Class insulin 2
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Class insulin 2

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Class insulin 2 Class insulin 2 Presentation Transcript

  • Dr. RAGHU PRASADA M S MBBS,MD ASSISTANT PROFESSOR DEPT. OF PHARMACOLOGY SSIMS & RC.
  • Exocrine, enzymatic  „Acinar cells Endocrine, hormonal-ISLET OF LANGERHANS  Alpha cells- Glucagon  „Beta cells -Insulin, proinsulin, amylin  „Delta cells -Somatostatin,  F cells- pancreatic polypeptide
  •  „ Regulation of storage and use of carbohydrates, fats and protein within liver, muscle and adipose tissue  „ Facilitation of cellular storage of nutrients following a meal  „ Release of metabolic substrates during fasting
  •  „ Synthesized as a preproinsulin  „ After cleavage of signal sequence proinsulin folds and forms S-S bonds  „ In proinsulin A and B chains are connected by a C peptide  „ Cleavage of C peptide forms final product  „ Species differences: biologic activities overlap but antigenic activities don’t
  •  Chromosome no-11  Involves all steps of protein synthesis. The signal sequence attaches mRNA to REM.  Endopeptidase breaks down the prepro-Ipro-II  Secretory vesicles- Insulin+c peptide+ endopeptidase+Zn.
  •  GLUT-2 present on ß cells,liver, intestine, kidney-facilitated transportation.(B CELL LIKES GLUT2)  GlucoseG -6-Po4glycolysis pathwaypyruvic acid  TCA cycleATP synthesis.
  •  ATP decreases ADP levelsclosing of ATP dependent K channels K inside cell-60mvolts -50mvactivation of voltage dependent Ca channels intracellular Cavesicles move towards membranerelease of insulin. Meglitinides
  • Polypeptide consisting of an A and B chain of 21 and 30 aa  „ Two chains are linked by a pair of S-S bonds  „ An intrachain S-S bond connects 6th and 11th aa within A chain  „ Forms a dimer with 2 Zn ions  Hexameric form
  • RAPID EFFECT  Promotes the uptake & storage of glucose,fats, & protein-effects on liver,muscles and adipose tissue  Carbohydrate Metb lipid metabolism  Protein metabolism LONGTERM EFFECT  Gene transcription  Cell proliferation and differenciation  Protein synthesis  Growth regulation
  •  Promotes Muscle Glucose Uptake and Metabolism  Storage of Glycogen in Muscle  Promotes Liver Uptake, Storage and Use of Glucose Mechanisms:  inactivates liver phosphorylase  causes enhanced uptake of glucose from the blood by the liver cells -by increasing the activity of the enzyme glucokinase
  •  Insulin promotes Fat Synthesis and Storage  Synthesis- Insulin promotes glucose transport through the cell membrane into the fat cells  Storage -Adipose Cells-Insulin inhibits the action of hormone-sensitive lipase  Insulin deficiency  causes increase metabolic use of fat causing lipolysis of storage fat and release of free fatty acids  increase plasma cholesterol and phospholipid  excess usage of fats during insulin lack causes  ketosis and acidosis
  •  insulin promotes protein synthesis and storage  stimulates transport of amino acids into the cells (valine, leucine, isoleucine, tyrosine,phenylalanine)  increases the translation of messenger RNA, forming new proteins  increases the rate of transcription of DNA genetic sequences in cell nuclei  inhibits catabolism of proteins  depresses the rate of gluconeogenesis
  •  Impaired or absent ß cell function:   insulin secretion  The insulin deficiency results in unacceptable blood glucose control
  •  Impaired ß cell function:   insulin secretion  Impaired insulin action:   insulin resistance  Results in unacceptable blood glucose control
  •  Minimizing the complications of diabetes requires:  Early diagnosis and treatment of diabetes  Maintaining HbA1C level < 7%  Achieving HbA1C < 7% requires control of post- prandial and fasting hyperglycemia
  •  Chronic pancreatitis  Chronic drug therapy- glucocorticoids, thiazides, protease inhibitors
  •  Gestational diabetes mellitus  Last trimester of pregnancy
  •  Integrated measure of glycaemic control  Non-enzymatic glycosylation of proteins  Rate of glycosylation is directly proportional to glucose concentration 
  •  Beef insulin  Pork insulin  Insulin by recombinant DNA technology  Human insulin
  •  Proinsulin and insulin  High molecular weight polypeptide  Metabolism  „ Degraded within the liver and kidneys  „80% metabolized in the liver-H.insulinase  „ Half-life of about 5 minutes  „ Degraded by hepatic glutathione insulin dehydrogenase  „ Enzyme disrupts S-S bonds
  •  Insulin lispro  Insuin aspart  Insulin glulisine-CSII  Rapid absorption from subcutaneous tissue
  •  Regular insulin  Prompt insulin-Zn suspension  recombinant DNA tech  NPH or isophane insulin Intermediate acting insulin  NPH or isophane insulin  Rapid absorption and sustained action
  • INSULIN GARGINE  Long acting insulin analogue  Soluble at pH 4 INSULIN DETRIMER  Has fatty acid side chain  Slow and sustained release
  •  Type 1 DM  Diabetic keto acidosis  Non-ketotic hyperglycemia
  •  Hypoglyceminia  Lipodystrophy  Allergic manifestations  Insulin resistance >100 units/day THANK YOU