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38 Cards in this Set

  • Front
  • Back
clinical presentation of diabetes?
blurred vision
itchy, dry skin
slow healing
what are some types of diabetes?
Type I & II
gestational diabetes
drug and chemicals
pancreatic disease
cystic fibrosis
what are some examples of known drug/chemicals to cause diabetes?
glucocorticoids (MC)
protease inhibitors (for HIV)
atypical antipsychotics
what endocrine pathologies can be indicitive of diabetes?
what is the role of insulin?
to lower glucose level and promote entry of glucose into the muscle cells/other tissues
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?
Dibetes Mellitus
this type of diabetes is due to pancreatic islet B cell destruction predominantly by an autoimmune process, and p are prone to ketoacidosis.?
type I
this type of diabetes accounts for 90% of the cases today, results from insulin resistance with a defect in compensatory insulin secretion?
type II
the idiopathic type of diabetes, where circulating endogenous insulin is sufficient to prevent ketoacidosis but is inadequate to prevent hyperglycemia due to tissue insensitivity?
type II DM
what prior clinical presentations/diagnosis can put your patient at a greater risk for diabetes type II?
gestational dm
COPD/asthma patients on glucocorticoid steroids
Patients w/ HIV on protease inhibitors
schitzo pat. on atypical antipsychotics
pancreatic disease
cystic fibrosis
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?
if the random plasma glucose > 200mg/dL with these symptoms
what is the level of a fasting plasma glucose that will indicate your p has dm?
fasting plasma glucose >126mg/dL
your patient has a two-hour post glucose greater than 200mg/dL during an oral glucose tolerance test. is this significant?
yes. this is diagnostic criteria for DM
according to the ADA what is the fasting glucoses for a patient who is considered to have a normal fasting glucose?
<100 mg/dl
acording to the literature, what is the range for IFG? impaired fasting glucose?
according to the literature what is the range/result fo a fasting glucose that indicates a provisional diagnosis of diabetes?
>126 mg/dL. must be confirmed by OGTT
what is the values for a normal glucose tolerance test 2 hours postload glucose?
<140 mg/dl
what is considered to be an impaired glucose tolerance test result 2 hours postload glucose?
what is the range of an OGTT that indicates a provisional diagnosis of diabetes 2 hours postload glucose?
who should be tested
all individuals with ANY risk factors or if they are in DKA!
what are some of the risk factors for DM?
age >45
BMI >25
first degree relative
high risk ethnic group
vascular disease
what element increases with hyperglycemia, is a representation of mean blood glucose and has normal values of 4-6%?
Glycosylated hemoglobin = HbgA1c
how often should HbgA1c be monitored?
q 6 months
what class of drug are considered to be the most powerful and popular in treating diabetes?
what is the representative example of biguanides ?
metformin (glucophage)
this class of medications that treats Type II diabetes MOA stimulates insulin release from the beta cells?
sulfonylureas and meglitinides (usually used as combo with metformin)
what are some adverse drug reactions for the sulfonylureas?
LFT increases
what is the main reason patients stop taking metformin?
MOA for sulfonylureas?
stimulate insulin release from pancreatic b cells
Decrease hepatic glucose
Increase # of insulin receptors
which sulfonylureas have active metabolites?
which sulfonylureas has the longest DOA?
chlorpropamide: 60 hours
name a med/dose for a second generation sulfonylurea?
glyburide 2.5mg PO BID
what is the best drug to give for a patient with renal failure to treat dm type II?
any of the q24 drugs:

tolazamide, acetohexamide
all second gen: but reduce dose
what is the most life threatening adverse effect for a patient on metformin?
lactic acidosis
what is MOA of Metformin?
Decreases hepatic glucose
Increases insulin sensitivity
decreases intestinal glucose absorption
Decreases TG
increases HDL
weight loss
initial dose for metformin?
500mg PO BID
which diabetes type II pharmocologic treatment is contraindicated in p with CHF?
what are the two drugs that are most commonly used for COMBO TX?
metformin + glybride