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33: Diabetes Mellitus > questions > Flashcards

questions Flashcards

0
Q

what is the most common type of diabetes?

A

type two diabetes

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1
Q

what is lipohypertrophy?

A

results in fat accumulation around the injection site

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3
Q

define: postprandial

A

after eating

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3
Q

how was insulin originally manufactured?

A

-from animal sources; pig and cow

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4
Q

how long after consuming alcohol beverages can delayed hypoglycemia occur?

A

24 hours

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5
Q

are some adverse reactions of α-glucosidase inhibitors?

A

-most commonly produce G.I. side effects: bloated feeling, diarrhea, stomach or intestinal gas, rumbling stomach and stomach pain or discomfort

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6
Q

what is the most effective agent for glycemic control?

A

insulin

-also reduces the hemoglobin A1C level by more than 2%

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7
Q

what are the four types of diabetes?

A
  1. Prediabetes
  2. type one diabetes
  3. type two diabetes
  4. gestational diabetes
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7
Q

what is a “diabetes” diet?

A

A diet that is high in fat and carbohydrates

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9
Q

_______ are sometimes categorized as oral hypoglycemic agents (OHA).

A

Sulfonylureas

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10
Q

which type of diabetes is an autoimmune disease?

A

type one diabetes

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11
Q

what types of disease or risk factors for diabetes?(9)

A
  • hypertension
  • angina
  • myocardial infarction
  • stroke
  • metabolic syndrome
  • insulin resistance
  • Hyperlipidemia
  • schizophrenia
  • polycystic ovary syndrome
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13
Q

how many diabetes suffers, suffer from type one diabetes?

A

only 5% to 10%

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13
Q

______ causes impaired fasting glucose(IFG) and impaired glucose tolerance(IGT)

A

Prediabetes

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14
Q

how is insulin administered?

A

subcutaneously

-your insulin may also be administered intravenously

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15
Q

of those suffering from diabetes, how many are suffering from type two diabetes?

A

90% to 95%

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16
Q

explain type two diabetes

A
  • pancreas initially produces sufficient insulin, but the body is unable to use the insulin effectively.
  • insulin production eventually decreases; however this may not occur for several years
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17
Q

what are the five risk factors of type two diabetes?

A
  1. obesity
  2. lack of physical activity
  3. Family history
  4. prior gestational diabetes
  5. increasing age
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18
Q

what are the symptoms of type one diabetes?(8)

A
  • blurred vision
  • Constant hunger (polyphagia)
  • diabetic ketoacidosis
  • Extreme fatigue
  • frequent urination (polyuria)
  • Hyperglycemia
  • increased thirst (polydipsia)
  • weight-loss
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19
Q

approximately ____ of persons diagnosed with __________ are overweight.

A

80%

take two diabetes

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20
Q

OHAs are only effective for the treatment of __________.

A

type two diabetes

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21
Q

what are the causes of type one diabetes?(3)

A
  • exposure to environmental factors
  • viruses
  • genetics
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22
Q

what are the dosage delivery systems for the administration of insulin?(3)

A
  1. insulin pump
  2. vial and syringe
  3. insulin pen
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23
Q

what was type two diabetes formally called? Why was the term replaced?

A

non-insulin-dependent diabetes mellitus
-this term has been replaced because people with type two diabetes sometimes may be required to manage the condition with insulin

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24
Q

what is gestational diabetes?

A

diabetes in pregnancy

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25
Q

how many people suffer from gestational diabetes?

A

approximately 3% to 8% of all pregnant women

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26
Q

what insulin must be refrigerated and discarded after 28 days(5 and 10mL)?

A

insulin glargine (Lantus)

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27
Q

what is a sign of gestational diabetes?

A

blood glucose levels are normally lower than normal during pregnancy so elevated blood glucose levels as a sign of gestational diabetes

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28
Q

_________s lower postprandial blood glucose levels by stimulating insulin secretion from pancreatic beta cells, similar to sulfonylureas. The action on basil insulin is less effective.

A

meglitinides

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29
Q

those who’ve had gestational diabetes have a ___ to ___ increased risk for the development of ________ within _____.

A

20% to 50%
type two diabetes
5 to 10 years

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30
Q

what are the symptoms of type two diabetes?(8)

A
  • blurred vision
  • fatigue
  • frequent urination
  • Hunger
  • Hyperglycemia
  • increased thirst
  • slow healing of wounds
  • weight-loss
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31
Q

what is insulin resistance?

