Diabetes

Question 1

Medication that promotes insulin secretion

Answer 1

Insulin secretagogues - sulfonylureas, meglitinides (Glucotrol)

Question 2

Medication that enhances insulin action and suppresses hepatic glucose production

Answer 2

Biguanides - Metformin (Glucophage)

Question 3

Medication that improves peripheral insulin sensitivity

Answer 3

Thiazolidinediones (Actos)

Question 4

Inhibits enzymes that digest carbohydrates, delaying absorption

Answer 4

Alpha glucosidase inhibitors (Acrobose, Precose)

Question 5

Medication that enhances insulin secretion and suppresses postprandial glucagon

Answer 5

Exenatide (Byetta)

Question 6

Medication that decreases glucagon production

Answer 6

Amylin agonist - Pramlintide (Smylin)

Question 7

Natural increase in early morning blood glucose and insulin requirements due to increased glucose production in liver after over night fast

Answer 7

Dawn phenomenon

Question 8

Hyperglycemia due ot insulin deficiency or excess carbohydrate intake.

Answer 8

Acute ketoacidosis - dehydration due to polyuria, increased pulse, fruity odor of ketones

Question 9

Tx for acute ketoacidosis

Answer 9

Insulin and rehydration

Question 10

Insulin reaction; due to insulin excess or lack of eating

Answer 10

Acute hyperglycemia - slow pulse, cool, clammy skin, hungry, weak, shakiness, sweating

Question 11

Tx for acute hypoglycemia

Answer 11

1. Begin with 15 g cho from glucose tablets, fruit juice or sugar.
2. Wait 15 minutes. If still below 70 mg/dL, give another 15 grams.
3. Repeat and treat until blood glucose is normal.

Question 12

Long term complications of diabetes

Answer 12

Retinopathy - leads to blindness
Neuropathy - peripheral and autonomic; gastroparesis
Nephropathy - leads to decreased kidney function

Question 13

Ascanthosis nigricans

Answer 13

Risk factor for diabetes - gray-brown skin pigmentation in skin folds

Question 14

Normal blood glucose

Answer 14

70 - 100 mg/dl

Question 15

Normal post-prandial glucose (2 hrs)

Question 16

Impaired fasting glucose

Answer 16

100-125 mg/dl

Question 17

Impaired glucose tolerance (2hr)

Answer 17

140-199 mg/dl

Question 18

Criteria for diabetes diagnosis

Answer 18

Fasting plasma glucose >126
Glucose tolerance test >200
Symptoms of diabetes plus casual plasma glucose >200 mg/dl
HgA1c >6.5

Question 19

Measures % of hemoglobin that has glucose attached; measures hemoglobin

Answer 19

Glycolsylated hemoglobin (HgA1c

Question 20

Normal A1c

Question 21

A1c goal for diabetics

Question 22

Measures of long term blood glucose control

Answer 22

A1c - 60-90 days

Question 23

A1c

Answer 23

65 and older

Question 24

Goals for all diabetics

Answer 24

Maintain normal blood glucose (average preprandial goal 70-130; peak post-prandial average 40/50)
Blood pressure goals

Question 25

Risk factor for developing gestational diabetes

Answer 25

BMI >30

Question 26

Strategies for Type 2 diabetes

Answer 26

``` Healthy eating and physical activity: Achieve glucose, lipid and blood pressure goals Weight loss if necessary Improve food choices, space meals Exercise ```

Question 27

Screening for gestational diabetes occurs between which weeks?

Answer 27

24-28 weeks

Question 28

Meal breakdown for gestational diabetes

Answer 28

3 small-medium meals, 2-3 snacks 175 g CHO/day 15-30 g CHO at breakfast, divide the rest evenly

Question 29

Compare blood glucose response of a food to a standard glucose load

Answer 29

glycemic index

Question 30

Meat exchanges: | Lean, medium-fat, high-fat

Answer 30

7 g pro, 0-3 g fat, 45 calories (canadian bacon) 7 g pro, 4-7 g fat, 75 calories 7 g pro, >7 g fat, 100 calories

Question 31

Fruit exchange

Answer 31

15 g CHO, 60 calories

Question 32

Vegetable exchange

Answer 32

5 g CHO, 25 calories

Question 33

Starch exchange

Answer 33

15 g CHO, 0-3 g CHO, 1g or less fat, 80 calories

Question 34

Fat exchange

Answer 34

45 calories, 5 g fat

Question 35

One choice from the starch, fruit, or milk list = 15 g CHO and each is one CHO choice

Answer 35

carb counting

Question 36

Insulin; Acts in 5-15 minutes; Usual duration is 4 hours

Answer 36

Rapid acting - aspart (Novolog), lispro (Humalog)

Question 37

Insulin; Take 30-45 minutes before eating; Usual duration of 3-6 hours; 1 unit covers 10-15 grams

Answer 37

Short-acting (Regular)

Question 38

Insulin; Onset 2-4 hours; duration 10-18 hours; Include bedtime snack consisting of CHO and protein

Answer 38

Intermediate acting - NPH

Question 39

Insulin; onset 2-4 hours; Duration 18-24 hours

Answer 39

Long acting - glargine (Lantus), determir (Levemir)

Question 40

Foods with low glycemic index

Answer 40

Legumes, milk, nuts, pasta, ice cream, yogurt