diabetes 1 Flashcards

1
Q

Diagnoses of DM from fasting

A

fasting glucose over 126mg/dl

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2
Q

diagnosis non fasting glucose

A

non fasting over 200mg/dl

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3
Q

diagnosis with glucose tolerance test

A

glucose tolerance over 200 at 2-3 hours after bolus

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4
Q

Onset of type !

A

less than 20 years

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5
Q

cause of DM I

A

autoimmunity against pancreatic beta cells and to insulin , familial

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6
Q

cause of DM II

A

Insulin resistance, then insulin deficiency and excess hepatic glucose production

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7
Q

diffenrence in body habitis of DM I and DM II

A

DM I often underweight onset prior to 20, DM II overweight and onset often after 30

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8
Q

is DM II familial

A

yes, 90-100 percent in twins, in DM I is 50% with twins

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9
Q

what is LADA

A

Latent onset adult diabets 1.5

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10
Q

when should you look for DM 1.5

A

in all non obease adults who present with apparent type 2 DM or those with DM II who have rapid detoriation of glucose control

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11
Q

what are the two secreatogues

A

Sulfonylureas and meglitinides (non sulpher)

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12
Q

what aret he type 2 DM drug types

A

biguanides, sulfonylureas, meglitinides, A-glucosidase inhibitors, thiazolidinediones TZD glitazones, dipeptidyl peptidase-4 (DPP-4)

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13
Q

with which of the type 2 DM drug classes can you also give insulin

A

most of them: buguanides, sulfonylureas, meglitinides, a glucosidase inhibitors, glitazones, Don’t give insulin to DPP-4 inhibitors.

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14
Q

what type of drug is metformine

A

Biguanides

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15
Q

how does MOA of biguanides

A

inhibit glucose production by liver and decrease insulin resistance

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16
Q

how do the secreatogue work,

A

sulfonylureas and meglitinides increase secretion of insulin

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17
Q

how do the alpha glucosidase inhibitors work

A

delay absorption of glucose by intestines.

18
Q

how to the glitazones, work

A

decrease insuline resistance

19
Q

how do the DPP-4 work

A

promote release of insulin after eating meal

20
Q

what meds delay absorption of glucose by intestines

A

alpha glucosidate inhibitors

21
Q

what drugs decrease insuline resistance

A

biguanides and the glitazones

22
Q

what drugs promote release on insulin after eating

A

DPP-4

23
Q

what drug inhibit glucose production by liver

A

biguanides

24
Q

what is the concern with oral diabetic medications and illness

A

may need to switch to insulin during acuted infection because they potentially will have wose glucose control. Also prior to inpatient surgery

25
Q

when would type II diabetics be given insulin rather than oral right off

A

if they become pregnant or develop gestation diabetes to maintain tighter glucose control.

26
Q

what has been associated wit horal diabetic medications and pregnancy

A

macrosomia

27
Q

what oral diabetic drug dose not cause hypoglycemia when used alone

A

biguanide -metformin/ alpha glucosidase inhibitors - acarbose

28
Q

what 2 oral drugs can cause hypoglycemia

A

secreatagogues: sulfonylureas and meglitinides

29
Q

would metformin or a sulfonylurea cause weight loss

A

metformin about 4-7 lbs

30
Q

what is the vitain B12 deficiency offten associated with

A

metformin

31
Q

what drug has severe sideefect lactic acidosis

A

metformin a biguanide

32
Q

who should not be on metformin

A

those with impaired renal function

33
Q

how does sulfonylurease cause insulin release

A

partial blocking of potassium channels increasing Ca release stage that signals insulin release

34
Q

what generation of sulfonylureases are most often used

A

2nd generation Glipizide

35
Q

most concerning about sulfonylureas

A

hypoglycemia and then there is often weight gain and lose effectiveness withing 5-10 years

36
Q

which sulfonylureas is most likely to cause hypoglycemia

A

gyburide

37
Q

how often dose metformin

A

twice daily

38
Q

how often dose glipizide

A

one morning dose

39
Q

what are the two meglitinides secretagogues

A

nateglinide and repaglinide which is more effective

40
Q

what drug class would you not want to mix meglitinides with

A

sulfonylureas because it would increase risk of hypoglycemia