A

A condition in which the body does not respond to insulin

-precursor to type two diabetes

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33
Q

The prevailing’s of type two diabetes is increased in: (4).

A
  • Aboriginal Canadians
  • native Americans
  • African Americans
  • Mexican Americans
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34
Q

what was type one diabetes formally called?

A

juvenile-onset diabetes mellitus

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35
Q

T/F: prediabetes increases the risk of cardiovascular disease

A

true

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36
Q

explain: type one diabetes

A
  • autoimmune disease
  • immune system attacks and destroys the insulin producing cells in the pancreas.
  • must inject insulin daily
  • equal among males and females but, more common in whites than non-whites
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38
Q

What are the 4 recommended lifestyle modifications in the treatment of diabetes?

A
  1. Low glycemic index foods
  2. engage in physical activity
  3. stop smoking
  4. lose weight
39
Q

what is the onset of action for long-acting insulin?

A

90 minutes.

40
Q

is the mechanism of action for an Amylin analogue?

A

-slows gastric emptying, reduces postprandial glucagon secretion and reduces appetite.

45
Q

meglitinide: ________, is rapidly and completely absorbed from the intestinal track. Peak effect is felt in 1- 1.5 hours

A

repaglinide

46
Q

what is a common ending for thiazolidinediones?

A

-glitazone

47
Q

when is rapid acting insulin injected?

A

5 to 15 minutes before eating, or even after a meal for some individuals

53
Q

T/F: diabetes mellitus causes microvascular and macrovascular damage

A

true

54
Q

how are thiazolidinediones administered?

A

-Orally

56
Q

what is ketoacidosis?

A

A condition in which the body breaks down fats to obtain its energy needs.
ketones are a byproduct of lipid metabolism, and their accumulation can lead to, and death

57
Q

how is insulin stored?

A

refrigerate unopen vial; do not freeze. Open vials of insulin may be stored at room temperature, but this will shorten the expiry date for most.

58
Q

what types of drugs are associated with hypoglycemia?(4)

A
  1. ASA; salicylates
  2. alcohol
  3. angiotensin-converting enzyme inhibitors; angiotensin II receptor blockers
  4. beta blockers
59
Q

_______ are used in the treatment of hyperglycemia and hypoglycemia.

A

beta blockers

60
Q

what is the mechanism of action for OHA’s?

A

primarily stimulate insulin release from pancreatic beta cells.
-also decrease glycogenolysis

61
Q

What 4 drugs are sulfonylureas?

A
  1. Glyburide
  2. glicazide
  3. glipizide
  4. glimepiride
62
Q

what is a serious side effect of sulfonylureas?

A

hypoglycemia

63
Q

what are some side effects of sulfonylureas?

A
  • weight gain
  • abdominal pain
  • diarrhea
  • dyspepsia
  • nausea and vomiting
  • headache
  • dizziness
64
Q

what are biguanides, and what is its mechanism of action?

A
  • Antidiabetic agents; only metformin
  • improves glucose tolerance and insulin resistance by increasing peripheral glucose uptake and utilization in skeletal muscles and adipose tissue.
65
Q

food ______ the absorption of immediate-release tablets but ______ the absorption of metformin solution and extended release tablets.

A
  • decreases

- increases

66
Q

T/F: extended release dosage forms of metformin are not substitutable

A

true

-designed to remain in the stomach and deliver metformin to the upper G.I. tract, where absorption is enhanced

67
Q

where some adverse reactions of metformin?

A

-common GI reactions: gas, heartburn, metallic taste in mouth, mild stomach ache, nausea, weight-loss

68
Q

what are the most common adverse reactions of therapy with thiazolidinediones ?

A

headache, Wiecking, diarrhea, nausea, and vomiting.
-patient should be instructed to report signs of muscle pain, jaundice, blurred vision, and signs of hypo- or hyperglycemia

69
Q

when is pramlintide administered? how?

A

with mealtime insulin to control blood sugar levels

-injected subcutaneously immediately prior to each meal

70
Q

________ may produce lactic acidosis, a rare but potentially fatal condition.

A

metformin

71
Q

T/F: Met Forman may stimulate ovulation in infertile women that have polycystic ovary syndrome

A

true

72
Q

what six dietary supplements have been found as adjunctive therapy for people with diabetes?

A
  1. alpha-lipoic acid*
  2. magnesium*
  3. chromium
  4. coenzyme Q10
  5. omega-3 fatty acids*
  6. garlic*
    * most evidence of possible usefulness
73
Q

what is a α-Glucosidase inhibitor?

