Type 2 DM Flashcards
microvascular complications of diabetes?
- retinopathy
- neuropathy
- nephropathy
macrovascular complicatiosn of diabetes
- CVD
- PVD
- coronary heart disease
dx: sx of diabetes + casual glu >___
200
what are the sx of diabetes?
polyuria, polydipsia, unexplained weight loss
dx: fasting blood glu >____on ___occasions
> 126 on 2 occasions
dx: 2 hour post-prandial glu >____ after 75g glu load
200
dx: HbA1c > ____
6.5%
alpha cells of islets of langerhans make_____
glucagon
D cells of islets of langerhans make _____
somatostatin
primary target tissues of insulin
live, muscle, fat
what does HbA1c correlate with?
3 month blood sugar avg
what can make a HgbA1c falsely elevated?
hemoglobunopatheis (sickle cell)
what can make a HgbA1c falsely low?
recent transfusion, anemia
what drugs act by preventing carb absorption from gut
alpha glucosidase inhibs
who are alpha glucosidase inhibs contraindicated in?
those with malabsorption
what DM med is the best option for patients with mild post prandial hyperglycemia?
alpha glucosidase inhibs
SE of alpha glucosidase inhibs
GI upset/bloating
what drugs stimulate insulin secretion by closing ATP-sensitive Potassium channels of pancreatic beta cells?
secretagogues
SE of secretagogues
hypoglycemia, weight gain
in ppl with severe renal or hepatic disease, which DM meds should be avoided?
secretagogues
what drugs fxn by decreasing hepatic gluconeogenesis, decr appetite?
biguanides
SE of biguanides
GI upset/lactic acidosis
in ppl with CRI (cr >1.5), CHF, liver disease, which drugs should be avoided?
biguanides
metformin/glucophage are?
biguanides
which drugs are PPAR gamma agonists?
thiazolinediones
where are PPAR receptors expressed?
adipose cells, muscles, vascular endothelium
how do PPAR receptors act?
induce adipose differentiation, promotoe fatty acid storage, fat cell redistribution
SE of thiazolinediones
fluid retention, weight gain
incretin mimetics can help with____, are used with_____
weight loss; Metformin/sulfonylurea/TZDs
what drug incr body’s active incretin hormone levels?
DDP inhibs
which class of drugs is generally well tolerated and does not have GI side effects?
DDP inhibs
what decr the post prandial glucagon?
symalin (pramlintide)
most common SE of symalin (pramlintide)
hypoglycemia, nausea
if want to decr A1c by 1.2-1.8%, how many agents to use?
2
when oral meds are failing, continue____, add____
- continue oral agents
2. add single injxn bedtime NPH or lantus
when oral meds are failing, stop____, start___ and ____
- stop oral agents
- start split mix insulin regimen
3, start MDIR
tx goals in T2DM: A1c____, fasting BG____, 2 hr post-prandial BG____
A1c under 7%, FBG under 110, 2 hr post-prandial BG under 160
tx goals in T2DM: TC ____, LDL____, TG_____
TC under 200, LDL under 100, TG under 150
after what age are ppl screened for DM?
age >45
