Diabetes Flashcards
Which diabetics are insulin dependent?
Type I
IFG
Impaired Fasting Glucose
IGT
Impaired Glucose Tolerance
Defects in Type II DM
Impaired insulin secretion
Insulin Resistance
Diagnosis of Pre-diabetes
A1C: 5.7-6.4%
FPG: 100-125 mg/dL (IFG)
2-hr PG: 140-199 mg/dL (IGT)
Diagnosis of Diabetes
A1C: ≥ 6.5%
FPG: ≥ 126 mg/dL
2-hr PG: ≥ 200 mg/dL
Random Glucose ≥ 200 mg/dL with symptoms of hyperglycemia
Clinical conditions associated with insulin resistance
Type II DM IGT Obesity (Central Visceral) Dyslipidemia Atherosclerosis Hypertension Acanthosis Nigricans
ADA Target Values
A1C: < 7.0%
Preprandial glucose: 70-130 mg/dL
Peak postprandial glucose: < 180 mg/dL
AACE
A1C: ≤ 6.5%
FPG: < 110 mg/dL
2-hr PG: < 140 mg/dL
Biguanide Indication
Type 2 DM
Biduanide MOA
increase activity of AMPK, stimulates fatty acid oxidation, glucose uptake, and nonoxidative metabolism. Reduces lipogenesis and gluconeogenesis.
Results in increase glycogen, lower hepatic glucose production, increase insulin secretion.
Biguanide Adverse Effects
Nausea, Indigestion, Abdominal cramps
Lactic Acidosis, pyruvate goes to lactic acid (careful with gout)
Renal toxicity
Thiazolidinediones indication
Type 2 DM
Thiazolidinediones MOA
Ligand for peroxisome proliferation activating receptors.
Improves insulin sensitivity does not increase insulin secretion.
Thiazolidinediones Adverse Effects
Weight gain Edema Increase body adiposity Increase incidence of congestive heart failure Hepatotoxic
