Diagnosis & Treatment
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| Onset of "Rapid Acting" Insulin | <15 minutes
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| Peak of "Rapid Acting" Insulin | 1-2 hours
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| Duration of "Rapid Acting" Insulin | 3-4 hours
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| Onset of "Regular" Insulin | 1/2-1 hour
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| Peak of "Regular" Insulin | 2-3 hours
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| Duration of "Regular" Insulin | 3-6 hours
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| Onset of "Intermediate Acting" Insulin | 2-4 hours
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| Peak of "Intermediate Acting" Insulin | 4-10 hours
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| Duration of "Intermediate Acting" Insulin | 10-16 hours
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| Onset of "Long Acting" (Lantus) Insulin | 2-4 hours
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| Peak of "Long Acting" (Lantus) Insulin | no peak
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| Duration of "Long Acting" (Lantus) Insulin | 20-24 hours
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| What is the diagnostic value of "serum fasting" blood sugar? | > or equal to 126 mg/dL on 2 separate days
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| What is the diagnostic "random" blood sugar and what sx's must accompany it? | > or equal to 200 mg/dL + 3 P's, wt loss, sores that don't heal, etc.
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| Normal FPG? | <99 mg/dL
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| Pre~Diabetes FPG (impaired fasting glucose)? | 100-125 mg/dL
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| OGTT normal? | <139
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| OGTT pre~diabetes (impaired fasting glucose)? | 140-199
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| OGTT diabetes? | 200 and > on 2 separate days
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| What is the rule of thumb when starting patients on insulin? | Regular 0.5 u/kg/day giving 2/3 in the AM and 1/3 in the PM
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| What conditions result in early morning hyperglycemia? | Somogyi effect & Dawn Phenomenon
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| Dawn Phenomenon? | tissues become desensitized to insulin nocturnally, blood sugar gets higher throughout the night
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| Somogyi Effect? | nocturnal hypoglycemia stimulates surge of counter regulatory hormones that raise blood sugar (rebound affect)...i.e. hypoglycemic @ 3 am and is elevated at 7 am
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| Signs associated with insulin resistance (4)? | Acanthosis Nigricans, HTN, Dyslipidemia, PCOD
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| What drug class is Metformin? | Biguanide
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| What type of patient should NOT receive Metformin? | hepatic/renal failure (increased cr.), alcoholics, those prone to hypoxia
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| Metabolic syndrome consists of at least 3 of the following? | Waist circumference > or equal to 40" in men & > or equal to 35" in women @ umbilicus~~BP > or equal to 130/85~~Triglycerides > or equal to 150~~FBG > or equal to 100~~ HDL: < 40 men & < 50 women
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| Name 1st generation Sulfonylureas? | Tobutamide (Orinase), Tolazamide (Tolinase), Chlorpropamide (Diabinese)
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| Name 2nd generation Sulfonylureas? | Glipizide (Glucotrol), Glyburide (Diabeta, Micronase)
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| What is the action of Sulfonylureas? | stimulation of the pancreas to secrete more insulin
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| What is the action of Biguanides? | increase insulin sensitivity, decrease glucogenesis, decrease glucose absorption
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| What are some Alpha-glucosidase inhibitors? | Acarbose (Precose), Miglitol (Glyset)
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| What is the action of Alpha-glucosidase? | to bind to disaccharidases more readily than sucrose, so less glucose is absorbed by the gut
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| Name Thiazolidinediones and it's action? | Actos; increase insulin sensitizing
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