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Pharmacology > Diabetes 1 > Flashcards

Diabetes 1 Flashcards

1
Q

diabetes is the number one cause of what

A

non-traumatic amputation
kidney disease
blindness

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2
Q

what is the cause of type 1 diabetes

A

auto-immune destruction of the pancreatic beta cells
or
A virus that causes beta cell destruction

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3
Q

what is the cause of type 2 diabetes

A

insulin resistance in muscle and adipose tissue
progressive decline in pancreatic insulin secretion
unrestrained hepatic glucose production
hormonal deficiencies
most common form of diabetes

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4
Q

what are the 3 signs of hyperglycemia

A

polyuria
polydipsia
polyphagia
fatigue

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5
Q

what are some risk factors for becoming a type 2 diabetic

A 
Overweight/obese
sedentary lifestyle
fam hx
cardiovascular disease
HTN
high triglycerides
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6
Q

what are risk factors for gestational diabetes

A

history of gestional diabetes
history of infant with birthweight >9lbs
polycystic ovary syndrome

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7
Q

When should you screen a person for diabetes?

A

asymptomatic people with BMI>or= 25kg/m in any adults who have one or more additional risk for DM
Testing should start at 45

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8
Q

what do you do if the tests for diabetes are negative

A

test again at 3 year intervals

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9
Q

what is the A1c of a normal person

A

less than 5.7%

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10
Q

what is the A1C for a prediabetic

A

5.7-6.4%

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11
Q

what is the A1C for a diabetic

A

> or= to 6.5%

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12
Q

what is the fasting glucose level of a normal person

A

less than 100mg/dl

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13
Q

what is the fasting glucose level of a pre-diabetic

A

100-125mg/dl

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14
Q

what is the fasting glucose for a diabetic

A

> or=to 126mg/dl

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15
Q

what is the OGTT for a normal person

A

<140

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16
Q

what is the OGTT for a prediabetic

A

140-199

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17
Q

what is the OGTT for a diabetic person

A

> or=to 200

18
Q

what is the level for a random glucose for a diabetic

A

> or=to 200

19
Q

what is the A1C goal for most diabetic patients

A

7%<

20
Q

what would you give a patient who is determined to have prediabetes with a IGT, IFG or A1C of 5.7-6.4%?

A

metformin

21
Q

What criteria would you use to determine when to use metfromin with a patient

A

BMI>35kg/m
60yo<
women with prior GDM

22
Q

What are macrovascular complications of diabetes

A

Coronary artery disease
HTN
Dyslipidemia

23
Q

what are microvascular complications

A

retinopathy
neuropathy
nephropathy

24
Q

what are you going to prescribe patients with coronary artery disease and diabetes

A

Asprin 81mg daily
men>50
women>60
with one risk factor of fam hx of CVD,HTN, smoking

25
Q

what are the treatment goals for diabetics with HTN

A

140/80

ACE-1 or ARB

26
Q

what is the goal for diabetics with dylipidemia

A

LDL<100

Start statins

27
Q

how would you manage a diabetic with retinopathy

A

manage HTN and glucose

laser treatment

28
Q

how would you manage a diabetic with neuropathy

A 
peripheral
manage HTN
gabapentin, lyrica and cymbalta
Autonomic:
PDE-5 inhibitors
reglan, erythromycin
stool softeners
29
Q

What else is another big thing that you want to reduce a diabetics risk of infection

A

Annual influenza vaccine

pneuomococcal vaccine

30
Q

what are non-pharmacological therapy for diabetes

A

exercise 30min for most days of week
change diet
avoid sat fats, carbs, sugar
increase fiber

31
Q

what are complications that are associated with GDM

A 
macrosomia (large baby)
need cesarean
shoulder dystocia and birth trauma
neonate metabolic problems
perinatal mortality
HTN/preeclampsia
32
Q

What are risk factors for GDM

A 
>25 yo
overweight
Fam Hx of DM2
abnorm glucose metabol
poor obstretic outcomes
children >9lbs
polycystic ovarian disease
Latino/hispanic, non-black, asain, native american, pacific islander
33
Q

when do you screen for GDM

A

1st prenatal visit in a person with those risk factors

if a woman does not have known DM test using OGTT at 24-48 WEEKS

34
Q

What is 1st line for GDM

A

diet modification and insulin

35
Q

what oral agents can you NOT USE with GDM

A

biguanides and TZDs

36
Q

What orals can you use with GDM

A

sulfonylureas

glipizide and glyburide

37
Q

what do you do with a woman who does have GDM

A

test them 6-12 week postpartum

If a woman does have GDM they should be screened every 3years for development of DM or prediabetes

38
Q

when are type 1 DM diagnosed

A

3/4 are diagnosed before 18

39
Q

what are the goals of treatment for children who have type 1

A

more lax with their treatment because they are at greater risk of hypoglycemia

40
Q

what are the treatment goals for the elderly patients

A

functional
cognitively intact
life expectancy
A1C<8

41
Q

what are difference of DM children respond to insulin compared to adults

A

changes in insulin sensitivity due to hormone changing
growth patterns
supervision at daycare

Pharmacology (7 decks)

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