Diabetes quick review Flashcards by Destiny Akins

Glucose Lowering Medications
(Non hypoglycemic)

Metformin
Glitazones
Alpha-glucosidase inhibitors
SGL2 inhibitors

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Metformin works by

Decreases hepatic (liver) production of glucose
Improves insulin sensitivity
- B12 def. may occur

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Glitazones have 2 types

Actos
Avandia

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Metformin AKA

Glucophage

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Glitazones work by

Increasing insulin sensitivity
- may cause weight gain

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Glucose Lowering Medications
(Potentially hypoglycemic)

GL1P Agonists
Insulin secretagogues
Amylin analogues

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GL1P Agonists work by

T2: Delay gastric emptying and promote satiety
T1: Stimulates insulin and suppresses glucagon
- injected

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Insulin secretagogues (2 classes)

Sulfonylureas
Glinides

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Alpha-glucosidase inhibitors (1)

Acarbose/Precose

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Berberine

May improve fasting and A1C blood glucose
Antioxidant/Anti-inflammatory

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Chromium

A mineral that enhances insulin action

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Alpha linoleic acid

May boost the ability to use insulin
May improve neuropathy symptoms
Antioxidant, energy, and protein metabolism

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Cinnamon

May improve fasting blood sugar, but not A1C
Antioxidant/Anti-inflammatory

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Someone with an FPG greater than or equal to _____ may have diabetes.

126

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Someone with a CPG greater than or equal to _____ may have diabetes.

200

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Someone with a 2 hr PG greater than or equal to _____ after an OGTT may have diabetes.

200

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Someone with an A1C greater than or equal to _____ may have diabetes.

6.5%

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Someone with a 2 hr PG greater than or equal to _____ may have pre-diabetes.

140-199

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Someone with an FPG between _____ may have pre-diabetes.

100-125

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Someone with an A1C greater than or equal to _____ may have pre-diabetes.

5.7-6.4

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Polydipsia

Excessive thirst

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Polyphagia

Excessive hunger

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LADA involves the autoimmune destruction of insulin-producing beta cells, like in Type 1, but it develops more gradually and usually occurs in adults over ____.

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Equal amounts of _____ and sucrose promote similar glycemic response

Starch

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The glycemic index (GI) measures the blood glucose response to foods based on a standardized portion of ___ grams of digestible carbohydrates (CHO), excluding fiber.

_______ differs from the glycemic index (GI) in that it considers both the quality (GI) and the quantity of carbohydrates in a specific serving size of food.

Glycemic Load

One serving of CHO =

15 g

___ cup of cooked cereal, grain, or starchy vegetable = 15g of CHO

1/2

___ oz of bread product = 15g of CHO

1 1/4 of a large bagel or 1 mini bagel 1 regular slice of bread 1/2 English muffin 1 small tortilla

___ cup dry cereal = 15g of CHO

___ cup cut fruit = 15g of CHO

1/2

___ small piece of fruit = 15g of CHO

___ T dried fruit = 15 g of CHO

___ cup milk/yogurt = 12 g of CHO

___ T honey/syrup/sugar = 15 g of CHO

Alpha-glucosidase inhibitors work by

Inhibiting the enzyme to prevent the breakdown and absorption of CHO to inhibit the effect of CHO on blood sugar - may cause GI issues due to fermentation of undigested CHO

SGL2 inhibitors (1)

Jardiance

SGL2 inhibitors work by

Preventing excessive glucose reabsorption in the kidneys

Amylin analogues work by

Suppressing glucagon (T1) Injected before meals to slow gastric emptying

Amylin analogues (1)

Symlin/Pramlintide

Insulin secretagogues work by

Stimulate insulin secretion - Type 2 diabetics who start to lose beta cell function

Insulin Secretagogues: Sulfonylureas (2)

Glipizide/Glucotrol Glyburide

Insulin Secretagogues: Glinides (2)

Prandin Starlix

Treatment for LADA includes

People with LADA initially may not need insulin, but they typically progress to requiring it as beta cell function declines over time.

Bolus/Meal time insulin

Rapid and short acting insulin Based on CHO content in the meal Insulin to CHO ratio Must know how to count carbs

Rapid acting (2 types)

Lispro/Humalog Aspart/Novalog

Rapid acting insulin description

Taken at start of meals Onset: <15 min Peak: 1-2 hrs Duration: 3-5 hours Less hypoglycemia compared to regular insulin, more preferred

Short acting is AKA

Regular insulin

Short acting insulin description

Taken 30-60 min before meals Onset: 30-60 min Peak: 2-3 hrs Duration: 3-6 hours More risk for hypoglycemia

Intermediate-acting insulin description

Onset: 2-4 hrs Peak: 4-10 hrs Duration: 10-16 hrs

Most common intermediate-acting insulin

NPH

Long acting insulin description

Taken at nigh to cover hepatic glucose output Bedtime snack Onset: 2-4 hrs Peakless Duration: 18-24 hrs Less nocturnal hypoglycemia compared to NPH

Long acting insulin (2 types)

Glargine/Lantus Determir/Levemir

Mixed Insulin

Premixed to contain intermediate-acting and rapid-acting insulins Must eat at specific times and be consistent with CHO intake Less flexible but fewer injections

Flexible/common insulin regime

Basal/Bolus

If dawn phenomenon occurs, patient would be on

Intermediate acting or basal/bolus regime due to hormonal changes in the middle of the night

Inhaled insulin

Before meals Rapid-acting Onset: 15 min Peak: 1 hour Duration: 2-3 hours Still need injections of basal insulin

Inhaled insulin (1)

Afrezza

Insulin pumps

Delivers rapid acting insulin Increase for bolus delivery before meals, then continuous insulin for 24/7

A mixed insulin contains a rapid and ______ acting insulin

Intermediate

Add 15 g of CHO for every 30- ___ mins of exercise

Double CHO content if pre-exercise BG levels are less than ___ mg/dL

100

Goals for diabetic A1C

Less than 7

Goals for diabetic fasting blood sugar

70-130

Goals for diabetic 2 hours post prandial less than

180

DKA is a result of

inadequate insulin or illness and causes a build up of ketones and has the same symptoms as T1DM, as well as fruity breath

DKA diagnosis is defined as BG more than ___ mg/dL due to hyperglycemia

250

Treatment for DKA is insulin and

Fluid and electrolyte replacement

Macrovascular

Dyslipidemia Hypertension

Microvascular

Nephrophathy Retinopathy Nueropathy

Types of GL1P Agonists

Byetta, Victoza, Trulicity, Wegovy, Ozempic