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Paper II — 2019 July (Supplementary) (2010 Scheme) — Q1

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Paper II
2019 July (Supplementary) (2010 Scheme)

Question

Enumerate the newer insulin analogues. What is the advantage of using insulin analogues over conventional insulin. How will you manage insulin resistance. (2+2+2)

Q16 marksEssays

Answer

Newer insulin analogues

  • Rapid-acting: Insulin lispro, Insulin aspart, Insulin glulisine
  • Long-acting: Insulin glargine, Insulin detemir, Insulin degludec

Advantages over conventional (human/regular/NPH) insulin

  • Rapid-acting analogues: faster onset and shorter duration → better postprandial glucose control, less late postprandial hypoglycaemia, can be given immediately before meals
  • Long-acting analogues: provide a steady, peakless basal insulin level → lower risk of nocturnal hypoglycaemia, once-daily dosing

Management of insulin resistance

  • Lifestyle modification: weight reduction, regular exercise, dietary changes
  • Metformin: first-line, improves peripheral insulin sensitivity
  • Thiazolidinediones (Pioglitazone): improve insulin sensitivity via PPAR-γ activation
  • Higher insulin doses or concentrated insulin formulations (e.g., U-500) may be required in severe resistance
  • Address underlying contributing factors (obesity, PCOS, medications causing insulin resistance)
  1. 1Diabetes Mellitus and Oral Hypoglycaemic Drugs

Other Years Asked

  1. 1Classify Oral antidiabetic drugs. Discuss in detail any one group. Describe briefly Human insulin. Discuss the management of Diabetic Ketoacidosis. (4+3+4+4)2023 January (Supplementary) (2019 Scheme)Essay · 15 marks
  2. 2(2022 February (2019 Scheme)Essay · 15 marks
  3. 3m2. He was asymptomatic and investigations revealed no end organ damage. He was advised suitable diet, exercise and other lifestyle modifications.2024 December (Supplementary) (2019 Scheme)Essay · 10 marks
  4. 4(2024 March (Supplementary) (2019 Scheme)Essay · 10 marks
  5. 5(2024 June (Supplementary) (2019 Scheme)Short Essay · 8 marks
  6. 6(2022 February (2019 Scheme)Short Essay · 8 marks
  7. 7Classify Oral anti diabetic drugs. Write the MOA and adverse effects of sulfonyl urea. (2+2+2)2023 March (Supplementary) (2010 Scheme)Essay · 6 marks
  8. 8Classify oral anti diabetic drugs and explain the mechanism of action of any two groups. Mention one insulin analog and list one advantage of it over conventional insulin (2+3+1=6)2016 October (Supplementary) (2010 Scheme)Essay · 6 marks
  9. 9Classify oral hypoglycemic agents. Explain the mechanism of action and adverse effects of any one group. (2+2+2)2017 August (Supplementary) (2010 Scheme)Essay · 6 marks
  10. 10A 25years old insulin dependent diabetes mellitus patient develops sweating, anxiety, palpitations and tremors after performing vigorous exercise. Answer the following:2016 February (2010 Scheme)Essay · 6 marks
  11. 11Classify Oral Anti diabetic drugs. Describe the mechanism of action, therapeutic uses and adverse effects of Metformin. (2+2+1+1)2. A 30 years old male patient admitted to hospital with a complaint of fever with chills since 5 days. Severe headache and yellowish discolouration of conjunctiva present. He is drowsy and irritable. Peripheral smear shows gametocytes of plasmodium falciparum. He is using chloroquine since onset of fever but fever not subsided.2021 May (Supplementary) (2010 Scheme)Essay · 6 marks
  12. 12Classify oral hypoglycemic drugs. Explain the mechanism of action, uses and side effects of sulfonylureas. (2+2+1+1)2018 February (2010 Scheme)Essay · 6 marks
  13. 13dl, HbA1c was 8%. A diagnosis of Type 2 diabetes was made….2024 March (Supplementary) (2010 Scheme)Essay · 6 marks
  14. 14dL, glycosylated hemoglobin (HbA12025 August (Supplementary) (2010 Scheme)Essay · 6 marks
  15. 15Enumerate insulin analogues and tabulate their pharmacokinetic characteristics.2025 March (Supplementary (SAY)) (2019 Scheme)Short Answer · 4 marks
  16. 16Classify insulins according to the duration of action giving suitable examples.2024 December (Supplementary) (2019 Scheme)Short Answer · 4 marks
  17. 17Metformin.2022 July (Supplementary) (2019 Scheme)Short Answer · 4 marks
  18. 18Alpha glucosidase inhibitors2014 March (2010 Scheme)Short Note · 3 marks
  19. 19Insulin analogues.2013 September (Supplementary) (2010 Scheme)Short Note · 3 marks
  20. 20Vildagliptin2021 February (Supplementary) (2010 Scheme)Short Note · 3 marks
  21. 21Dipeptidyl peptidase 4 (DPP-4) inhibitors2021 December (Supplementary) (2010 Scheme)Short Note · 3 marks
  22. 22Sulfonylureas in type II diabetes mellitus.2017 February (2010 Scheme)Short Note · 3 marks
  23. 23Short acting insulin analogues2022 May (Supplementary) (2010 Scheme)Short Note · 3 marks
  24. 24Insulin analogs2013 April (2010 Scheme)Short Note · 3 marks
  25. 25Newer Insulins2023 July (Supplementary) (2010 Scheme)Short Note · 3 marks
  26. 26Dipeptidyl Peptidase 4 inhibitors2022 October (Supplementary) (2010 Scheme)Short Note · 3 marks
  27. 27Metformin2021 December (Supplementary) (2010 Scheme)Short Answer · 1 mark
  28. 28Insulin used in diabetic ketoacidosis2018 July (Supplementary) (2010 Scheme)Short Answer · 1 mark
  29. 29Longest acting insulin given as once daily dose2015 February (2010 Scheme)Short Answer · 1 mark
  30. 30Insulin analogues2017 August (Supplementary) (2010 Scheme)Short Answer · 1 mark
  31. 31Peroxysome proliferator activated receptor gamma agonists2015 February (2010 Scheme)Short Answer · 1 mark
  32. 32Metformin2023 July (Supplementary) (2010 Scheme)Short Answer · 1 mark
  33. 33Metformin2024 August (Supplementary) (2010 Scheme)Short Answer · 1 mark
  34. 34Short acting insulin analogues2024 March (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  35. 35Short acting Insulin analogues2025 August (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  36. 36Long acting Insulin analogues2024 August (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  37. 37 Lente insulin in diabetic ketoacidosis Name the following (Two examples for each) (5x1=5)2021 December (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  38. 38Long acting Insulin analogs2023 July (Supplementary) (2019 Scheme)Short Answer · 0.2 marks
  39. 39Sitagliptin for insulin resistance in a diabetic patient.2024 March (Supplementary) (2019 Scheme)Short Answer · 0.2 marks

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