Diabetes Management
About this set
Created by:
ksizemore90 on December 2, 2011
Subjects:
Log in to favorite or report as inappropriate.
Order by
44 terms
Terms | Definitions |
|---|---|
 CAD, PVD, Stroke | What are the macrovascular complications of diabetes? |
| nephropathy, retinopathy, neuropathy | What are the microvascular complications of diabetes? |
| Insulin dep, juvenile onset, 10%, inflammation of islets, prone to DKA, HLA association, no obesity, vascular complications | What is type I diabetes? |
| Not insulin dep, maturity onset, 90%, inability of insulin action, no HLA, obesity is risk factor, vascular complications | What is type II Diabetes? |
| -In type I there is no insulin release -In type II there is a delayed response In a normal patient there is a normal hump In a normal obese patient it has a higher peak | What are the different responses for the glucose tolerance test? |
| oInsulin binds to alpha subunits of insulin receptor to stimulate tyrosine kinase of the beta subunits oGlucose transport proteins are activated and translocated from the cytoplasm to the cell membrane which stimulates glucose entry into the cell | What is the model of insulin action on glucose transport in muscle and adipocytes? |
| oBovine (>antigenic) oPorcine (pig) oRecombinant human | What are the 3 things you can get insulin from? |
| oAdministration: vary rate of absorption by complexing insulin protein oInsulin -> zinc crystals and protamine complex | What affect does the administration of insulin have? |
| oStop getting glucose in the blood oIncrease glucose storing | What are the actions of insulin? |
| absorption of carbs stimulates insulin secretion by beta cells. Hyperglycemia and hyperinsulinemia suppress hepatic glucose production and promote increased uptake of glucose by muscle and other peripheral tissues | What is the pathogenesis of nondiabetics? |
| beta cells, liver, and muscle lead to impaired insulin secretion, increased HGP and decreased peripheral glucose uptake. Resistance to insulin and elevated glucose levels | What is the pathogenesis of diabetics? |
| hypoglycemia, lipodystrophy at injection site, immunopathology | What are the complications of insulin therapy? |
| relieved by glucose administration in severe with 50% glucose IV, 1 mg of glucagon Marked hypoglycemia must be countered by food intake to prevent shock and rebound hyperglycemia; 1-2 injections of short and intermediate establish reasonable blood glucose over 24 hours | What occurs with hypoglycemia and insulin therapy? |
| Insulin allergy: immediate hypersensitivity (bovine or porcine insulin) Immune insulin resistance- patients develop low titre of IgG | What occurs with immunopathology and insulin therapy? |
| Glyburide | What are examples of sulphonylureas? |
| induce insulin from pancreas, reduce serum glucagon, potentiates action of insulin on target tissues | What is the mode of action of sulphonylureas? |
| severe hypoglycemia, N/V, hypersensitivity reactions | What are the adverse drug reactions of sulphonylureas? |
| Type 2 patient who can't get control with diet modifications | What is the indication of sulphonylureas? |
| Metformin | What is the example of biguanides? |
| decrease hepatic glucose production, increase insulin action on peripheral muscle and fat (no effect on pancreas, glucagon, or growth hormones) | What is the mode of action of biguanides? |
| contraindicated in renal impairment and hepatic disease | When are biguanides contraindicated? |
| pioglitazone | What are examples of Thiazolidinediones? |
| nuclear PPAR gamma agonist, bind to PPAR gamma in order to activate insulin responsive genes to regulate carb and lipid metabolism; promotes glucose transport to muscle and tissues, require insulin to be present for their action | What is the mode of action of Thiazolidinediones? |
| edema, severe heart disease (with rosiglitazone) | What are the adverse drug reactions of Thiazolidinediones? |
| monitor LFT in 1st year | What must you monitor with Thiazolidinediones? |
| Sulfonylureas | What drug can Thiazolidinediones be combined with? |
| Acarbose | What is an example of alpha glucosidase inhibitors? |
| reduce intestinal absorption of starch by inhibiting action of enzyme alpha-glucosidase (no effect on insulin release) | What is the mode of action of alpha glucosidase inhibitors? |
| dose related malabsorption, flatulence, diarrhea | What are the adverse drug reactions of alpha glucosidase inhibitors? |
| Significant greater insulin stimulatory effect evoked after an oral glucose load than that evoked from IV glucose when plasma concentrations are matched | What is the incretin effect and GLP1? |
| GLP- 1 agonists and DPP-4 inhibitors | What are the two newer diabetes type II drugs? |
| Exenatide -injectable | What are the examples of GLP-1 agonists? How is it administered? |
| induce insulin release before blood glucose is elevated, increase in beta cell mass, increase insulin secretory capacity | What is the mode of action of GLP-1 agonists? |
| nausea, vomiting, headache | What are the adverse drug effects of GLP- 1 agonists? |
| Sitagliptin | What are the examples of inhibitors of DPP4? |
| inhibit degradation of incretins to increase concentration of GLP-1 | What is the mode of action of inhibitors of DPP 4 |
| orally | How is DPP-4 inhibitors administered? |
| headache, risk of infections | What are the adverse drug reactions of DPP 4 inhibitors? |
| -Lifestyle interventions (at every visit) -Check AIC 1 until <7% (every 3 months then every 6 months once at goal) | How do you monitor Diabetes type II patients? |
| oStep 1: lifestyle and metformin oStep 2: lifestyle + metformin + sulfonylureas oStep 3: lifestyle + metformin + insulin | What are the three steps when treating Diabetes type II patients? |
| -short | What is the duration of Lispro? |
| -intermediate | What is the duration of NPH? |
| •has peak -long lasting | What is the duration of Ultralente? |
| •peakless -long lasting | What is the duration of Glargine? |
First Time Here?
Welcome to Quizlet, a fun, free place to study. Try these flashcards, find others to study, or make your own.