Diabetes

Question 1

GLP-1 Stimulates

Answer 1

Insulin secretion
Somatostatin secretion
Beta cell proliferation
Gastric Acid secretion

Question 2

GLP-1 Inhibits

Answer 2

Gastric emptying
Appetite
Beta cell death

Question 3

Insulin Stimulates

Answer 3

Glycogenesis
Glycolysis
Pentose Shunt
FA Synth
Indirect: TG synth

Question 4

Insulin Inhibits

Answer 4

Glycogenolysis
Gluconeogenesis
Lipolysis
FA Beta Ox
Indirect: Ketogenesis

Question 5

Glucagon Stimulates

Answer 5

Glycogenolysis
Proteolysis
Gluconeogenesis
Lipolysis
FA Beta Ox
Indirect: Ketogenesis

Question 6

Glucagon Inhibits:

Answer 6

Glycogenesis
Glycolysis
FA Synth

Question 7

Normal Fasting Plasma Glucose

Answer 7

<100

Question 8

Pre-Diabetes Fasting Plasma Glucose

Answer 8

100-125

Question 9

Diabetic Fasting Plasma Glucose

Answer 9

> = 126

Question 10

75g Oral Glucose tolerance test (OGTT), Normal

Answer 10

<140

Question 11

75g Oral Glucose tolerance test (OGTT), Pre-Diabetic

Answer 11

140-199

Question 12

75g Oral Glucose tolerance test (OGTT), Diabetic

Answer 12

> = 200

Question 13

Hgb A1c, Normal

Answer 13

<5.7

Question 14

Hgb A1c, Pre-Diabetic

Answer 14

5.7-6.4

Question 15

Hgb A1c, Diabetic

Answer 15

> = 6.5

Question 16

Random Plasma Glucose diabetes diagnosis

Answer 16

> 200 + symptoms

Question 17

Insulin half life and metab

Answer 17

3-5 minutes

Insulases in liver (50%), kidney, placenta

Question 18

C-peptide half life and metab

Answer 18

3-4x insulin

Degraded by kidney

Question 19

Benefit of short insulin half life

Answer 19

permits rapid changes in circulating levels

Question 20

Benefit of long C-peptide half life

Answer 20

ideal marker of endogenous insulin produx and secretion

Question 21

Basal insulin purpose

Answer 21

COntrol plasma glucose during fasting/between meals to prevent liver from making too much glucose
prevent ketosis

Question 22

T1DM insulin dosing

Answer 22

Basal 24hrs + rapid w meals

Question 23

T2DM insulin dosing

Answer 23

start basal and progress to meals if needed

Question 24

NPH dosing

Answer 24

Humulin-N
Novolin-N
QHS or BID
DOA 12-16 hrs

Question 25

Levemir dosing

Answer 25

Detemir
QD or BID
DOA ~18 hrs

Question 26

Glargine 100 dosing

Answer 26

Lantus
Basaglar
QD
DOA 24 hrs

Question 27

Glargine 300 (Toujeo)
Degludec U100 or U200 (Tresiba) dosing

Answer 27

QD, but flex dosing for degludec

DOA >24 hrs

Question 28

Humalog U100 or U200, Apidra, Fiasp dosing

Answer 28

Lispro
Aspart
Glulisine
Onset 5-15 min
Peak 1 hr
DOA 3-4 hrs

Question 29

Regular dosing

Answer 29

Novolin R
Humulin R
Onset ~30 min
Peak 2-4 hrs
DOA 6-8 hrs

Question 30

Insulin to grams of carb

Answer 30

1 unit insulin:15 g carbs

Question 31

Insulin to correct hyper-g

Answer 31

<150 - no insulin
for every 50 above, 1 unit insulin to a max of 5 units (350 glucose)

With food: start with 5 units, use increments up to 10 units

Question 32

Pre-mixed insulin admin

Answer 32

BID before meals

70/30 of basal/bolus

Question 33

Type 1 dose

Answer 33

0.4-0.7 units/kg/day

Question 34

Type 2 dose

Answer 34

0.5-2.0 units/kg/day, sometimes need much more

Question 35

Initiation of basal insulin in T2DM

Answer 35

• Start 10 units daily or ~0.2u/kg/day
• Measure daily fasting am glucose
• Titrate basal insulin to fasting glucose goal
(e.g. 80 - 140mg/dL)

Question 36

How to adjust basal insulin

Answer 36

around FASTING glucose levels

Question 37

How to adjust bolus insulin

Answer 37

glucose levels 2 hrs before or after meal

Question 38

How to adjust premixed insulin for a.m.

Answer 38

prelunch and predinner glucose

Question 39

How to adjust premixed insulin for p.m.

Answer 39

post dinner, bedtime, &/or morning fasting

Question 40

Insulin Pump

Answer 40

constant low basal infusion

Bolus manually direted

Question 41

Artificial pancreas

Answer 41

No patient input

Senses glucose and transmits info to pump to determine insulin/glucagon secretion