What are the long term complications for DM?
CVD, Heart disease, HT, stroke, Kidney damage, Blindness, Neuropathies (Amputation, Impotence, gastroparesis, orthostatic hypotension without reflex tachycardia)
What are the 9 types of insulin?
lispro, aspart, glulisine, Regular insulin, Neutral protamine Hagedorn, detemir, glardine
Which types of insulin are fast but short acting?
aspart, lispro, glulisine
Which type of insulin is around all the time (baseline)?
Which types of insulin can be mixed and how should they be drawn up?
aspart, lispro, and glulisine can be mixed with NPH; draw up short acting first to avoid contamination
What are side effects of insulin?
hypoglycemia, wt gain, atherogenesis, lipodystrophy, allergic rxns
What are oral antidiabetic agent classes?
Sulfonylureas, meglitinides, biguanides, thiazolidinediones, alpha-glucosidase inhibitors, 'gliptins, combo products
How is sulfonylurea used to treat DM?
Promote insulin release (can only be used in type II)
What are the SEs of sulfonylurea?
hypoglycemia, do not use in PG or breastfeeding women
What are the names of drugs in first gen sulfonylurea?
Tolbutamide, acetohexamide, tolazamide, chlorpropamide
What are the names of drugs in second gen sulfonylurea?
Glipizide, glyburide, glimepiride
What are the two meglitinides?
What is unique about metformin?
does not increase insulin secretion, so cannot cause wt gain or hypoglycemia
What are the SE of metformin?
A/N/D/V, decreased absorption of vitamin b12 and folic acid, lactic acidosis (rare)
What is the MOA of thiazolidinediones?
primarily increased peripheral insulin receptor sensitivity but also some suppression of hepatic glycogenolysis (cannot cause wt gain or hyperglycemia)
What are the two thiazolidinedione drugs?
pioglitazone and rosiglitazone ('glitazones)
What are the two alpha-glucosidase inhibitors?
○ Acarbose, migiltol
What are the ADRs of alpha-glucosidase inhibitors?
Gi intolerance due to flatulence, cramps, distention, borborygmy (loud bowel sounds)
What is the brand new class of oral insulin agents?
What are the SE of 'gliptins?
nasopharyngitis, URI, HA, possible immune effects