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Exam 3 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Type 1 Diabetes

A

Autoimmune- born with it
Most diagnosed in childhood
Body does not produce insulin
Can only be fixed with insulin

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2
Q

Type 2 Diabetes

A

Often due to “you” (diet, weight, exercise)
Obesity
Many times over 40 (sometimes children)
Body has insulin, it just isn’t utilizing it correctly

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3
Q

Criteria for diagnosis of diabetes

A

Fasting plasma glucose level of 126 mg/DL or higher (don’t drink or eat for over 8 hours. Test more than once)
HgA1C greater than 6.5%

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4
Q

A1C target levels for normal people

A

Less than or = less than 5.7%

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5
Q

A1C target level for pre-diabetes

A

5.7-6.4%

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6
Q

A1C target level for diabetics

A

6.5% or more

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7
Q

A1C target level for elderly

A

NEVER below 6%

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8
Q

Rapid Acting Insulin - (Clear)

A

Medication end in -log - Humalog, Novalog
Take with or before meals
Onset: 15 minutes
Peak: 1-2 hour

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9
Q

Short Acting Insulin - (Clear)

A

Medication end in -R - Humulin R, Novalin R
SQ, IV is blood sugar is dangerous
Onset: 30-60 minutes
Peak: 2.5 Hours

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10
Q

Intermediate Acting Insulin (Cloudy)

A

Medication end in -N - Humulin N, Novolin N
SQ
You can mix short acting and intermediate insulin (r+n)
Onset: 1-2 Hours
Peak: 4-8 Hours
1x or 2x daily

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11
Q

Long Acting Insulin

A

Medication - Lantus (long for lantus)
1x daily for steady blood sugar
Onset: 1-2 Hours
Peak: No peak
Duration: 24 Hours

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12
Q

Hyper drugs for hypoglycemic (elevate blood sugar)

A

Glucagon - IV, IM ,SQ
50% dextrose (d50) - IV
“Fast 15”

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13
Q

“Fast 15”

A

Only done when patient is awake and alert and hypoglycemic. GIve 4 oz of juice of 15 carbs.

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14
Q

Hypoglycemic and unconscious

A

Give 50 Dextrose by IV
OR
Give Glucagon either IM, IV, or SQ

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15
Q

ozempic-semaglutide

A

FOR TYPE 2 Diabetes
SQ once weekly
Causes increase in insulin release & decreases in glucagon release.
Slows gastric emptying and suppresses appetite.
May alter absorption of other meds

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16
Q

Mounjaro - tirzepatide

A

SQ weekly
Unlikely to cause significant hypoglycemia unless given with other meds.
CONTRAINDICATED - personal/family history of thyroid cancer. Type 1 diabetes.

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17
Q

S/S of diabetes

A

Hunger, sex problems, bad circulation (tingling/numbness), nausea, fatigue, dry skin, slow wound healing, infections, Weight gain for type 2 - obese, weight loss for type 1 - small.
The three P’s - Polyphagia (excessive hunger), polydipsia (excessive thirst), Polyuria (urinating frequently)

18
Q

Hypoglycemia

A

Decrease in blood sugar
Causes: too little food, too much insulin or diabetes medication, extra exercise
Sudden: may progress to insulin shock

19
Q

Symptoms of Hypoglycemia

A

Shaking, tachycardia, sweating, anxious, dizziness, hunger, impaired vision, weakness, fatigue, headache, irritable

20
Q

Hyperglycemia

A

Increased blood sugar

21
Q

Hyperglycemia Symptoms

A

Dry mouth, weakness, blurred, headache, increased thirst, blurred vision, frequent urination

22
Q

Normal Blood Sugar Level

A

70-100

23
Q

Low Blood Glucose

A

Glucagon released by “alpha cells” of pancreas, liver releases Glucose into blood

24
Q

High Blood Glucose

A

Insulin released by “beta cells” of pancreas, fat cells take in glucose from the blood.

