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Pharmacology - Diabetes (Increasing Insulin Sensitivity useful for T2 DM…

- - - - Clinical Cases
        
        Clinical Case
        
        Notes:
        
        note that
        
        Clinical Case
        
        Pioglitazone Clinical Case
        
        Notes
        
        Pioglitazone is a Thiazolidindione = TZD
        
        think Pioglitazone = TZD patients get "TEASED because they get fat"
        --> pioglitazone and other TZD's increase differentiation of preadipocytes into adipocytes and activity of PPAR-gamma
        --> this increases the uptake of FAs?
        
        TZDs also increase the expression of Glucose-type 4 receptors that increase glucose uptake in liver and muscle cells
      - PPAR family = TZD's / Thiazolidinediones and Fibrates
        
        both fibrates and TZDs lower FFAs by increasing their uptake into addipose cells
        --> fibrates work on PPAR - alpha
        --> TZDs work on PPAR - gamma
        
        fat people with diabetes and large THY SIZE ... dancing at the PPARty FIBRATE the floor
        
        TZD and Fibrates both work on PPAR to increase FFA uptake and lower insulin resistance
- - - - Insulin resistance - higher baseline normal glucose response Case
        
        Notes
        
        note that in a glucose challenge you can have a normal glucose response even when there is insulin resistance
        --> normal glucose challenge meaning the levels don't rise above 140 mg/dL or 11 mmol/L
        
        but you must recognize signs of insulin resistance
        --> look at the baseline of the insulin before the challenge
        --> if baseline is raised, this means there is insulin restance since body needs higher levels to get a response