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47 Cards in this Set

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  • Back
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The action of TZD's thiazolidinediones lower glucose by
increasing muscle and fat tissue sensitivity to allow more glucose to enter the cell in presence of insulin
increase muscle
what classification of commonly prescribed drugs may mask symptoms of hypoglycemia when taken concurrently with insulins
beta adrenergic blocking agents.
most rapid type of insulins are
lispro and aspart
long acting suspension form of insulin is
what type of insulin can be given both IV and SC
Insulin is required to transport glucose into the skeletal and heart muscle and fat. It is not required for glucose transport into
the brain
a provisional diagnosis of DM is made when the FBG is
126mg/dl or >
short acting insulin regular IletinII has an onset action of
o.5 - 1hr.
quickly less than 1
side effects with acarbose(precose) or miglitol (glyset)
abdominal cramps, diarrhea, flatulence. will resolve with continue use of precose or glyset.
what effect can acarbose and miglaitol have on digoxin absorption.
may inhibit digoxin absorption
what is the action of glucagon
breaks down stored glycogen to glucose used as energy source
break down.
tx for hyperglycemia
give insulin IV
stabilize electrolytes es.K+
hyperglycemia requires intense therapy.
How can complications of diabetes affecting the kidneys be identified
presence of proteinuria
and elevated serum cr. and bun
symptoms of hyperglycemia
gradual onset
headache, N&V,rapid pulse, shallow reps. acetone order on breath
symptoms of hypoglycemia
rapid onset, nervousness, tremors, lack of coordination, blurred vision, sweating.
The only insulin can be used IV
regular insulin
What does U-100 Mean
100 units contained in 1ml of solution.
major advatage of glargine, biosynthetic long acting insulin
absorbed more uniformly reducing possiblity of hypoglycemic reactions
how far in advance should short acting insulin be administered
30 min before meals
short acting are Humulin R, Novolin R, Regulare Iletin I&II, veslosulin BR
how far in advace should rapid acting insulin be administered
rapid acting aspart and lispro are given 10-15 min. before meals
what are the most rapid acting insulins
lispro (Humalog)and aspart(Novolog)
Differentiate among onset, peak and duration in relation to insulin.
Onset-the time required for intial effect
Peak-time of maxium effect of insulin
Duration-length of time insulin remains active
why cant insulin be administered orally
it is destroyed by the proteolytic enzymes of the GI tract
signs of peripheral vascular disease
cynosis hands, ft, legs. Ulcerations may develop.
pedial and radial pulses should be Ck'd q4
AiC, and fructosamine tests
fructosamine tests-glucose bonded to protein fructosamine over previous 1-3wks.
when should urine ketone test be performed
glucose >240mg/dl
usual causes of hypoglycemia
to much insulin, insuff food intake to cover insulin taken, imbal from diarrhea and vomitting, excessive exercise
recommended guidelines for glucose levels while exercising
don't exercise if
>250mg/dl or < 100mg/dl
What does the tx of type 1 DM require?
adq. wgt. loss, dietary control and exogenous insulin
what does the tx of type 2 DM
ad. wgt. loss, dietary control, possible use of oral hypoglycemic or antihyperglycemic agents.
tx for hypoglycemia
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
ultralente (Humulin U) s an example of _____type of insulin.
long acting
how long
Endogenous insulin is produced by ___in what organ.
beta cells, in the pancreas
short acting (regular) insulins (humulinR) and NovolinR have a duration time of hrs.?
Type___DM is treated with oral hupoglycemic antihyperglycemic or insulin
type II
Numbness or tingling of extremities is known as
What is the immediate goal of tx of DM
Prevent Ketoacidosis and symptoms resulting from hyperglycemia
Type II is what type of DM
Non insulin
Insulin-dependent diabetes is known as
Type I
DM is a diease that causes abnormal metabolism of
fats, proteins and carbohydrates
DM definition
group of diseases characterized by hyperglycemia resulting from defects in insulin secreations, actions or both
Type I affects what part of the population and what are the signs or symptoms
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
normal fasting glucose level
Impaired fasting glucose range
Provisional diagnosis of DM
FPG 126mg/dl or greater
Type II diabetes definition and symptoms
90% of population, pancreas still produces some insulin,
symptoms numbness of extremities, orthostatic hypotentin, impetence, neurogenic bladder
Dietary Control of DM
Weight loss, decrease lipids, cholesterol, triglycerides, don't omit meals, food balances