25
Q

Biguanide
Metformin - Glucophage

A

Decreases glucose production in liver
Decreases intestinal absorption of glucose
Significant chance of Hypoglycemia

26
Q

Biguanide
Metformin - Glucophage
Adverse Effects

A

Weight loss (6-8 pounds), bloating, nausea, anorexia, abdominal cramping, metallic taste, vitamin b12 & folic acid deficiency

27
Q

Biguanide
Metformin - Glucophage
Contraindications

A

Stop for 2 days before Iodine contrast (CT scan) and not started for 2 days after.
Monitor kidney function - if creatinine is high, hold med and contact PCP (1.5 mg/dL in males, 1.5 mg/dL in females)

28
Q

Sulfonyureas
End in - IDE
Glipizide - Glucotrol
Glyburide - Diabeta

A

PO - Give 30 minutes before a meal
Stimulates release of insulin from pancreas, decreases secretion of glucogon
Works best in early stages of type 2
Can be used w/ metformin or alone
Only given to type 2, stop taking if/when insulin is required.

29
Q

Sulfonyureas
End in - IDE
Glipizide - Glucotrol
Glyburide - Diabeta
CONTRAINDICATIONS

A

Advanced diabetes dependent on insulin
NPO status - if N/V it will raise insulin and make them hypoglycemic
Alcohol use, advanced age
Allergic to sulfonamides, may have cross allergy
Caution in severe heart or liver disease

30
Q

Sulfonyureas
End in - IDE
Glipizide - Glucotrol
Glyburide - Diabeta
ADVERSE EFFECTS

A

Hypoglycemia (especially if they aren’t eating or are NPO) , weight gain, skin rash, nausea, epigastric fullness, heartburn, some GI disturbances

31
Q

Glinides (meglitinides)
DRUG - repaglinide - Prandin

A

Increase insulin secretion from pancreas
Short duration, given at each meal
Can be used with metformin
Cannot be used with sulfonyureas (they function the same way)

32
Q

Glinides (meglitinides)
DRUG - repaglinide - Prandin
CONTRAINDICATIONS

A

Type 1 Diabetes
NPO status, alcohol use, advanced age (these will cause blood sugar to drop low or bottom out. With older age, more adverse reactions can occur)

33
Q

Glinides (meglitinides)
DRUG - repaglinide - Prandin
Adverse Effects

A

Hypoglycemia
weight gain (people stop taking usually if they are already having weight gain issues)
Eat w/ dose

34
Q

Thiazolidinediones(glitazones) - like actos

A

Makes you more sensitive to insulin
Decreases insulin resistance by in handing sensitivity of inclusion receptors.
Take weeks to monitor for full effect, slow onset.

35
Q

Pioglitazone (Actos)

A

Type 2 diabetes (contraindicated in type 1)
May combine with metformin or sulfonyurea

36
Q

Thiazolidinediones (glitazones)- like Actos

A

Do not take if you have severe heart failure
Caution with liver or kidney disease
Causes peripheral edema or weight gain
Can cause reduced bone mineral density & increased risk of fractures

37
Q

Alpha-glucosidase inhibitor
MED - acarbose (Precose)

A

Inhibit enzyme alpha-glucosidase in small intestine It is responsible for changing saccharides to glucose. Blocking it causes glucose absorption to be delayed. Because of action it must be taken with food- PO
Prevents or reduces postprandial glucose spike
For Type 2 diabetes

38
Q

Alpha-glucosidase contraindications (Precose)

A

IBS
Malabsorption syndrome
Intestinal obstruction

39
Q

Alpha-glucosidase Adverse/side effects (Precose)

A

Flatulence (gas), diarrhea, abdominal pain

Do not usually cause hypoglycemia or weight gain

40
Q

Alpha-glucosidase drug interaction

A

Bioavailability of drugs such as digoxin (lanoxin) and propranolol (Inderal) may be reduced

41
Q

Dipeptidyl peptidase IV inhibitors (gliptins)
MED - Sitagliptin (Januvia)

A

Decreases release of glucose, lowers blood sugar for fasting and postprandial.

42
Q

Adverse effects (Januvia)

A

Significant hypoglycemia can occur when drug is combined with a sulfonyurea
Treatment for type 2

Exam 3 (3 decks)

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