Diabetes Lecture

Question 1

Which type of diabetes mellitus characteristically has no insulin production / patients are insulin dependent?

Answer 1

Type 1

Question 2

Which type of diabetes mellitus characteristically has some insulin production and is treated with oral hypoglycmics and insulin?

Answer 2

Type 2

Question 3

What is a normal non-diabetic fasting glucose range?

Answer 3

70-99

Question 4

A hemoglobin A1C below 5% is indicative of:

Answer 4

Normal / no diabetes

Question 5

A hemoglobin A1C of 5.7-6.4% is indicative of:

Answer 5

Prediabetes

Question 6

A hemoglobin A1C of 6.5% or greater is indicative of:

Answer 6

Diabetes

Question 7

Glucose lower than ___ is hypoglycemia and higher than ____ is hyperglycemia.

Answer 7

60 / 250

Question 8

Signs of hypoglycemia:

Answer 8

Nervousness, tremors, cold/clammy, diaphoretic, confusion/slurred speech, seizures/coma, death

Question 9

Signs of hyperglycemia:

Answer 9

Thirsty, polyuria, fruity breath, kussmauls breathing, rapid pulse, dry mucous membranes

Question 10

What’s an easy way to remember the difference between hypoglycemia and hyperglycemia?

Answer 10

Cold and clammy, need some candy
High and dry, sugar’s high

Question 11

When is less insulin required?

Answer 11

With exercise

Question 12

When is more insulin required?

Answer 12

Fever, infection, illness or stress

Question 13

What are the onset, peak and duration of RAPID acting insulin?

Answer 13

10-30 / 30-90 / 1.5-5

Question 14

What are the onset, peak and duration of SHORT acting insulin?

Answer 14

30 / 1.5-3.5 / 4-12

Question 15

What are the onset, peak and duration of INTERMEDIATE acting insulin?

Answer 15

1.5 / 4-12 / 14-24

Question 16

What are the onset, peak and duration of LONG acting insulin?

Answer 16

1-2 / 0-12 / 24-42

Question 17

Which insulins are clear / cloudy?

Answer 17

Rapid and short are clear. Intermediate is cloudy. Long-acting could be clear or cloudy.

Question 18

RAPID insulin is AKA ____ and is given ___.

Answer 18

Lispro, humalog, insulin aspart. Given with meals

Question 19

SHORT ACTING insulin is AKA ____ and is given ___.

Answer 19

Regular insulin, humulin R, novolin R. Given 30-60 mins before meals.

Question 20

INTERMEDIATE ACTING insulin is AKA ____.

Answer 20

Insulin isophane, NPH, humulin N, novolin N.

Question 21

LONG-ACTING insulin is AKA ____ and is given ___.

Answer 21

Insulin glargine, lantus (no peak) or insulin detemir (peak: 6-8 hrs). Normally given at bedtime.

Question 22

Name combination insulins (3)

Answer 22

Humulin 70/30
Insulin Isophane NPH 50/50
Humalog 75/25

Question 23

4 medications that interact with insulin by INCREASING glucose

Answer 23

Thiazide diuretics, glucocorticoids, thyroid agents, estrogens

Question 24

4 medications that interact with insulin by DECREASING glucose

Answer 24

Tricyclic antidepressants, MAOIs, aspirin products, oral anticoagulants

Question 25

How should you mix regular and NPH insulin?

Answer 25

Regular (clear) then intermediate (cloudy)

Question 26

What is the only oral medication that can be used for both types of DM?

Answer 26

Pramlintide

Question 27

Which oral diabetic meds are contraindicated in class 3 and 4 heart failure due to dose-related fluid retention?

Answer 27

Thiazolinediones