Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

6-Clinical Nutrition 1 > Diabetes Pharmacological Management > Flashcards

Diabetes Pharmacological Management Flashcards

1
Q

What are the patterns of insulin and glucose throughout the day?

A

glucose mimmics insulin

higher after meal, lower 3 hours after meal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the bolus types of insulin?

A

Rapid-acting –> Lispro

Short-acting –> Regular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the basal types of insulin?

A

Intermediate-acting –> NPH
Long-acting –> Glargine

***Premixed –> 30/70 (30% reg/70% NPH) –> on its own group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the

  • brand name
  • onset
  • peak
  • duration

for rapid acting Lispro insulin?

A
  • brand name: Humalog
  • onset: 10-15 min
  • peak: 1-2h
  • duration: 3-5h
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the

  • brand name
  • onset
  • peak
  • duration

for Short-acting –> Regular insulin?

A
  • brand name: Humulin-R
  • onset: 30min
  • peak: 2-3h
  • duration: 6.5h
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the

  • brand name
  • onset
  • peak
  • duration

for Intermediate-acting –> NPH insulin?

A
  • brand name: Humulin-N
  • onset: 1-3h
  • peak: 5-8h
  • duration: 10-18h
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the

  • brand name
  • onset
  • peak
  • duration

for Long-acting –> Glargine insulin?

A
  • brand name: Lantus
  • onset: 30-60 min
  • peak: no peak
  • duration: 10-16h
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the

  • brand name
  • onset
  • peak
  • duration

for Premixed –> 30/70 (30% reg/70% NPH) insulin?

A
  • brand name: Humulin-R 30/70
  • onset: 30-60min
  • peak:dual
  • duration: 10-16h
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Basal vs Bolus insulin

A

Basal

  • same molecular form as human insulin, made from microbes = ecoli
  • they are mimicking human insulin but they have some specificity, slower release better action by the pharma companies

Bolus

  • rapid acting
  • acts immediately after injection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the considerations for premixed?

A
  • premixed is for old people, uneducated and don’t know how to use these medications
  • lunch time the glucose will be higher than insulin so the person might have hyperglycemia
  • it mostly covers the breakfast and dinner
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the types of insulin regimens?

A

Conventional : premixed or fixed insulin plan

Intensive: recommended for better control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some considerations for intensive insulin therapy?

A

¢ Basal insulin + injections of rapid insulin before meals: more closely mimics physiology
¢ More flexibility in timing and content of meals: insulin is adjusted according to CHO intake –> must learn carb counting
¢ Insulin dose may be adjusted to exercise
¢ SMBG frequent
¢ Intensive therapy delays onset and slows progression of complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Conventional vs intensive treatments in terms of risk reduction of nonfatal MI, stroke or death from CVD

A

intensive insulin treatments reduces more risk than conventional insulin treatments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the techniques used to deliver insulin?

A

Syringe
Pen
Continuous glucose sensor (closed-loop system)
Insulin pump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some antihyperglycemic agents?

A
  • Metformin (GlucophageTM)
  • α-glucosidase inhibitors
  • Insulin secretagogues*, meglitinide, sulfonylurea
  • Incretin mimetics, DPP-4 inhibitors GLP-1 receptor agonists
  • Thiazolidinediones (TZDs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the recommended initial drug to treat T2DM

A

Metformin (GlucophageTM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the class name of Metformin (GlucophageTM)?

A

biguanide

18
Q

What is the mechanism of action of biguanide?

A

↓ GNG → ↓ glucose production

↑ insulin sensitivity → ↑ glucose uptake

19
Q

Where does the source of Metformin come from?

A

Galega officinalis

20
Q

What are the advantages of Metformin?

A

Known safety, no hypoglycemia, helps with weight control

21
Q

What are some side effects of Metformin?

A 
mostly GI (transient), B12 deficiency (10-30%
of cases)
22
Q

What are some contraindications of Metformin?

A

renal insufficiency, liver or heart failure

23
Q

What is the mechanism of action of α-glucosidase inhibitors?

A

Delay intestinal glucose absorption

24
Q

What is the mechanism of action of Insulin secretagogues*

meglitinide sulfonylurea?

A

Stimulate insulin secretion
Short-acting (4-7h)
Long-acting (once daily)

25
Q

What is the mechanism of action of Incretin mimetics

DPP-4 inhibitors GLP-1 receptor agonists?

A

Stimulate insulin and reduce glucagon secretion; delays gastric emptying

26
Q

What is the mechanism of action of Thiazolidinediones (TZDs)?

A

Increase insulin sensitivity in peripheral tissues and liver

27
Q

What is the mechanism of action of DPP-4 inhibitors specifically?

A

inhibit DPP-4 enzyme that inhibits GLP-1

28
Q

What are the functions of GLP-1?

A
  • Stimulates insulin release
  • Inhibits glucacon release
  • Slows gastric emptying
  • Increase satiety
29
Q

What is the mechanism of action of GLP-1 receptor agonists specifically?

A

promote GLP-1

30
Q

What are the drug-nutrient interactions or concerns of buigandes?

A

Reduce folate and vit B12 absorption, take with meals

31
Q

What are the drug-nutrient interactions or concerns of α-glucosidase inhibitors?

A

Take with first bite of meal, limit alcohol

32
Q

What are the drug-nutrient interactions or concerns of Insulin secretagogues?

A

avoid alcohol

33
Q

What are the drug-nutrient interactions or concerns of Thiazolidinediones (TZDs)?

A

none

34
Q

What is the mechanism of action of SGLT2 inhibitors?

A

Block glucose transport in the proximal renal tubule –> glycosuria –> lower blood glucose and body weight

35
Q

When added to SGLT 2 Inhibitors, ______ has better efficacy on lowering A1C than other agents

A

metformin

36
Q

What are some advantages of SGLT2 inhibitors?

A

rare hypoglycemia, lower BP, raise HDL

37
Q

What are some contraindications of SGLT2 inhibitors?

A

renal failure, loop diuretics, T1DM

Also: elevate LDL modestly (CVD risk remains to be
evaluated)

38
Q

What are some side effects of SGLT2 inhibitors?

A

risk of urinary tract infections, genital mycotic infections, hypotension (due to osmotic diuresis), more risk of diabetic ketoacidosis

39
Q

What is conventional insulin treatment? Explain how it is done and the considerations?

A
  • insulin injections (1-3/d) and meals must be consistent from day to day
  • strict meal plan: CHO content , meals should not be skipped
  • physical activity may lead to hypoglycemia
40
Q

How is intensive insulin treatment done?

A
  • multiple daily injections (≥3/d) or continuous subcutaneous insulin infusion (CSII, insulin pumps)

6-Clinical Nutrition 1 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions