Diabetes Exam 2 Flashcards by Madelynn Packer

Normal FBG

< 100mg/dL

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Normal OGTT

< 140 mg/dL

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Normal A1c

< 5.7 %

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Normal Random Glucose

< 200 mg/dL

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Diabetic FBG

greater or equal to 126

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Diabetic A1c

greater or equal to 6.5%

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Diabetic random glucose

greater or equal 200

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Diabetic OGTT

greater or equal 200

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IFG

100-125

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IGT

140-199

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pre diabetic A1c

5.7 - 6.4

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sulfonylureas structures

O
||
HN-C-NH

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glinides structures

phenylalanine

  C + a ring
   | HN-C-COOH

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SGLT2 inhibitor structures

glucose molecules hooked to bulky hydrophobic group

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biguanides structures

NH \N/
|| |
/\ /
H2N N NH
H

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Thiazolidinediones

thiazole on the ends

resistin

-elevated in T2DM
-mRNA dec due to TZD
-dec insulin sensitivity

Adiponectin

-dec in T2DM
-mRNA inc cue to TZD
-inc insulin sensitivity

TNF-alpha

-inc in T2DM
-mRNA dec due to TZDs
-dec insulin sensitivity

NPH

-slow onset
-long duration
-protamine w/ bound insulin

Lispro insulin (humalog)

-rapid onset
-short action
-reverse position of proline & lysine
-forces insulin not to dimerize

Insulin Aspart (Novolog)

-rapid onset
-short action
-proline switched to aspartate

Insulin Glulisine

-rapid onset
-short action
-switch Asn 3 to Lys and Lys 29 to Glu

Insulin Glargine (lantus)

-slow onset
-once daily
-Asn to Gly
-2 arg residues

Insulin Detemir

-slow onset -once daily -FA added & binds to albumin

Insulin Degludec

-slow onset -once daily -FA added & binds to albumin

sulfonylurea MOA

act as ATP to bind to Katp channels to close it

sulfonylurea AEs

hypoglycemia, GI problems, CV events, weight gain, inc secondary failure

sulfonylurea DDI

alcohol, high dose salicylates, thiazides, epi

Glinides vs sulfonylureas

same MOA and DDIs and AEs however there is less risk of hypoglycemia

TZDs MOA

bind to PPARy that affects gene transcription of adipokines