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38 Cards in this Set
- Front
- Back
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clinical presentation of diabetes?
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polyuria
polydypsia polyphagia blurred vision itchy, dry skin slow healing |
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what are some types of diabetes?
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Type I & II
gestational diabetes drug and chemicals pancreatic disease cystic fibrosis endocrinopathies |
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what are some examples of known drug/chemicals to cause diabetes?
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glucocorticoids (MC)
protease inhibitors (for HIV) atypical antipsychotics |
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what endocrine pathologies can be indicitive of diabetes?
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hyperthyroidsm
Cushings |
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what is the role of insulin?
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to lower glucose level and promote entry of glucose into the muscle cells/other tissues
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a syndrome with disordered metabolism and inappropriate hyperglcemia due to either a deficiency of insulin secretion or to a combo of resistance and inadequate insulin secretion to compensate?
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Dibetes Mellitus
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this type of diabetes is due to pancreatic islet B cell destruction predominantly by an autoimmune process, and p are prone to ketoacidosis.?
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type I
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this type of diabetes accounts for 90% of the cases today, results from insulin resistance with a defect in compensatory insulin secretion?
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type II
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the idiopathic type of diabetes, where circulating endogenous insulin is sufficient to prevent ketoacidosis but is inadequate to prevent hyperglycemia due to tissue insensitivity?
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type II DM
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what prior clinical presentations/diagnosis can put your patient at a greater risk for diabetes type II?
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gestational dm
COPD/asthma patients on glucocorticoid steroids Patients w/ HIV on protease inhibitors schitzo pat. on atypical antipsychotics pancreatic disease cystic fibrosis |
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p presents complaining of polyuria, polydypsia and has not been sleeping well. you perform a random plasma glucose in the office. what results would be diagnostic criteria for DM?
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if the random plasma glucose > 200mg/dL with these symptoms
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what is the level of a fasting plasma glucose that will indicate your p has dm?
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fasting plasma glucose >126mg/dL
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your patient has a two-hour post glucose greater than 200mg/dL during an oral glucose tolerance test. is this significant?
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yes. this is diagnostic criteria for DM
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according to the ADA what is the fasting glucoses for a patient who is considered to have a normal fasting glucose?
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<100 mg/dl
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acording to the literature, what is the range for IFG? impaired fasting glucose?
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100-125mg/dl
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according to the literature what is the range/result fo a fasting glucose that indicates a provisional diagnosis of diabetes?
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>126 mg/dL. must be confirmed by OGTT
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what is the values for a normal glucose tolerance test 2 hours postload glucose?
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<140 mg/dl
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what is considered to be an impaired glucose tolerance test result 2 hours postload glucose?
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140-199mg/dL
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what is the range of an OGTT that indicates a provisional diagnosis of diabetes 2 hours postload glucose?
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>200mg/dl
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who should be tested
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all individuals with ANY risk factors or if they are in DKA!
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what are some of the risk factors for DM?
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age >45
BMI >25 first degree relative high risk ethnic group HTN HDL<35 TRG>250 vascular disease obesity |
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what element increases with hyperglycemia, is a representation of mean blood glucose and has normal values of 4-6%?
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Glycosylated hemoglobin = HbgA1c
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how often should HbgA1c be monitored?
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q 6 months
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what class of drug are considered to be the most powerful and popular in treating diabetes?
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Biguanides
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what is the representative example of biguanides ?
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metformin (glucophage)
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this class of medications that treats Type II diabetes MOA stimulates insulin release from the beta cells?
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sulfonylureas and meglitinides (usually used as combo with metformin)
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what are some adverse drug reactions for the sulfonylureas?
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hypoglycemia
hematologic GI LFT increases |
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what is the main reason patients stop taking metformin?
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diarrhea
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MOA for sulfonylureas?
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stimulate insulin release from pancreatic b cells
Decrease hepatic glucose Increase # of insulin receptors |
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which sulfonylureas have active metabolites?
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"CAT"
Chlorpropamide Acetohexamide Tolazamide |
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which sulfonylureas has the longest DOA?
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chlorpropamide: 60 hours
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name a med/dose for a second generation sulfonylurea?
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glyburide 2.5mg PO BID
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what is the best drug to give for a patient with renal failure to treat dm type II?
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any of the q24 drugs:
tolazamide, acetohexamide all second gen: but reduce dose |
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what is the most life threatening adverse effect for a patient on metformin?
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lactic acidosis
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what is MOA of Metformin?
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Decreases hepatic glucose
Increases insulin sensitivity decreases intestinal glucose absorption Decreases TG increases HDL weight loss |
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initial dose for metformin?
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500mg PO BID
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which diabetes type II pharmocologic treatment is contraindicated in p with CHF?
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METFORMIN
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what are the two drugs that are most commonly used for COMBO TX?
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metformin + glybride
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