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15 Cards in this Set

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Diabetes Mellitus
Type I
- insulin-dependent
- juvenile Onset (but not always)
- Beta Cells
- Inflammation of Islet cells
- Ketoacidosis Prone
- Vascular complications
Diabetes Mellitus
Type II
- Non-insulin dependent
- Resistance to insulin action
- Maturity onset
- Beta cells involvement is variable
- not ketoacidosis prone
- Obesity is common
- Vascular complications
Exercise will ...
- decrease insulin release
Rapid Acting Insulins (2)
- Lispro (peaks .25 hours, lasts 3-4 hours)
- Regular (peaks .5-3 hours, lasts 5-8)
Intermediate Acting Insulins(2)
- NPH (isophane)
- Lente
- both have a peak of 8-12 hours and duration of 18-24 hours
Slow acting Insulins (2)
- Ultralente (peak 8-16, duration 20-36)
- Lantis - very long acting
Target blood sugars
- pre meal = 80
- post meal = 160-180
Long term vascular effects
- there is evidence that strict control of blood glucose levels reduced the risk for long-term vascular complications in Type I Diabetics
Insulin Shock
- hypoglycemia
- confusion
- seizures
- unconscious
Diabetic Coma
- hyperglycemia
- irritability
- weakness
- weight loss
- acidosis
- coma
Name the drugs that are used to tx Type II
- Sulfonylureas
- Biguanides (metformin)
- Thiazolidinediones
- Acarbose
Sulfonyl Urea Drugs
- Mechanism= increase insulin secretion, overxome insulin resistance
- good oral bioavailability
- TOLBUTAMIDE
- GLYBURIDE, GLIPIZIDE, GLIMEPIRIDE (second gen's)
Metformin
- increase glucose utlization in muscle
- antihyperglycemic drug
- decrease glucose production in liver
Thiazolidinediones (TZD's)
- TROGLITAZONE
- increases insulin sensitivity
- redues hepatic glucose production
- used for type I and II that are poorly controlled on insulin
Algorithm for Type II diabetes
- Nonpharmacological Therapy
- Monotherapy
- Combination Therapy
- Insulin