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Hypoglycaemia: difference between revisions

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Revision 1 — 18:02, 6 Aug 2024
CrudePeptidePearl (talk)
create article — adverse-effect stub
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Revision 2 — 03:47, 10 Aug 2024
RegainRomilly (talk)
add the monitoring recommendation as attributed to the labelling
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11Incretin agonists carry a low intrinsic risk because their action on [[Insulin secretion|insulin secretion]] is glucose-dependent: they amplify a response that glucose has initiated rather than initiating one. Below the glucose threshold for triggering, there is nothing to amplify.{{r|nauck2016}}11Incretin agonists carry a low intrinsic risk because their action on [[Insulin secretion|insulin secretion]] is glucose-dependent: they amplify a response that glucose has initiated rather than initiating one. Below the glucose threshold for triggering, there is nothing to amplify.{{r|nauck2016}}
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+13== Why glucose dependence matters ==
+14The beta cell distinguishes a triggering signal from an amplifying one. Glucose metabolism raises the ATP:ADP ratio, closes potassium channels and admits calcium — the trigger. Incretin signalling raises cAMP, which increases the amount of insulin released per unit of calcium — the amplifier.{{r|nauck2016}}
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+16Sulfonylureas act on the trigger, closing the potassium channel pharmacologically regardless of glucose, which is why they cause hypoglycaemia. Injected insulin bypasses the beta cell entirely.
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13== References ==18== References ==
14{{reflist}}19{{reflist}}