Diabetes/Hyperlipidemia Flashcards
Glutamic Acid Decarboxylase Antibody is used to confirm diagnosis of ____
Type 1 Diabetes
Diabetic Ketoacidosis (DKA) seen in ____
Type 1 Diabetes
What laboratory findings must be present to diagnosis Diabetic Ketoacidosis?
Ketones
Anion gap
Which of the following is NOT a symptom of Type 1 DM? A. Weight gain B. Dehydration C. Fatigue D. Nausea E. Muscle cramps
A. Weight loss
Which of the following is a sign of Type 1 DM? A. Bradycardia B. Hypertension C. Hypothermia D. Edema
C
A. Tachycardia
B. Hypotension
D. Dehydration
2 main sources of sugar
Hepatic gluconeogenesis: basal
Food: bolus
Which of the following is NOT a long acting insulin? A. Glargine B. Glulisine C. Determir D. NPH
B. Glulisine is short acting
How many times a day?
Glargine
1 x/ day
How many times a day?
Determir
BID
How many times a day?
NPH
BID
Regular/NPH administration instruction
Take both BID w/ breakfast + supper
Which of the following is NOT a short acting insulin? A. Regular B. Aspart C. Glargine D. Lispro E. Glulisine
C. long acting
Hyperosmolar Hyperglycemic States (HHS) seen in severe cases of _____
Type 2 Diabetes
T/F: Only insulin will work at treating Type 1 Diabetes.
True
T/F: Metformin should only be given to DM2 patients with HbA1c > 10%.
False. Metformin for EVERYONE!
T/F: Every insulin agent drops HbA1c by ~1%.
False. Non-insulin agent
If HbA1c >10%, treat w/ ____
insulin w/ metformin
If HbA1c
non-insulin therapy. Start w/ metformin. ADD agents as needed.
Name the drug:
Inhibits hepatic gluconeogenesis → decreased clearance of lactic acid
Reduces endogenous glucose production
Metformin
Metformin is contraindicated for pts w/ (2)
heart failure
renal failure
T/F: Metformin increases insulin sensitivity and leads to increase in insulin levels.
False. It does NOT do either of these features.
Name the class of drug: Acarbose
Alpha glucosidase inhibitors
Name the class of drug: Inhibit upper GI enzymes that convert complex polysaccharide carbohydrate in monosaccharides → slow absorption of glucose
Alpha glucosidase inhibitors (Acarbose)
T/F: Alpha glucosidase inhibitors does NOT affect insulin secretion
True. Therefore, no hypoglycemia
Name the class of drug: Pioglitazone
PPAR gamma agonists: thiazolidinediones
PPAR gamma agonists is contraindicated for pts w/ ___
CHF
Name the drug:
• Lower blood glucose by enhancing effects of insulin
• Enhance fat storage → Lower plasma free fatty acid
PPAR gamma agonist: Pioglitazone
Expressed in adipose tissue → regulates genes involved in adipocyte differentiation, fatty acid uptake/storage, and glucose uptake
Name the class of drug: Glipizide, glimepiride, glyburide
Sulfonylureas
Sulfonylureas act by:
- Binds to sulfonylurea receptor on beta cell membrane → inhibit ATP sensitive K+ cannels → insulin release
- Depolarize cell → calcium influx → insulin release WITHOUT the presence of glucose
T/F: Sulfonylureas induces glucose independent insulin secretion.
True. Must take with food to avoid hypoglycemia
Name the class of drug: Exenatide, liraglutide
GLP-1 agonists
Which of the following does NOT enhance insulin secretion? A. Sulfonylureas B. GLP-1 agonists C. DDP-IV inhibitors D. PPAR gamma agonists
D. Enhances effects of insulin
Which of the following is NOT glucose dependent in enhancing insulin secretion?
A. GLP-1 agonist
B. Sulfonylureas
C. DDP-IV inhibitors
B. Glucose independent
GLP-1 agonists are contraindicated for pts w/ ___
hx of pancreatitis
T/F: Exenatide, liraglutide causes weight loss due to nausea from slow down gastric emptying.
True. GLP-1 agonists
Name the class of drug: Sitagliptin, saxagliptin, linagliptin
Effect/Mechanism:
DDP-IV inhibitors
• Makes endogenous GLP-1 last longer
• Glucose dependent insulin secretion
o NO hypoglycemia
T/F: DDP-IV inhibitors cause weight loss.
False.
Name the class of drug: Canagliflozin
SGLT-2 inhibitors
Name the drug:
Promote renal excretion of glucose
Canagliflozin: SGLT-2 inhibitors
T/F: Canaglifozin (SGLT-2 inhibitor) may cause hypoglycemia.
False.
Screening for microvascular complications should be performed at the time of diagnosis in ____
Type 2 DM
Adult onset Type 1 DM
T/F: Screening at the time of diagnosis of DM should be performed to prevent macrovascular complications
False. Screen test for macrovascular complications is NOT recommended: screening is asymptomatic pt does NOT improve outcome
T/F: Tighter glycemic control decreases macrovascular disease in type 2 diabetes.
False. Type 1 diabetes
Tighter glycemic control does NOT prevent macrovascular disease in type 2 diabetes
PSCK9 mutation causes:
Excessive degradation of LDL receptor
Triglycerides
Statin
Triglycerides >500 mg/dL treated with ___
Fibrates
niacin
Fish oil
T/F: There are no medications to increase HDL cholesterol
True
Which of the following is NOT a patient that belongs to statin benefit group?
A. Pts w/ atherosclerotic CVD
B. Pts w/ LDL > 200 mg/dl
C. Pts 40-75 y/o w/ LDL 70-189 and DM
D. Pts 40-75 y/o w/ LDL 70-189, no DM, no CVD BUT 10 year of atherosclerotic CVD > 7.5%
B. Pts w/ LDL > 190 mg/dl
