Welcome to pharmacology by Lecturio. I'm Dr. PJ Shukle and
we're going to be talking about drugs in diabetes today.
When we talk about drugs and diabetes, let's
start off talking about how insulin was discovered.
Let's go back to Canada in 1921. There were 4 important
individuals which led to the discovery of insulin.
The first was Frederick Banting who is a physician
studying at the University of Western Ontario.
The second, was a man by the name of James Collip,
a brilliant biochemist at the University of Alberta.
J. J. R. Macleod was a physiologist who is
working at the University of Toronto.
And finally Charles Best, who was a medical student at the
University of Toronto. Now, Charles Best lost the lottery,
in terms of which job and which research project he was going
to be working for. When he found out that he was going to be
working for Frederick Banting in the summer of 1921, he actually
tried to give away his research clerkship to somebody else.
That other medical student ended up taking a more popular
position, relegating him to the ranks of people we don't know
anything about. Charles Best then, kind of said okay, I'll
work with this guy, we know that he is kind of mean,
and mean spirited but I'll work with him. Together they
isolated insulin and revolutionized they way we look at diabetes.
Prior to 1921, everybody who had diabetes died. These
dicoveries would not have happened without James Collip,
who is the biochemist, who actually helped them synthesize
and isolate this important chemical, this important hormone.
So let's talk about insulin and how it works in the body.
In the liver, it increases glycogen synthesis
and decreases protein catabolism. Now, it uses a
porter called GLUT 2 to move sugar into cell membranes.
There is increased synthesis using pyruvate kinase,
phosphofructokinase and glucokinase.
In the skeletal muscle, insulin inreases glycogen synthesis
and protein synthesis. And it uses the porter GLUT 4,
into the cell membranes. And in the adipose tissue, it increases
triglyceride storage and decreases protein catabolism.
It uses the porter GLUT 4 and moves most sugar into cell
membranes. There is increased synthesis and activity,
in adipose tissue under the influence of insulin
and we use a hormone called lipoprotein lipase.
Now these are things that I want you to remember because
these are things that do get put on exams,
because insulin is so important, the makers of exams want to
make sure that you know, the ins and outs of how it works.