part 4

Question 1

For who and why is Dawn phenomenon common?

Answer 1

• adolescence or young adults

- because of the 2 counterregulatory hormones (growth hormone and cortisol which are excreted in early morning

Question 2

What is the treatment for Dawn phenomenon?

Answer 2

increase insulin before bed

Question 3

Explain Dawn effect?

Answer 3

steady increase in BG all night
pt is hyperglycemic in the AM
TX: increase insulin before bed

Question 4

Oral agents (OAs) and noninsulin injectable agents work to improve the mechanisms by which insulin and glucose are produced and used by the body. On what 3 defects of T2DM do these work?

Answer 4

• insulin resistance
• decreased insulin production
• increased hepatic glucose production

Question 5

In what combinations do OA and noninsulin injectable agents work with?

Answer 5

• agents from other classes

- with insulin to achieve blood glucose goals

Question 6

Would oral agents ever be used for T1DM?

Answer 6

no

Question 7

What do biguanides do to hepatic glucose production?

Answer 7

decreases rate of hepatic glucose production

Question 8

What do biguanides do to insulin sensitivity and glucose?

Answer 8

• increase insulin sensitivity

- improves glucose uptake by tissues (especially muscles)

Question 9

What do thiazolidinediones do to glucose?

Answer 9

• increases glucose uptake in muscle

- decreases endogenous glucose production

Question 10

What do sulfonylureas do?

Answer 10

• stimulates release of insulin from pancreatic islets
• decreases glycogenolysis and gluconeogenesis (not making glucose)
• enhances cellular sensitivity to insulin

Question 11

What do meglitinides do?

Answer 11

stimulates a rapid and short lived release of insulin from the pancreas