Diabeetus Flashcards
Type 1 diabetes
insulin-dependent, loss of beta cells. 5-10% of diabetics
Type 2 diabetes
insulin-independent, decreased response to insulin, 85-90% of diabetics
Type 3 diabetes
caused by gene mutations
Type 4 diabetes
gestational diabetes (4% of all pregnancies)
Central goal of DM therapy
correct hyperglycemia and maintain BGL near normal range. preventing, delaying, or reducing complications, minimizing side effects of therapy, and improving quality of life
non-pharmological approaches to treatment
diet and exercise: large reduction in type 2 incidence
what stimulates insulin release?
glucose, which stimulates depolarization of beta cells through closing K+ channels, causing the opening of Ca2+ channels
what does insulin do?
stimulates the production of triglycerides in adipose tissue, stimulates the production of glycogen in liver cells, and stimulates the production of protein in muscles
types of insulin
rapid acting, short acting, intermediate acting, and long acting
rapid-acting
peak in 30 min-2 hrs, can be injected or inhaled
inhaled insulin (Exubera)
used in combination with other insulin in Types 1 and 2 or alone in Type 2. contraindicated in smokers, not recommended for asthma or COPD patients. side effects are cough, shortness of breath, hypoglycemia
oral hypoglycemic agents
Sulfonylureas and meglitinides; act to increase the levels of insulin
sulfonylurea mechanism of action
block K+ channels, causing beta cell depolarization
prototypical sulfonylureas
tolbutamide (1st gen,~8hr duration) and glyburide (2nd gen, ~12-24 hr duration)
sulfonylurea contraindications
sulfa drug alerrgy, pregnancy, major stress (surgery, trauma, infection)
sulfonylurea side effects
hypoglycemia, weight gain, rash, elevated liver enzymes, allergic reaction
Meglitinides mechanism
inhibition of K+ channel at a different site from sulfonylureas