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Pharmacy Practice I > Diabetes Lecture > Flashcards

Diabetes Lecture Flashcards

1
Q

Euglycemia

A

Normal BG levels

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2
Q

Preprandial

A

Before meal

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3
Q

Postprandial

A

After meal

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4
Q

HbA1c

A

Hemoglobin A1C

Estimate of average BG over past 3 months

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5
Q

Prevalence of type 1 diabetes is highest among which race/ethnicity group?

A

Non-Hispanic whites

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6
Q

T/F diabetes affects almost every organ system

A

True

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7
Q

Diabetes is the ___ leading cause of death in 2017

A

7th

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8
Q

Normal roles of insulin and glucagon
What are insulin and glucagon?
Where are these hormones produced?

A

Pancreas produces insulin due to stimulus of high BG to lower BG, produces glucagon due to stimulus of low BG to raise BG
The two main hormones

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9
Q

Which organ converts glycogen to glucose and vice versa?

A

Liver

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10
Q

Which hormones regulate blood glucose?

A

Insulin
Amylin
Glucagon
GLP-1

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11
Q

What is amylin?

A

Hormone that slows gastric emptying
Suppresses glucagon secretion
Increases satiety

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12
Q

What is GLP-1

A

Hormone that carries out lactose dependent insulin secretion
Suppresses postprandial (after meal) glucagon secretion
Regulates gastric emptying
May increase beta-cell mass

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13
Q

Describe the process from the release of GLP-1

A

GLP-1 releases from GI tract to stomach to inhibit gastric emptying to lower BG. Also releases to pancreas to lower glucagon secretion and increase insulin release

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14
Q

What is DPP4?

A

Dipeptidyl peptidase 4

Breaks down GLP-1

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15
Q

What is SGLT-2?

A

Sodium glucose like transporter 2
Responsible for reabsorbing glucose from urine to kidneys
Exchanges sodium for glucose

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16
Q

Normal fasting plasma glucose in people w/o diabetes?

A

<100 mg/dl

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17
Q

Normal 2 hour postload glucose in ppl w/o diabetes

A

<140 mg/dl

18
Q

Inside a red blood cell, glucose and hemoglobin can combine to form?
Determining the amount of this product is used to determine what?

A

Glycohemoglobin

HbA1c

19
Q

Higher percentage of HbA1c means?

A

More glucose in blood

20
Q

Normal HbA1c in ppl w/o diabetes? (%)

A

< or equal to 5.5 or 5.7%

21
Q

What guidelines do we use for diabetes?

A

American Diabetes Association
AACE/ACE Clinical Practice Guidelines
International Guidelines

22
Q

Classification of Diabetes (types)

A
  1. Prediabetes
  2. Type 1 diabetes
    - beta-cell destruction (rapid dec of ins. production)
  3. Type 2 diabetes
    - progressive insulin secretory defect
  4. Gestational Diabetes Mellitus (GDM) (occurs during pregnancy, risk factor for developing type 2 diabetes)
  5. Other specific types of diabetes
    - Monogenic diabetes syndromes (MODY)
    - diseases of exocrine pancreas
    - drug/chemical induces diabetes
23
Q

Diagnostic criteria for prediabetes

A

Fasting plasma glucose 100-125 mg/dL
Or
2-h plasma glucose 140-199 mg/dL
A1C 5.7-6.4%

24
Q

Diabetes risk factors

A 
Age
Gender
Pregnancy (gestational)
Genetics
HBP
Exercise
Body mass
25
Q

Criteria to diagnose diabetes

A

Fasting plasma glucose > or equal to 126 mg/DL
Or
2-h plasma glucose > or equal to 200 mg/dL
Or
A1C > or equal to 6.5%
Or
Classic diabetes symptoms + random plasma glucose > or equal to 200 mg/dL

26
Q

Metabolic syndrome

A 
Recognized group of characteristics that puts a pt at risk for type 2 diabetes 
Include:
Obesity
Hypertension 
Hyperlipidemia 
Insulin resistance/ glucose intolerance
Proinflammatory state
27
Q 
Type 1 vs type 2:
frequency
age of onset
body mass
symptomatic
insulin for survival
insulin for treatment
presence of antibodies
A

f: t1 5-10% t2 90%
a: <30, >30
bm: lean, obese
s: symptomatic, symptomatic
is: yes, no
it: yes, usually
poa: yes, rare

28
Q

Frequent symptoms of diabetes

A 
May be asymptomatic in type 2 diabetes
3 P’s: polyuria, polydispia: great thirst , polyphagia: excessive hunger
Ketoacidosis 
Weakness/fatigue
Glycosuria: peeing sugar
Dry, itchy skin
Visual changes
Skin and mucous membrane infections
29
Q

Polyuria

A

Peeing a lot due to high BG

30
Q

Polydipsia

A

Thirsty all the time

31
Q

Polyphagia

A

Hungry all the time

32
Q

Ketoacidosis
Define?
Symptoms?
Relationship to insulin?

A 
If you can’t break down glucose for energy your body breaks down fatty acids to ketones leading to pH imbalance 
Fruity odor breath
Polydipsia
Polyuria
Common when insulin is not present
33
Q

Hyperglycemia complications

A 
Diabetic ketoacidosis (common in type 1)
Hyperglycemic hyperosmolar nonketotic syndrome
34
Q

Hyperglycemic hyperosmolar nonketotic syndrome

Type 1 or type 2?

A 
More common in type 2
Drawing fluid into blood vessels
Polyuria
Polydipsia
UTI
35
Q

Two pathways for development of complications?

A

Advanced glycosylation endproducts (AGE’S)

Sorbitol (polyol) pathway

36
Q

Advanced glycosylation endproducts (AGE’S)

A

Elevated levels of circulating glucose attaches to proteins or lipids and glycolates them
Accumulate over lifetime
indicates development of certain disease including diabetes

37
Q

Sorbitol Pathway

A

Some cells not dependent on insulin for entry of glucose

Glucose enters these cells and is enzymatically converted to sorbitol and fructose

38
Q

Sorbitol pathway complications

A

Elevated glucose within cell leads to incr formation of sorbitol and fructose increasing water pulled within cell causing cell swelling and cell damage

39
Q

alpha cells refer to what? what does it do? resulting effect?

A

glucagon
act on liver to release glycogen
inc blood sugar

40
Q

beta cells refer to what? what does it do?

A

insulin

dec blood sugar

41
Q

delta cells refer to what? what does it do?

A 
somatostatin
stops glucagon, insulin and growth hormone secretion
slows gastric emptying
dec blood sugar
released by other cells

Pharmacy Practice I (15 decks)

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