Type 2 DM

Question 1

microvascular complications of diabetes?

Answer 1

1. retinopathy
2. neuropathy
3. nephropathy

Question 2

macrovascular complicatiosn of diabetes

Answer 2

1. CVD
2. PVD
3. coronary heart disease

Question 3

dx: sx of diabetes + casual glu >___

Answer 3

200

Question 4

what are the sx of diabetes?

Answer 4

polyuria, polydipsia, unexplained weight loss

Question 5

dx: fasting blood glu >____on ___occasions

Answer 5

> 126 on 2 occasions

Question 6

dx: 2 hour post-prandial glu >____ after 75g glu load

Answer 6

200

Question 7

dx: HbA1c > ____

Answer 7

6.5%

Question 8

alpha cells of islets of langerhans make_____

Answer 8

glucagon

Question 9

D cells of islets of langerhans make _____

Answer 9

somatostatin

Question 10

primary target tissues of insulin

Answer 10

live, muscle, fat

Question 11

what does HbA1c correlate with?

Answer 11

3 month blood sugar avg

Question 12

what can make a HgbA1c falsely elevated?

Answer 12

hemoglobunopatheis (sickle cell)

Question 13

what can make a HgbA1c falsely low?

Answer 13

recent transfusion, anemia

Question 14

what drugs act by preventing carb absorption from gut

Answer 14

alpha glucosidase inhibs

Question 15

who are alpha glucosidase inhibs contraindicated in?

Answer 15

those with malabsorption

Question 16

what DM med is the best option for patients with mild post prandial hyperglycemia?

Answer 16

alpha glucosidase inhibs

Question 17

SE of alpha glucosidase inhibs

Answer 17

GI upset/bloating

Question 18

what drugs stimulate insulin secretion by closing ATP-sensitive Potassium channels of pancreatic beta cells?

Answer 18

secretagogues

Question 19

SE of secretagogues

Answer 19

hypoglycemia, weight gain

Question 20

in ppl with severe renal or hepatic disease, which DM meds should be avoided?

Answer 20

secretagogues

Question 21

what drugs fxn by decreasing hepatic gluconeogenesis, decr appetite?

Answer 21

biguanides

Question 22

SE of biguanides

Answer 22

GI upset/lactic acidosis

Question 23

in ppl with CRI (cr >1.5), CHF, liver disease, which drugs should be avoided?

Answer 23

biguanides

Question 24

metformin/glucophage are?

Answer 24

biguanides

Question 25

which drugs are PPAR gamma agonists?

Answer 25

thiazolinediones

Question 26

where are PPAR receptors expressed?

Answer 26

adipose cells, muscles, vascular endothelium

Question 27

how do PPAR receptors act?

Answer 27

induce adipose differentiation, promotoe fatty acid storage, fat cell redistribution

Question 28

SE of thiazolinediones

Answer 28

fluid retention, weight gain

Question 29

incretin mimetics can help with____, are used with_____

Answer 29

weight loss; Metformin/sulfonylurea/TZDs

Question 30

what drug incr body’s active incretin hormone levels?

Answer 30

DDP inhibs

Question 31

which class of drugs is generally well tolerated and does not have GI side effects?

Answer 31

DDP inhibs

Question 32

what decr the post prandial glucagon?

Answer 32

symalin (pramlintide)

Question 33

most common SE of symalin (pramlintide)

Answer 33

hypoglycemia, nausea

Question 34

if want to decr A1c by 1.2-1.8%, how many agents to use?

Answer 34

2

Question 35

when oral meds are failing, continue____, add____

Answer 35

1. continue oral agents

2. add single injxn bedtime NPH or lantus

Question 36

when oral meds are failing, stop____, start___ and ____

Answer 36

1. stop oral agents
2. start split mix insulin regimen
   3, start MDIR

Question 37

tx goals in T2DM: A1c____, fasting BG____, 2 hr post-prandial BG____

Answer 37

A1c under 7%, FBG under 110, 2 hr post-prandial BG under 160

Question 38

tx goals in T2DM: TC ____, LDL____, TG_____

Answer 38

TC under 200, LDL under 100, TG under 150

Question 39

after what age are ppl screened for DM?

Answer 39

age >45