Glucose Regulation pt 2 Flashcards
what is optimal nutrition
all nutrients are available in balanced amounts for cellular metabolism and physiological function for the individual
what is suboptimal nutrition
malnouished state
what is mechanical breakdown
chewing and peristalsis propelling food through stomach and intestines
what do proteins do for cells
must be available for cells to manufacture other proteins
carrier proteins
enable tissue growth and repair
what do carbs do for cells
provides energy for protein to do its many jobs
required to provide glucose for unique fuel needs of the brain, neurologic system, and RBCs
what do essential fatty acids do for cells
maintain integrity of the phospholipid-based cell membranes, found around every cell
what do zinc and folic acid do for cells
critical for production of proteins and cellular structures
what are the pregnancy risk factors
insulin resistance
risk of hyperglycemia
screening for gestational diabetes at 24-28 weeks
what infants are at risk for hypoglycemia
large gestational age infants
infants whose mothers had gestational diabetes
neonatal hyperinsulinemia
premature infants
small gestational age infants
what can cause obesity
overreating
inactivity
genetics
what is obesity defined as
BMI>30 or being more than 20% over ideal body weight
what BMI is overweight
25-29.9
what does exercise do for glucose regulation
improves insulin resistance
improves cellular metabolism (more transporter molecules in cells)
what is insulin resistance
problem w/ how cell responds to insulin signaling
reduction of insulin receptors or glucose transporter molecules
pancreas overproduces insulin to compensate for reduced cellular glucose uptake (hyperinsulinemia)
what is bariatric surgery
restricts pt’s ability to eat
interferes w/ ingested nutrient absorption
sleeve gastrectomy
what is dumping syndrome
post bariatric surgery- vasomotor and GI symptoms
rapid transit of food bolus from stomach to small intestines
occurs w/in a few min to 2 hr after eating
high sugar foods exacerbate
what happens to blood glucose post bariatric surgery
bg rises rapidly
reactive hypoglycemia
what is the rapid acting insulin called
lispro
what is the onset for lispro
15-30 min
what is the peak for lispro
.5-3 hr
what is the duration for lispro
3-5 hr
what is the short acting insulin called
regular insulin (novolin R)
what is the onset for regular insulin
.5-1 hr
what is the peak for regular insulin
1-5 hrs
what is the duration for regular insulin
6-10 hrs
what is the intermediate acting insulin
NPH (Humulin)
when is NPH typically given
morning and evening
what is the onset for NPH
1-2 hrs
what is the peak for NPH
4-14 hrs
what is the duration for NPH
14-24 hrs
what is the long acting insulin called
insulin glargine u-100 (lantus)
what insulin is weight dependent
detemir (Levemir)
what is the onset for glargine
1-4 hrs
what is the duration for glargine
24 hrs
what does insulin do
promotes cellular uptake of glucose
converts glucose into glycogen
moves potassium into cells along w/ glucose
how do beta blockers interact w/ diabetics
mask hypoglycemia
impairs body’s natural ability to breakdown glycogen stores to raise blood glucose levels
decreases HR, BP, and fight or flight
how do glucocorticoids interact with diabetics
increases blood glucose levels
how do thiazides interact with diabetics
increases blood glucose levels
what are sulfonylureas
oral
insulin release from pancreas
glyburide, glipizide, and glucotrol
what are meglitinides (glinides)
oral
insulin release from the pancreas
repaglinide, nateglinide
what are alpha-glucosidase inhibitors
oral
slows carb absorption and digestion
miglitol
acarabose
what are DPP-4 inhibitors (gliptins)
oral
promote release of insulin and decreases secretion of glucagon
lowers fasting and post-prandial blood glucose levels
sitagliptin
what are SGLT-2 inhibitors
oral
used in combo w/ insulin type 1
limits the rise of glucose postprandial
excretes glucose through the urine by preventing its reabsorption in the kidney
canagliflozin, dapagliflozin
what are the side effects of glipizide
hypoglycemia
wt gain
combined w/ alc can cause nausea, vomiting, palpitations, and flushing
what are the side effects of metformin
GI- nausea, anorexia, diarrhea
wt loss 3-4 kg
vit b-12 and flic acid deficiency
alters absorption
using iodnie contrast can cause acute kidney failure
what are the side effects of piglitazone
fluid retention
elevates LDL
hepatotoxicity
