A 55‑year‑old male with type 2 diabetes is started on a sulfonylurea drug. (a) Explain how sulfonylureas stimulate insulin release from pancreatic β‑cells. (b) Mention one common adverse effect of sulfonylureas and a dietary recommendation to manage it.
Answer
Sulfonylureas close ATP‑sensitive K⁺ channels, depolarising the β‑cell membrane, opening voltage‑gated Ca²⁺ channels, and triggering insulin exocytosis. The common adverse effect is hypoglycaemia; it is managed by limiting simple carbohydrates and eating balanced meals at regular intervals.
Step-by-step solution
- Explain the drug target: ATP‑sensitive K⁺ channel in β‑cells.
- Describe channel closure and resulting membrane depolarisation.
- State that depolarisation opens Ca²⁺ channels and Ca²⁺ influx stimulates insulin release.
- Identify hypoglycaemia as a frequent side effect of sulfonylureas.
- Propose a dietary measure: limit simple sugars and ensure regular balanced meals to prevent hypoglycaemia.
Common mistake: Attributing insulin release to β‑cell proliferation rather than membrane depolarisation
Concept tested: Mechanism and side‑effects of sulfonylureas
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