Essay On Diabetes & Thyroid

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Diabetes & Thyroid

Insulin

Insulin plays a key role in the conversion of fuels for oxidation or storage. It controls intermediary metabolism in the body. Insulin has metabolism effects on lipids and carbohydrates. Further, it also helps in mineral and protein metabolism.

What is the mechanism of action of insulin?

Insulin receptors are located inside plasma membrane. The insulin receptor comprises of duo alpha subunits. These alpha chains are extracellular and they contain many insulin binding domains. This insulin receptor acts as an enzyme that mobilizes phosphate groups to intracellular target proteins. These proteins are initially located in ATP phosphate groups. Thus, insulin stimulates uptake, storage and utilization of glucose. This glucose is stored in the form of glycogen. Further, insulin synthesizes fatty acids in the liver (Saltiel & Pessin, 2011).

What are the differences in insulin therapy and type 1 and type II diabetes mellitus?

Insulin is very vital in the body. This is because metabolizes glucose, which can be used by the body. Further, it eliminates excess glucose from the body. If one’s body produces little or no insulin, then this is diagnosed as type 1 diabetes. Further, if one’s body cannot utilize the insulin it makes, this condition is known as type II diabetes (Saltiel & Pessin, 2011).

What is an incretin and how it is currently utilized for drug therapy in diabetes mellitus?

Incretins are hormones found in the body, which facilitate the secretion of insulin. There are two types of incretin hormones; gastric inhibitory peptide and glucose-like peptide-1. An increase in the glucose concentration in the blood causes incretin hormonal response. Incretin therapy helps in treating type II diabetes mellitus. Type II diabetes mellitus can be cause by a deficiency of insulin secretion by the body, thus incretin therapy is used to improve this condition. Consequently, incretins trigger insulin secretion in manner that is glucose dependent. Moreover, incretin stimulates inhibition of glucagon secretion. This reduces the level of blood sugar levels in the body (LeRoith, Taylor & Olefsky, 2012).

What is the mechanism of action for metformin?

Metformin improves the level of glucose tolerance among type II diabetes patients. It lowers both postprandial and basal plasma. Metformin works by increasing insulin sensitivity in the body and decreases the intestinal absorption of glucose (LeRoith, Taylor & Olefsky, 2012).

Why does metformin not cause hypoglycemia?

Metformin only causes little insulin sensitivity in the peripheral tissues and liver. The drug cannot affect the pancreas directly. Thus, it does not take part in stimulation of insulin secretion (Saltiel & Pessin, 2011).

What are the indications and contraindications?

Metformin is considered as a first drug choice for type II diabetes treatment. The drug is shown to reduce postprandial blood and fasting glucose. Further, metformin does not interact with sulfonylureas. Sulfonylureas causes hypoglycemia (LeRoith, Taylor & Olefsky, 2012).

What is potentially deadly adverse effect of biguanide therapy and how can this be avoided?

Biguanide therapy has various side effects such as coughing, lower back pains, muscle pains, diarrhea, loss of appetite, chills and fever among others. Deadly cases can lead to blurred vision, headaches, depression and coma. However, these symptoms can be avoided by close monitoring of ketones, blood glucose and electrolytes in the patient’s body (LeRoith, Taylor & Olefsky, 2012).

What are the mechanisms of action of sulfonylureas?

Sulfonylureas are used to treat non-insulin dependent mellitus. These drugs have hypoglycaemic effects, which stimulate insulin secretion in the pancrease. The sulfonylureas receptors have close molecular mechanisms with K-ATP channels. This leads to insulin release in the body (Saltiel & Pessin, 2011).
What are the side effects and precautions of sulfonylurea?

Sulponylureas can lead to hypoglycemia, skin rashes, stomach aches and weight gains. Further, these drugs can lead to high levels of fluid retention, respiratory infections and liver failure in some cases (Saltiel & Pessin, 2011).

Can these drugs be used with other classes of oral agents?

Sulfonylureas can be used in combination therapy with other oral agents. For instance, glucovate is a diabetes pill that contains both glyburide, which is a sulfonylurea, and metformin (LeRoith, Taylor & Olefsky, 2012).

References

Saltiel, A. R., & Pessin, J. E. (2011). Mechanisms of insulin action. Austin, Tex: Landes Bioscience.
LeRoith, D., Taylor, S. I., & Olefsky, J. M. (2012). Diabetes mellitus: A fundamental and clinical text. Philadelphia: Lippincott Williams & Wilkins.

Question 2

Summarize the biosynthesis of the thyroid hormones

Synthesis of thyroid hormones entails the conversion of iodide to iodine. This iodine is then transformed into tyrosine residues that are located along the thyroglobulin. The reaction results into formation of iodothyroglobulin. Moreover, when iodothyrosine molecules are combined they form T3 and T4 hormones. T4 is formed when two di-iodotyrosine molecules bind together, whereas T4 is formed by combination of mono-iodotyrosine and di-iodotyrosine (Brophy, 2011).

What are the different roles of T3 and T4

These thyroid hormones help in the conversion of calories and oxygen to energy. However, T3 is thrice as strong as T4. Both of these hormones are present in the serum. T4 molecules are more tightly bound to the plasma proteins than T3. Therefore, this makes T4 more available for cellular uptake than T3. However, T3 is able to bind nuclear receptors more than T4. Thus, T3 is more rapid and active than T4 (Brophy, 2011).

How does the presentation of thyroid hyperfunction differ from hypofunction?

Hormones are responsible for the regulation of body functions. Hyperthyroidism is where the is excess thyroid hormone in the body. On the other hand, hypothyroidism is were there is redundant thyroid hormone in the body. Symptoms of hypothyroidism include dry skin, fatigue, weight gain and fever. Moreover, hyperthyroidism leads to weight loss, seating, irregular menstrual patterns, increase appetite and tachycardia (Brophy, 2011).

How a patient receiving thyroid hormone replacement therapy should be monitored?

Patients undergoing thyroid hormone replacement should receive frequent monitoring of the TSH levels. This should be done for relatively five months. In addition, symptoms should be monitored every month until they return to stable levels. Patient follow-up program should be done annually to ensure positive patient progress (Brophy, 2011).

References

Brophy, K. (2011). Clinical drug therapy for Canadian practice. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.