Hypoglycaemia: difference between revisions
Diff·revision 3 → 4·10:26, 5 Sep 2024
Difference between revision 3 and revision 4 of Hypoglycaemia. 2 lines changed; the page grew by 235 bytes.
| Revision 3 — 06:20, 17 Aug 2024 BiliaryBea (talk) expand §Why glucose dependence matters 1,779 bytes ±0 | Revision 4 — 10:26, 5 Sep 2024 MTC_Marisol (talk) add the interaction with the mechanism that explains it 2,014 bytes +235 | ||
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| 11 | Incretin 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}} | 11 | Incretin 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}} |
| 12 | 12 | ||
| + | 13 | Risk arises when they are combined with agents that are not glucose-dependent — insulin and sulfonylureas — and the usual response on initiating an incretin agonist alongside either is to reduce the background agent.{{r|ada2024}} | |
| + | 14 | ||
| 13 | == Why glucose dependence matters == | 15 | == Why glucose dependence matters == |
| 14 | The 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}} | 16 | The 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}} |