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47 Cards in this Set
- Front
- Back
- 3rd side (hint)
The action of TZD's thiazolidinediones lower glucose by
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increasing muscle and fat tissue sensitivity to allow more glucose to enter the cell in presence of insulin
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increase muscle
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what classification of commonly prescribed drugs may mask symptoms of hypoglycemia when taken concurrently with insulins
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beta adrenergic blocking agents.
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beta
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most rapid type of insulins are
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lispro and aspart
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L&A
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long acting suspension form of insulin is
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ultralente
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ul
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what type of insulin can be given both IV and SC
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regular
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Insulin is required to transport glucose into the skeletal and heart muscle and fat. It is not required for glucose transport into
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the brain
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a provisional diagnosis of DM is made when the FBG is
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126mg/dl or >
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short acting insulin regular IletinII has an onset action of
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o.5 - 1hr.
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quickly less than 1
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side effects with acarbose(precose) or miglitol (glyset)
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abdominal cramps, diarrhea, flatulence. will resolve with continue use of precose or glyset.
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what effect can acarbose and miglaitol have on digoxin absorption.
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may inhibit digoxin absorption
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what is the action of glucagon
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breaks down stored glycogen to glucose used as energy source
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break down.
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tx for hyperglycemia
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hospitalization
hydration give insulin IV stabilize electrolytes es.K+ |
hyperglycemia requires intense therapy.
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How can complications of diabetes affecting the kidneys be identified
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presence of proteinuria
and elevated serum cr. and bun |
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symptoms of hyperglycemia
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gradual onset
polydipsia headache, N&V,rapid pulse, shallow reps. acetone order on breath |
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symptoms of hypoglycemia
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rapid onset, nervousness, tremors, lack of coordination, blurred vision, sweating.
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The only insulin can be used IV
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regular insulin
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What does U-100 Mean
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100 units contained in 1ml of solution.
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major advatage of glargine, biosynthetic long acting insulin
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absorbed more uniformly reducing possiblity of hypoglycemic reactions
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how far in advance should short acting insulin be administered
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30 min before meals
short acting are Humulin R, Novolin R, Regulare Iletin I&II, veslosulin BR |
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how far in advace should rapid acting insulin be administered
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rapid acting aspart and lispro are given 10-15 min. before meals
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what are the most rapid acting insulins
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lispro (Humalog)and aspart(Novolog)
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Differentiate among onset, peak and duration in relation to insulin.
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Onset-the time required for intial effect
Peak-time of maxium effect of insulin Duration-length of time insulin remains active |
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why cant insulin be administered orally
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it is destroyed by the proteolytic enzymes of the GI tract
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signs of peripheral vascular disease
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cynosis hands, ft, legs. Ulcerations may develop.
pedial and radial pulses should be Ck'd q4 |
blue
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AiC, and fructosamine tests
measurements |
aic-8-10wks
fructosamine tests-glucose bonded to protein fructosamine over previous 1-3wks. |
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when should urine ketone test be performed
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glucose >240mg/dl
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usual causes of hypoglycemia
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to much insulin, insuff food intake to cover insulin taken, imbal from diarrhea and vomitting, excessive exercise
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recommended guidelines for glucose levels while exercising
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don't exercise if
>250mg/dl or < 100mg/dl |
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What does the tx of type 1 DM require?
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adq. wgt. loss, dietary control and exogenous insulin
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what does the tx of type 2 DM
require? |
ad. wgt. loss, dietary control, possible use of oral hypoglycemic or antihyperglycemic agents.
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tx for hypoglycemia
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2-4oz of fruit juice with 2tsp. sugar or honey added, or 1c skim milk, 4oz. reg.pop, frosting, not chocolate. if unable to swallow give20-50ml glucose 50% IV
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ultralente (Humulin U) s an example of _____type of insulin.
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long acting
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how long
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Endogenous insulin is produced by ___in what organ.
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beta cells, in the pancreas
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short acting (regular) insulins (humulinR) and NovolinR have a duration time of hrs.?
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5-10hrs
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Type___DM is treated with oral hupoglycemic antihyperglycemic or insulin
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type II
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Numbness or tingling of extremities is known as
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paresthesia
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What is the immediate goal of tx of DM
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Prevent Ketoacidosis and symptoms resulting from hyperglycemia
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Type II is what type of DM
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Non insulin
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Insulin-dependent diabetes is known as
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Type I
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DM is a diease that causes abnormal metabolism of
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fats, proteins and carbohydrates
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DM definition
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group of diseases characterized by hyperglycemia resulting from defects in insulin secreations, actions or both
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Type I affects what part of the population and what are the signs or symptoms
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Type I is insulin Dependent
5-10% of population has rapid onset of symptoms polydipsia, polyuria, polyphagia, wgt.loss, no insulin is secreted from the pancreas |
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normal fasting glucose level
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<110mg/dl
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Impaired fasting glucose range
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110-125mg/dl
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Provisional diagnosis of DM
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FPG 126mg/dl or greater
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Type II diabetes definition and symptoms
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90% of population, pancreas still produces some insulin,
symptoms numbness of extremities, orthostatic hypotentin, impetence, neurogenic bladder |
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Dietary Control of DM
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Weight loss, decrease lipids, cholesterol, triglycerides, don't omit meals, food balances
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