Chapter 32- Antidiabetic Drugs Flashcards
Diabetes Mellitus
A complex disorder of carbohydrate, fat, and protein metabolism resulting primarily from the lack of insulin secretion by the B-cells of the pancreas or from defects in the insulin receptors. There are type 1 and type 2 diabetes.
Diabetic ketoacidosis (DKA)
Severe metabolic complication of uncontrolled diabetes, which,if untreated, leads to diabetic coma and death.
Gestational diabetes
Diabetes that develops during pregnancy. May resolve after pregnancy but may also be a precursor of type 2 diabetes.
Insulin must be given to prevent birth defects.
Glucagon
Hormone produced by the a-cells in the islets of Langerhans that stimulates the conversion of glycogen to glucose in the liver
Glucose
A simple sugar that serves as a major source of energy
Glycogenolysis
The breakdown of glycogen to glucose
Hemoglobin A1C (HbA1c)
Hemoglobin molecules to which glucose molecules are bound; blood levels of hemoglobin A1C are used as a diagnostic measurement of average daily blood glucose in the monitoring of diabetics
Hyperglycemia
A fasting blood glucose level of 7mmol/L or higher or a non fasting blood glucose level of 11.1mmol/L or higher
Hyperosmolar nonketotic syndrome (HNKS)
A metabolic complication of uncontrolled diabetes, similar in severity to DKA but without ketosis and acidosis.
Hypoglycemia
Blood glucose level less than 2.8mmol/L.
Mild cases treated with diet.
Early symptoms: confusion, irritability, tremor, sweating. Later symptoms: Hypothermia, seizures, coma and death will occur if not treated.
Imparied fasting glucose level
A pre diabetic state defined as a fasting glucose level of at least 6.1mmol/L but lower than 6.9mmol/L; prediabetes
Insulin
A naturally occurring hormone secreted by the B-cells of the islets of Langerhans in the pancreas in response to increased levels of glucose in the blood.
Ketones
Organic chemical compounds produced through the oxidation of secondary alcohols (fat molecules) including dietary carbohydrates
Polydipsia
Chronic excessive intake of water; it is a common symptom of diabetes
Polyphagia
Excessive eating; common symptom of diabetes
Polyuria
Increased frequency or volume of urinary output; common symptom of diabetes
Type 1 diabetes mellitus
Genetically determined autoimmune disorder involving a complete or nearly complete lack of insulin production; most commonly develops in children or adolescents.
Type 2 diabetes mellitus
Most commonly presents in middle age. Disease may be controlled by lifestyle modifications, oral drug therapy, insulin, or a combination of these measures, but patients are not necessarily dependent on insulin.
Long term complications of Diabetes
Macrovascular: atherosclerotic plaque. Coronary arteries, cerebral arteries, peripheral vessels.
Microvascular: capillary damage. Retinopathy, neuropathy, nephropathy (kidney damage)
Acute complications of Diabetes
Diabetic ketoacidosis- Life Threatening!: Extreme hyperglycaemia, presence of ketones in serum, acidosis, dehydration, electrolyte imbalances.
Hypersmolar nonketotic syndrome: Triggered by extreme hyperglycaemia, precipitated by physical or emotional stress. Treated with IV fluids and electrolyte replacement, Insulin therapy.
Insulins
Substitute for endogenous hormone and has same effects as normal endogenous insulin.
Restore the diabetics patients ability to metabolize carbs, fats and proteins. Store glucose in the liver and convert glycogen to fat storage
Most now use recombinant DNA technologies
Aim to reduce the incidence of long-term complications
Rapid Acting insulins
10-15 minutes. Shorter duration. Given SubQ or infusion pump but not IV.
Ex) Insulin aspart (NovoRapid), insulin lispro (Humalog)
Short Acting Insulins
Onset 30-60 minutes. Ex) Regular insulin (Humulin R)-only one given IV and (Toronto)
Intermediate Acting Insulin
NPH (Humulin-N)
Cloudy appearance. Slower in onset and more prolonged duration
