Diabetes

Question 1

Pharmacology for Type 1 and 2 insulin MOA

Answer 1

Decreases blood glucose by stimulating peripheral glucose uptake (skeletal and fat) and inhibits hepatic glucose production

Question 2

Rapid Acting

Answer 2

Aspart, Lispro, Gluisine duration 3 hours

0.5-1 unit/kg/day give <15 minutes prior to meal

Question 3

Short acting

Answer 3

Regular, duration 6 hours

Question 4

Intermediate

Answer 4

NPH, duration 12 hours

Question 5

Long acting

Answer 5

Detemir, Glargine, duration up to 24 hours

0.5-1 unit/kg/day sq

Question 6

Type 2 pharmacotherapy

Answer 6

Sulfonylureas (pancreas) indicated for lean pts with high BG example Glyburide (Diabeta)
Biguinide (Liver) indicate for obese pts with dyslipidemia example Metformin (glucophage)

Question 7

Other pharm for diabetics if cardiovascular risk factors

Answer 7

ACEI >55
Statin >40
ASA >40

Question 8

What is Diabetic ketoacidosis

Answer 8

Acute, potentially life threatening complication of DM

Question 9

Four characteristics of diabetic ketoacidosis

Answer 9

Hyperglycemia
Ketosis
Metabolic acidosis
Dehydration
"DMKH"

Question 10

Diabetic ketoacidosis signs/symptoms

Answer 10

Tachycardic, Acetone breath, Hyperventilation/Kussmaul respirations, Lethargy, Malaise, Polyuria, polydypsia, decreased reflexes

Question 11

Diabetic ketoacidosis Labs and results

Answer 11

EKG: sinus tach
Serum glucose: 250-400
Positive urine ketones, glucosuria
Positive Acetoacetate
Check K+, ABG, Glucose, chem, lytes, Na+

Question 12

Diabetic ketoacidosis tx

Answer 12

inpatient: O2, normal saline, regular insulin bolus, glucose testing, sodium bicarb to restore acide/base balance, K+ if hypokalemic

Question 13

What is dawn phenomenon

Answer 13

Insulin resistance in the AM

Question 14

What is somogyi effect

Answer 14

Rebound HYPERglycemia following an episode of HYPOglycemia, tx: reduce insulin to control