When developing some pharmaceutical strategy that can improve the regulation of

Question

When developing some pharmaceutical strategy that can improve the regulation of blood glucose levels in type2 diabetes describe how your chosen approach would lead to improved regulation of blood glucose levels. Consider the following questions when answering.

Will you attempt to target insulin secretion or insulin sensitivity?

Which receptor, channel, transporter or intracellular factor will be targeted and will it be activated or inhibited?

Explain how targeting this receptor or other factor lead to altered insulin secretion or insulin sensitivity?

Explain how this targeting will lead to improved blood glucose homeostasis.

By considering the action of your targeting at basal glucose, between meals, could there be a risk of hypoglycemia? Describe why?

Explanation / Answer

Diabetes type 2 w main cause is in the inabilty of body cells to use the insulin as they should and hense they fail to uptake glucose from blood stream leading to rise in blood glucose levels . This reduced sensitivity is known as insulin resistance.

Having insulin resitance means the body has a problem in metabolising glucose

The body usually repsonds to low sensitivity to insulin by producin high amount of insulin to normalise the uptake of glucose.

Thus while developing pharmacological stratergy to improve the blood glucose levels , Targeting insuline sensitivity (increased insuline resistance in this case) would be a better approach compaed to insulin secretion.

Reason being that since body is already secreting ore insulin to make up for the lost sensitivity, Increasing insuline secretion furthur through medication would only lead to more insulin in the blood stream (hyperinsulinemia) is known to be associated with damage to blood vessels, high blood pressure, heart disease and heart failure, obesity, osteoporosis and even cancer.

GLUT4 is a insulin responsive facilitative glucose transporter, mediates insulin-dependent glucose uptake.Decreased translocation of this glucose transporter in cell membrane leads to hepatic gluconeogenesis(glucose production from glycogen) and inhibition in the peripheral utilisation of glucose .

it is expressed in adipose, skeletal muscle, and cardiac muscle cells. GLUT4 expression levels are correlated with whole-body insulin-mediated glucose homeostasis. GLUT 4 in skeletal muscle takes in the exogeneous glucose which is oxidised to produce energy

People with insulin resistance tend to gain weight and suffer from carbohydrate cravings that in some cases can be quite intense. They may not feel satisfied if they eat a meal that doesn’t contain carbohydrates, and they may find it difficult to stop eating carbohydrates once they’ve started.Many of these people also suffer from hypoglycemia, a condition that can cause fatigue, anxiety, and shakiness if they don’t eat frequently enough. Thus treating insuline resistance would reduce the chances of Hypoglycemia

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