Hypoglycemics: Insulin secretagogues

Hypoglycemics are used to treat high blood sugar, a condition commonly known as diabetes mellitus.

As a quick review, Type 1 diabetes mellitus, which most commonly affects children and adolescents, arises when certain cells of the pancreas known as beta cells are unable to produce enough insulin to maintain normal blood glucose levels.

This is in contrast to Type 2 diabetes mellitus where the body is able to produce insulin, but the tissues don’t respond as well to it, or in other words, these individuals are insulin resistant.

In this video, we’ll be focusing specifically on the use of insulin secretagogues like sulfonylurea for the treatment of Type 2 diabetes.

In general, diabetes mellitus occurs when your body has trouble moving glucose from your blood into your cells.

This leads to high levels of glucose in your blood and not enough in your cells, and remember that your cells need glucose as a source of energy.

So not letting glucose enter, means that the cells starve for energy despite having glucose right on their doorstep.

Insulin reduces the amount of glucose in the blood by binding to insulin receptors embedded in the cell membrane of various insulin-responsive tissues like muscle cells and adipose tissue.

When activated, the insulin receptors cause vesicles containing glucose transporter that are inside the cell to fuse with the cell membrane, allowing glucose to be transported into the cell.

Now in Type 2 diabetes, the body usually makes insulin, but the tissues don’t respond as well to it.

The exact reason why cells don’t “respond” isn’t fully understood, but the cells don’t move their glucose transporters to their membrane in response, which if you remember, is needed for glucose to get into the cell, these cells are therefore insulin resistant.