Diabetes Flashcards
Hormones that the pancreas produces (endocrine and exocrine gland)
insulin- Promotes uptake of glucose. Produced in response to digestion.
Amylin- moderates appetite, gastric emptying, and glucagon/insulin secretion.
Gluacgon- Produced when blood sugar falls.
Somatostatin- Inhibits secretory cells
Pancreatic peptide- facilitates digestion
Ghrelin- Increases growth hormone release
during a meal…
The gut releases GLP-1 (incretin). This signals the pancreas to release insulin. Insulin allows the cell to absorb and store glucose.
Glucagon secretion decreases and the liver stores glucose.
If insulin remains low (or the cells don’t get the memo) then the liver will continue to produce glucose.
Role of incretin
Signals the pancreas to release insulin.
insulin replacement
Give basal insulin (long acting or intermediate acting) and pre-meal insulin (rapid acting)
multiple daily injections (most common) regimen
Excessive doses of insulin can lead to
Hypoglycemia. Give candy!
HA, tachycardia, vertigo, anxiety
Pramlintide
Amylin agonist. (amylin is a hormone secreted with insulin from beta cells following food intake. Delays gastric emptying)
Can be used as adjunct to meal time insulin.
admin SUBQ!!!!!!!!!! Do not mix with insulin. Rapid acting insulin dose should be decreased by 50%.
GLP 1 agonists end in
Tide
Incretin agonist. Increases insulin release and slows gastric emptying.
Sub Q
DPP4 Antagonists end in
Gliptin
SUB Q
Sub Q meds
Insulins, pramlintide, GLP 1 agonists, DPP4 antagonists.
Dosing for the DPP4 inhibitors
1x per day.
Minimal effect. Use in combo.
Weight neutral.
Sodium glucose transporter 2 inhibitors end in
Flozin
What Sodium glucose transporter 2 inhibitor can increase lower leg amputations
Canagliflozin
Sodium glucose transporter 2 inhibitors adverse effects
UTi, yeast infection, urinary frequency
Decrease BP = hypotension.
