Pancreas

Question 1

lack of insulin
o Loss of insulin-producing beta cells of the islets of Langerhans
o Complications: retinopathy, nephropathy, neuropathy, diabetic ketoacidosis o Oral antihyperglycemic agents not effective

Answer 1

type 1 diabetes

Question 2

insulin resistance
o Reduced # of receptors, receptors less responsive
o Greater incidence r/t to obesity among children and adolescents
o Higher: abdominal obesity, triglycerides, and BP (strong associated with dev.) o Obesity worsens insulin resistance b/c adipose tissue is the site of the body’s defective insulin receptors

Answer 2

Type 2 diabetes

Question 3

Hyperglycemia – fasting plasma glucose should be____

Answer 3

> 7 mmol/L

Question 4

Hypoglycemia – blood glucose level is ____

Answer 4

<2.8 mmol/L

Question 5

Onset, peak and duration for rapid acting

Answer 5

Onset: 10-15 minutes
Peak: 1-2 hours
Duration: 3-5 hours

Question 6

aspart-NovoRapid, lispro-Humalog, glulisine-Apidra are examples of what type of insulin

Answer 6

Rapid acting

Question 7

onset peak and duration for short acting and give examples

Answer 7

Onset: 30 minutes
Peak: 2-3 hours
Duration: 6.5 hours
regular, Humulin R, Toronto

Question 8

Humulin N*, NPH are what type of insulin

Answer 8

intermediate acting

Question 9

onset, peak and duration for intermediate acting

Answer 9

Onset: 1-3 hours
Peak: 5-8 hours
Duration: up to 18 hours

Question 10

glargine-Lantus*, lente are examples of what type of insulin?

Answer 10

Long acting

Question 11

onset, peak and duration for long acting

Answer 11

Onset: 90 minutes
Peak: none identified
Duration: 24 hours

Question 12

onset, peak and duration for long acting

Answer 12

Onset: 90 minutes
Peak: none identified
Duration: 24 hours

Question 13

true or false: long acting insulin has a peak

Answer 13

false

Question 14

Humulog, Humulin 30/70*, 20/80 are type of what insulin

Answer 14

Combination Insulin products

Question 15

stimulate insulin secretion

Answer 15

Insulin secretagogues

Question 16

Glyburide-Diabeta, Chlorpropamide-Diabense,
tolbutamide, Glimepiride, gliclazide
are examples of

Answer 16

Sulfonylureas

Question 17

Hypoglycemia, hematological effects, nausea, epigastric
fullness, heartburn are side effects of

a. glyburide
b. biguanides
c. both

Answer 17

a

Question 18

Repaglinide, nateglinide are examples of what?

Answer 18

Non-sulfonylureas

Question 19

· Decrease liver production of glucose 
· decrease glucose absorption in bowel 
· increase receptor sensitivity 
· Increase uptake of glucose by tissues 
· Does not increase insulin secretion from pancreas therefore does not cause hypoglycemia

Answer 19

Biguanides

Question 20

side effects of Biguanides

Answer 20

Abdominal bloating, nausea, cramping, diarrhea, metallic taste, reduced B12 levels – taken with meals to reduce GI effects

Question 21

Reversibly inhibit the enzyme alpha-glucosidase in the small intestine
· Result: delayed absorption of glucose
· Must be taken with meals to prevent excessive postprandial blood glucose elevations (given with the first bite of each main meal)

Answer 21

Alpha-glucosidase inhibitors

Question 22

side effects of Alpha-glucosidase inhibitors

Answer 22

flatulence, diarrhea, abdominal pain

Question 23

Decrease insulin resistance - “Insulin sensitizing agents”
· Increase glucose uptake and use in skeletal muscle
· Inhibit glucose and triglyceride production in the liver

Answer 23

Thiazolidinedione/Glitazones

Question 24

Thiazolidinedione/Glitazone side effects

Answer 24

moderate weight gain, edema, mild anemia, hepatic toxicity

Question 25

Hypoglycemia S&S

Answer 25

``` ● hunger and headache ● nervousness /shakiness ● perspiration ● dizziness or light-headedness ● sleepiness ● confusion ● difficulty speaking ● blurred vision ● feeling anxious or weak ```