulation. I(cid:374)effe(cid:272)ti(cid:448)e i(cid:374) the a(cid:271)se(cid:374)(cid:272)e of fu(cid:374)(cid:272)tio(cid:374)i(cid:374)g -cells work best in the early stages of t2d and have a high failure rate. Efficacy decreases fbg by 3. 3-3. 9 mmol/l; decreases a1c by 1-1. 5% Most commonly used su; given with breakfast or the fist main meal of the day.