A
  • prolong digestion of carbohydrates and delay their absorption in the small intestine
  • do not promote insulin secretion like many other antidiabetic agents nor do they cause hypoglycemia
74
Q

what are meglitinides?

A
  • oral antidiabetic agent used in the treatment and management of type two diabetes
75
Q

what are some adverse side effects of meglitinides?

A

-headache, nausea and vomiting

76
Q

________s should be used with caution in patients with liver dysfunction

A

meglitinides

77
Q

what is a common ending for meglitinides?

A

-glinide

78
Q

what is amylin analogue?

A
  • synthetic analogue of the hormone amylin

- Amylin levels are absent in type one diabetes and decreased in type two diabetes.

79
Q

Thiazolidinediones are also called _______; they are used for the treatment of type two diabetes.

A

-insulin sensitizers

80
Q

what are some serious side effects linked to thiazolidinediones ?

A

heart failure, heart attack, and liver failure

81
Q

dipeptidyl peptidase-4 inhibitors, _____ insulin release and ______ glucagon levels

A
  • increase

- decrease

82
Q

what is ALA? how does it help in the treatment of diabetes?

A

Alpha-Lipoic Acid

-and antioxidant

83
Q

pancreatitis is a rare but serious adverse reaction associated with the use of ______.

A

sitagliptin or liraglutide

84
Q

How does magnesium help in controlling diabetes?

A

Low magnesium levels may worsen glucose control in type two diabetes by interrupting insulin secretion

85
Q

what is magnesium? Where is it found?

A

A mineral found it green leafy vegetables, nuts, seeds and some whole grains

86
Q

what is a warning label found on DPP-4’s?

A

take at the same time each day, with or without food

87
Q

what two warning labels are found on meglitinides?

A
  1. take immediately prior to meals( skip if meal is missed)

2. take with a full glass of water

88
Q

The warning labels “limit or avoid alcohol” and “take with a full glass of water”are found on what type of drugs?

A

thiazolidinediones

89
Q

The warning label “store in the refrigerator; do not freeze”can be found on which drug used in the treatment of diabetes?

A

insulin

90
Q

incretin mimetics mailing be administered for ________ diabetes

A

type 2

91
Q

he adverse reactions associated with pramlintide?

A
  • Hypoglycemia, redness, swelling, bruising, itching at the injection site, loss of appetite, stomach pain, indigestion, upset stomach, excessive tiredness, dizziness, coughing, sore throat, and joint pain
  • nausea and vomiting are dose-dependent
92
Q

what is the most common side effect/s with exenatide and liraglutide?

A

nausea, affecting up to 50% of patients

93
Q

what is the mechanism of action for thiazolidinediones?

A
  • increased tissue sensitivity to insulin
  • do not increase insulin secretion so do not promote hypoglycemia
  • increased uptake of glucose in the liver and muscles
94
Q

T/F: it is important to eat a diet rich and complex carbohydrates while taking acarbose and miglitol

A

true

-must be administered with the first bite of each meal

97
Q

what drugs are associated with hyperglycemia?(10)

A
  1. atypical antipsychotics
  2. beta blockers
  3. diuretics, thiazides (>25mg hydrochlorothiazide)
  4. glucocorticoids
  5. growth hormone
  6. nicotinic acid
  7. pentamidine
  8. phenytoin
  9. protease inhibitors
  10. sympathomimetics
98
Q

what are some of the symptoms of hypoglycemia?

A
  • anxiety, nervousness, irritability
  • blurred vision
  • Cold sensations
  • confusion
  • difficulty concentrating
  • fatigue, uncontrolled yarning
  • headache
  • Hunger
  • loss of consciousness
  • muscle weakness
  • numbness of the mouth
  • palpitations, rapid heartbeat
  • shallow breathing
  • sweating
  • tingling in the fingers
100
Q

why is diabetes sometimes classified as a disease of lifestyle?

A

because lifestyle factors can increase the risk for type 2 diabetes and all types of diabetes can be improved by weight-loss, engaging in physical activity, consuming foods with low glycemic index, quitting smoking, and other lifestyle changes

101
Q

what is the onset of action for rapid acting insulin?

A

15 minutes

102
Q

how is insulin manufactured today?

A

genetically engineered using recombinant DNA technology to match human insulin

103
Q

what does insulin do?

A

helps the body metabolize carbohydrates, fats, and proteins from the diet

126
Q

what is lipoatrophy?

A

Mountain areas of fat loss around the site of injection, causing depressions.

33: Diabetes Mellitus (2 decks)

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