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40 Cards in this Set
- Front
- Back
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Define DM
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chronic, progressive dysfunction of:
1. metabolism of PICF (protein, insulin, carb, fat) 2. function & structure of blood vessels nerve |
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4 types of DM
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1. Type 1
2. Type 2 3. Gestational 4. secondary |
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type 1 DM is also known as
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1. insulin-dependent DM
2. juvenile-onset DM 3. ketosis-prone DM |
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define KETOACIDOSIS
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accumulation of ketone bodies in body tissues & fluid
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type 2 DM is also known as
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1. non-insulin-dependent DM
2. adult-onset DM |
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Insulin's function in the body (6)
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1. DEC fat breakdown to ketones
2. Enhance fat storage (lipogenesis), prevent lipolysis 3. Inhibits glycogenolysis (production of glucose from liver or muscle glycogen) 4. Inhibits gluconeogenesis (formation of glucose from AA) 5. promotes incorporation of AA to protein 6. Stimulates glucose transport across cell membranes and promotes storage of of glucose as glycogen in muscle & liver cells |
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counerregulatory hormones of insulins are
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1. glucagon
2. epinephrine 3. NE 4. growth hormone 5. cortisol |
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renal threshold for glucose
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180mg/dl
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classic sxs of DM
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1. polyuria
2. polydipsia 3. polyphagia |
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Differentiate DM 1 vs. DM 2
1. onset 2. wt 3. beta-cell function |
DM 1 = rapid, wt loss, absolute beta-cell destruction
DM 2 = progressive, wt gain, progressive beta-cell destruction |
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criteria for dx of DM
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1. casual BG > 200 mg/dL + sxs of DM (triad)
OR 2. FPG >= 126mg/dl OR 3. 2-h BG >=200mg/dL during an OGTT |
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goal A1c
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< 7%
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goal preprandial BG
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90 - 130 mg/dL
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goal peak posprandial BG
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<180mg/dl
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Goal BP
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130/80
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goal LDL
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< 100mg/dL
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goal TRIG
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< 150mg/dL
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goal HDL
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> 40mg/dL
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recommended vaccinations
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1. annual INFLUENZA (> 6 months old & no CI)
2. PNEUMOCOCCAL (Q5yr if < 65, once if > 65y/o) |
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DM complications
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1. retinopathy
2. nephropathy 3. polyneuropathy 5. autonomic neuropathy 6. foot infections 7. coronary atheroscleorisis 8. cerebrovascular atheroscleorisis 9. peripheral vascular dz |
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HYPOglycemia BG
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< 70mg/dL
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DKA BG
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>250mg/dL
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HYPOglycemia BG symptoms
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mild = tremor, palpitation, sweating
severe = unreponsive, unconcious, convulsion |
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HYPOglycemia BG treatments
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Mild = 15 - 20 g PO glucose
Severe = IV glucose, glucagon |
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Secretagogues MOA
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1. STIMULATE insulin release from pancreas
2. decrease hepatic gluconeogenesis & insulin resistance in muscle |
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classes of SECRETAGOGUES
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1. sulfonylureas
2. meglitinides |
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1st generation SULFONYLUREAS
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TOLBUTamide
TOLAZamide ACETOHEXamide CHLOPROPamide |
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2nd generation SULFONYLUREAS
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GLYburide
GLIPizide GLIMepride |
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MEGLITINIDES are
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REPAglinide
NATEglinide |
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which sulfonylurea has longest DOA
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CHLOPROPamide
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secretagogues should be avoided in elderly. Reason.
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CHLORPROPamide
longest DOA, risk for more frequent and severe SE in renal & hepatic impairment |
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secretagogues that are safe in renal & hepatic insufficiency
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GLIPizide
GLIMEPiride |
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why should secreatagogues be avoided in patient with ALCOHOL use
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hypoglycemia and alcohol intolerance (disulfiram-like rxn)
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secretagogues CI
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1. pregnant
2. lactating 3. children 4. DKA 5. severe infxn 6. surgery 7. trauma 8. SULFA allery |
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frequency of administration of sulfonylurea
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QD or BID ac
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frequency of administration of meglitinides
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before each meal of the day, skip a meal, skip a dose
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secretagogues DIs
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CYP2C9 & 3A4 drugs INC. HYPOglycemia
1. anticoagulatns 2. fluconazole 3. salicylate 4. gemfibrozil 5. sulfonamides 6. TCA 7. Dig |
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classes of insulin SENSITIZERS
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1. biguanides
2. thiazolidinediones |
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Biguanides are
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metformin
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thiazolidinediones are
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ROSIglitazone
PIOglitazone |
