Diabetes and Dyslipidemia

Question 1

Pancrease

Endocrine function–?
Exocrine function–?

Answer 1

Islets of Langerhans
Digestive enzymes

Question 2

Four types of DM
Type 1?
Type 2?
Type 3?
Type 4?

What are some chronic complications of DM?

Answer 2

Type 1- insulin dependent
Type 2- non-insulin dependent
Type 3- other cause ex: pancreatitis, drug
Type 4- Gestational

Question 3

What do Beta cells secrete? What are the parts?

Answer 3

Insulin

C- peptide no function

Question 4

What type of receptor are insulin?

Effects of insulin?

Answer 4

Tyrosine kinase receptor
GLUT
^Glycogen

Question 5

Glulisine

Answer 5

Rapid acting insulin

Question 6

Aspart

Answer 6

Rapid acting insulin

Question 7

Lispro

Answer 7

Rapid acting insulin

Question 8

Novolin

Answer 8

Short acting (Regular) insulin

Question 9

Humulin

Answer 9

Short acting (Regular) insulin

Question 10

Neutral protamine Hagedorn
NPH

Answer 10

Intermediate Acting insulin

Question 11

Glargine

Answer 11

Long acting insulin

Question 12

Detemir

Answer 12

Long acting insulin

Question 13

Degludec*

Answer 13

Long acting insulin

Question 14

Insulin Regimen
How would you give insulin?

What illness ? DKA vs Hyperosmolar hyperglycemic syndrome

Answer 14

DKA- more type 1
HHS- more type 2

Question 15

BOLUS INSULIN

1 Unit of RA insulin disposes of how many grams of Carbs??

If you eat 60g carbs, how many units of RA insulin do you need ?

Correction?

Answer 15

Disposes 12-15g of carbs soooo

60/15= 4 units

Question 16

What is basal insulin coverage?

Answer 16

1 injection, long acting

Ex Long acting insulins:
-Glargine
-Detemir
-Degludec

Question 17

Metformin

Answer 17

Anti-diabetic
Biguanides

Question 18

Insulin Secretagogues MOA

Example of drug:

Answer 18

Classes:
Sulfonylureas– 1st gen= safer
Meglitinide – 2nd gen, short 1/2 life

Bind to K+ Ch and depolarizes

Question 19

Thiazolidinediones (Tzds)

What are the risks?

Answer 19

PPAR– Peroxisome proliferator activated receptor= ^ GLUT 4

Decreases insulin resistance
Increase insulin signal transduction

Watch for MI risk!!

Medication: Avandia (Rosiglitazone)

Question 20

Incretin-Based therapies

GLP-1 function?- agonist
DPP-4 function?- antag

Answer 20

Glucagon-like polypeptide-1:
Stimulates insulin release and inhib glucagon release to LOWER BG

Dipeptidyl Peptidase 4 (DPP-4) usually inactivates GLP1 (increase BG)—– so antagonist blocking DPP4 to decrease BG

Question 21

Dapagliflozin (Farxiga)

Answer 21

Gliflozins
SGLT2 Inhibitor

Glucosuria

Question 22

Canagliflozin (Invokana)

Answer 22

Gliflozin
SGLT2 Inhibitor

Glucosuria

Question 23

Empagliflozin (Jardiance)

Answer 23

Gliflozin
SGLT2 Inhibitor

Glucouria

Question 24

Answer 24

Question 25

Sterols are important precursors for:

Answer 25

Steroid hormones
Cell membranes
Vitamin D
Bile Salts

Question 26

LDL/HDL Cholesterol Risk Ratio. Avg?

What are our goals for total cholesterol? LDL? HDL?

Answer 26

3.5 Ratio risk is average

Question 27

Gemfibrozil (Lopid)

Answer 27

Fibrate
Decrease VLDL

Question 28

Fenofibrate (Tricor)

Answer 28

Fibrate
Decrease VLDL

Question 29

Ezetimbie (Zetia)

What to watch out for ?

Answer 29

NPCL1 Antagonist
Block GI uptake of chol.
Reduce LDL

Arterial wall thickening?? :((

Question 30

Avandia (Rosiglitazone)

Answer 30

Thiazolidinedions (Tzd)
PPAR = ^ GLUT4
Decrease insulin resistance– body responds more to insulin

Question 31

Amylin Analog MOA?

Answer 31

Amylin= suppress glucagon release

Question 32

Acarbose

Answer 32

Alpha-glucosidase Inhibitors

For pre-diabetics
**Block complex carb digestion

Question 33

“Gliflozin”

Answer 33

SGLT2 Inhibitor
-Prevent glucose reabsorption in PCT
***PEE GLUCOSE

-> Decrease BP, weight loss, dehydration