Question 1

Glugagon-like peptide type 1 (GLP-1)receptor agonists such as exenatide (Byetta)and liraglutide (Victoza)sensitize pancreatic ____ cells so that a relatively greater amount of _____ is released when these cells sense a rise in blood glucose.

A) alpha; insulin
B) beta; insulin
C) alpha; glucagon
D) beta; glucagon
E) delta; somatostatin

beta; insulin

Accepted Answer

GLP-1 receptor agonists sensitize pancreatic beta cells so that a relatively greater amount of insulin is released when these cells sense a rise in blood glucose.

Question 2

Drugs that stimulate insulin secretion (e.g.,sulfonylureas)or increase tissue sensitivity to insulin (e.g.metformin)&#10;A) are used to treat patients with poor glucagon production&#10;B) are effective in some patients with Type I diabetes.&#10;C) are effective in some patients with Type II diabetes.&#10;D) all the above are true&#10;E) none of the above are true; these drugs have no clinical indications

Accepted Answer

Drugs that stimulate insulin secretion (sulfonylureas) or increase tissue sensitivity to insulin (metformin) are effective in some patients with Type II diabetes. They are not used to treat patients with poor glucagon production or effective in some patients with Type I diabetes. Therefore, option C is the correct answer.

Question 3

Insulin _____ the storage of glucose in skeletal muscle and other tissues,thereby _____ plasma glucose levels after a meal.&#10;A) increases; increasing&#10;B) increases; decreasing&#10;C) decreases; increasing&#10;D) decreases; decreasing&#10;E) none of the above are true

Accepted Answer

Insulin increases the storage of glucose in skeletal muscle and other tissues, thereby decreasing plasma glucose levels after a meal.

Question 4

At the present time,insulin must be administered by parenteral (non-oral)routes because&#10;A) insulin will irritate the stomach&#10;B) insulin will be destroyed during &#34;first-pass&#34; metabolism in the liver&#10;C) the insulin molecule is too large to be absorbed through the gastrointestinal wall&#10;D) all the above are true&#10;E) none of the above are true

Accepted Answer

Insulin is a protein, and if taken orally, it would be broken down by the digestive enzymes in the stomach and intestine, similar to any other protein we consume. Therefore, it cannot be absorbed effectively through the gastrointestinal wall to exert its effects. The primary reason it's administered through parenteral routes (such as injections) is because the insulin molecule is too large to be absorbed through the gastrointestinal wall, not because it irritates the stomach or due to first-pass metabolism in the liver.

Question 5

All of the following are characteristics of type I diabetes mellitus EXCEPT&#10;A) disease onset usually occurs in childhood&#10;B) body weight is usually at or below normal levels&#10;C) pancreatic insulin production is low or absent&#10;D) tissue sensitivity to insulin is low&#10;E) diet and exercise are used in conjunction with drug therapy to maintain optimal health

Accepted Answer

In type I diabetes mellitus, tissue sensitivity to insulin is usually normal or high. It is the lack of insulin production by the pancreas that is the primary issue in type I diabetes. The other characteristics listed are correct for type I diabetes.

Question 6

The primary problem in type 2 diabetes is _____.&#10;A) decreased release of glucagon from pancreatic alpha cells&#10;B) increased release of glucagon from pancreatic alpha cells&#10;C) decreased sensitivity of peripheral tissues to circulating insulin&#10;D) increased sensitivity of peripheral tissues to circulating insulin&#10;E) decreased production of antidiuretic hormone

Accepted Answer

Type 2 diabetes is characterized by decreased sensitivity of peripheral tissues to circulating insulin, a condition called insulin resistance. This results in impaired glucose uptake by cells and increased glucose levels in the bloodstream.

Question 7

People who are on insulin therapy for diabetes mellitus are more at risk for hypoglycemia if&#10;A) they administer too much insulin&#10;B) they skip a meal&#10;C) they exercise too strenuously&#10;D) all the above are true&#10;E) none of the above are true

Accepted Answer

People on insulin therapy for diabetes mellitus are at risk for hypoglycemia if they administer too much insulin, skip a meal, or exercise too strenuously. These factors can all contribute to a drop in blood sugar levels, which can be dangerous for individuals on insulin therapy. It is important for individuals with diabetes to carefully monitor their insulin doses, eat regular meals, and engage in moderate exercise to avoid hypoglycemia.

Question 8

Certain forms of biosynthetic insulin are absorbed more rapidly than regular human insulin because&#10;A) other substances such as acetate or protamine have been added to the insulin molecule in increase absorption&#10;B) zinc has been added to the insulin molecule to increase absorption&#10;C) newer forms of biosynthetic insulin can be administered orally via slow-release or sustained-release preparations&#10;D) the amino acid sequence of the insulin molecule has been altered to allow more rapid absorption&#10;E) none of the above are true

Accepted Answer

The amino acid sequence of the insulin molecule has been altered to allow more rapid absorption. Certain forms of biosynthetic insulin, like rapid-acting insulin analogs, have been developed with altered amino acid sequences to increase their absorption rate and onset of action. Zinc or other substances like acetate or protamine may also be added to insulin to alter its absorption rate, but these are not the primary reasons for the more rapid absorption of certain biosynthetic insulin forms. Additionally, insulin cannot be administered orally via slow-release or sustained-release preparations as it would be broken down by digestive enzymes before it could be absorbed into the bloodstream.

Deck 32: Pancreatic Hormones and the Treatment of Diabetes Mellitus