Diabetes Mellitus Flashcards
What are the two main functions of the pancreas, and what hormones does it produce?
Produces hormones (insulin and glucagon) and produces pancreatic digestive enzymes.
Alpha cells release ______ while beta cells of the pancreas release _______.
Alpha cells: glucagon. Beta cells: Insulin
HbA1c allows us to determine the average blood sugar control over a 6-12 week period. How is this possible?
HbA1c is formed in a non-enzymatic glycation pathway by hemoglobin’s exposure to plasma glucose. As plasma glucose increases, the fraction of glycated hemoglobin increases in a predictable way, reflecting the average level of glucose to which the RBC has been exposed to during its life cycle. (which is 100-120 days).
Duration of glycemic burden should be measured how often and what does it tell us?
Every 3 months, it is a strong predictor of adverse outcomes
To diagnose diabetes mellitus: HbA1c has to be greater than or equal to _____, fasting plasma glucose has to be _______, and two hour glucose during an OGTT (75 g glucose in water) has to be _______. With symptoms of hyperglycemia with a random glucose of ______.
HbA1c: > 6.5%
Fasting sugar: 126 mg/dL
2-hr glucose during OGTT: >200
Random glucose: >200
Glycemic targets: HbA1C
<7%
Glycemic Targets: Preprandial plasma glucose
70-130
Glycemic targets: postprandial plasma glucose
<180
Polyuria, polydipsia, polyphagia, glucosuria, weight loss, and fatigue are clinical manifestations of what?
Type 1 DM
Body breaks down fatty acids for fuel if it can’t utilize insulin.
Diabetic ketoacidosis
Primary treatment for Type 1 DM
Insulin
Onset 15 min, peak 1-3 hrs, duration 3-5 hours. Dose according to how many carbs are ingested, give 15 minutes before or immediately after a meal.
Rapid acting insulin
Onset 30-60 minutes, peak 2.5-5 hours, duration 4-12 hours. Give 30-60 minutes before meal.
Short acting insulin
Onset 1-2 hours, peak 4-12 hrs, duration 14-24 hours. Cloudy.
Intermediate acting
Onset 3-4 hours, no peak, duration 24 hours. Give once daily @ bedtime (or twice if needed). cloudy.
Long acting insulin
True or False: To alleviate pain, apply heat to SC injection sites of insulin.
FALSE! Do not rub or place heat on injection site.
Rapid acting or short acting insulin given based on blood glucose levels. Reactive approach to blood sugar control.
Sliding Scale Insulin
What is the MOA of insulin?
Moves glucose transporters to the cell surface, facilitating taking glucose into the cell.
Hypoglycemia can occur at any blood sugar level below…
70 mg/dL.
True or false: Insulin has drug-drug interactions with drugs that decrease hypoglycemic effects (not drugs that increase hypoglycemic effects).
False! It interacts with both. (decrease: antiretrovirals, corticosteroids, thizaides, loop diuretics, thyroid preparations. Increase: alcohol, beta blockers, lithium, MAOIS, sulfonylureas, salicylates).
Dizziness, irritability, diaphoresis, blurred vision, confusion, difficulty paying attention, and seizures are symptoms of what?
Hypoglycemia
What do you give a pt in a state of hypoglycemia?
Sugar or glucagon.
Induces liver glycogen breakdown, releasing glucose from the liver.
Glucagon.
Non-insulin dependent diabetes
Type 2 DM
