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Stack #40786
Diabetes
| Question | Answer |
|---|---|
| Hyperglycemia | increase in sugar levels >126mg/dl fasting |
| Hypoglycemia | decreased blood sugar levels 50-80 mg/dl |
| Diabetic Coma | Blood sugar levels 250 - 500 mg/dl - requires hospitalization |
| Diabetic Shock | sugar levels above 600 mg/dl |
| Insulin Coma | blood sugar levels <60mg/dl requires adjustment of insulin |
| Insulin Shock | blood sugar levels <50 mg/dl. Glucose tablet needed before levels reach 60mg/dl. If shock occurs IV Glucagon is needed |
| Signs of Low blood sugar | headache, irritable, shaking, sweating |
| when levels are < 40mg/dl | less then 5 minutes to live |
| Islets of Langerhan produce? | alpha cells = glucagon & beta cells = insulin |
| Function of Insulin on body | 1. promotes glycogen synthesis in liver & muscle 2. Essential for metabolism of fat & protein. 3. Aids in storage of fats & protein |
| Where is glycogen stored? | liver and muscle tissues or as trigylcerides which then get converted into fat |
| Carohydrate catabolism | 1. used directly for energy 2. stored temp. as glycogen in the liver and muscle. 3. Converted to fat and amino acids |
| Fat conversion | glycerol and lipases |
| Ketosis | occurs during prolonged tissue starvation. Insulin isn't facilitating sugar into the cells |
| Fat kilocalories | 9 kcal/g |
| Carbohydrate and Protein kilocalories | 7 kcal/g |
| Glycogenolysis | catabloism of glycogen into glucose |
| How does the body prevent hypoglycemia during sleep? | glycogenolysis by the liver at night |
| Type I Diabetes Mellitus | Insulin Dependant, juvenile, 10-20% of diabetic pts, ketodid and diabetic coma common, thin body type |
| Type II Diabetes Mellitus | non-insulin dependant, adult onset, 80-90% of pts, Ketosis and diabetic coma rare, body type obese, insulin treatment only for about 20-30% |
| Type III Diabetes Mellitus | Develops during pgy after the 5th month. Cause increased risk of maternal and fetal death, increased risk of still birth and oversized babies |
| Type IV Diabetes Mellitus | caused by insulin producing tumor, IV reatment that destroys Islet cells. |
| Symptoms of Diabetes Mellitus | Glycosuria, Polyuria, Polydipsia, Polyphagia |
| Side Effects of Diabetes Mellitus | GI probs, Impotence, incontinence, ortho-static hypotension, retinal hemorrhages, blindness, renal dysfunction, neuropathy, recurrent resistant skin infections, arhtrosclerosis |
| Complications of uncontrolled Diabetes | High BP, Heart attacks - age 35 Kidney failure - age 40 Strokes - age 65-70 Blindness - age 80 Amputation of lower limbs - age 85+ |
| Diseases common in Diabetics | Thrush, repeated skin infections, pneumonia |
| Goal in treating Diabetes | non-fasting levels 160-200 mg/dl |
| Name the 4 types of insulin | Quick acting, Short acting, intermediate acting, long acting |
| Humalog | Quick acting |
| Humalog Onset and DOA | 5-15 minutes, DOA 3-4 hrs |
| Semilente Onset and DOA | short/regular acting 30 minutes - 1 hr, DOA 6-8 hrs |
| Lente (NPH Isophen) | Intermediate actingOnset 1 - 3 hrs, DOA 18 -24 hrs |
| Ultralente | Long actingOnset 4-8 hrs, DOA >36 hrs |
| Combination Insulin | Humulin 70/30 (70% intermediate acting and 30% short acting/regular) |
| Lantus | DOA 24 hrs, used for controlling fluctuations in sugar levels |
| Side effects of insulin use | allergy, swelling, itching, lipodystrophy |
| How is insulin measured? | in units, standard is 100u/ml |
| What is type II Non-drug therapy | Diet, exercise, maintain weight, education |
| What is type II drug therapy goal? | to stimulate Beta cells to increase insulin secretion |
| 1st Generation of class I oral anti-hypergylcemic drugs | Sulfonylureas "Amides" rarely used now |
| What is a draw back to 1st generation sulfonylureas? | have many drug interactions and pts that are allergic to sulfa may not be able to use them |
| Side effects of sulfonylureas. | Red rashes, joint pain, photosensitivity |
| Class II oral anti-hyperglycemics | Biguanides |
| What is the common Biguanide | Metformin (Glucophage) |
| What is the MOA of Biguanides? | suppress appetite, prevent liver form breeaking down glycogen, and increases insulin receptors on cells |
| What are side effects of Biguanides? | lactic acidosis = muscle myalgia, GI disturbances, cardiovascular and respiratory depression |
| What is class III of anti-hyperglycemics? | Thiazlidinediones "glitazones or TZD's" |
| What is the MOA for Glitazones? | increase insulin sensitvity and decrease hepatic gluconeogenesis |
| What is a common glitazone drug? | Rosiglitazone (Avandia) |
| What are side effects of glizatones? | liver failure, fluid rentention, weight gain, headaches, fatigue |
| What is class IV of anti-hyperglycemics? | alpha glucose inhibitors |
| What is the MOA of alpha glucosidase inhibitors? | (blocks alpha receptors) which delays digestion and absorptoin of glucose in the small intestines, giving a smaller increase in blood sugar |
| What is a common alpha glucosidase inhibitor drug? | Acarbose (Precose) |
| What are the side effects of alpha glucosidase drugs? | bloated belly, D/V |
| What is class V of anti-hyerglycemic drugs? | Meglitindes |
| What is the MOA for Meglitinides? | stimulates beta cells |
| What is a common Meglitinide drug? | Repaglinide (Prandin) |
| What is an advantage of Meglitinide drgs? | they stimulate beta cells like sulfonylureas but do not have sulfa side effects |
| What are the side effects of Meglitinides? | N/V/D and pts may become severely hypogylcemic |
Created by:
TBess
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