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pharm 26
| Question | Answer |
|---|---|
| diabetes mellitus | high blood glucose levels due to the body's inability to produce or effectively use insulin. |
| prediabetes | blood glucose 6.1- 6.9mmol/L |
| type 1 diabetes | (juvenile diabetes) requires lifelong inj |
| type 2 diabetes | Non–insulin-dependent diabetes (NIDDM), also known as adult-onset diabetes 80% of patients overweight. due to insulin resistance |
| Gestational diabetes | occurs in 3% to 8% of all pregnant women, typically late in pregnancy. caused by pregnancy hormones or shortage of insulin. Symptoms disappear after delivery, but have a 20% to 50% risk of developing type 2 diabetes within 5 to 10 years. |
| fasting blood gluclose test /diagnosing diabetes | 4- is normal anything over 7 is diabetes |
| oral glucose tolerance test | over 11 is diabetes |
| microvascular damage | diabetes complication/ Weakens blood vessels in the eye (retinopathy can lead to blurred vision and blindness), nephropathy (kidney damage), and neuropathy (numbness in the lower limbs). |
| macrovasuclar damage | diabetes complication/ Can cause hypertension, angina, and myocardial infarction. |
| blood glucose monitoring | 1 to 4 times daily depending on diabetes type |
| flash glucose monitoring (freestyle monitoring) | Nonpharmacological Management |
| Insulin | management for all types of diabetes / rDNA origin An opened product can be kept at room temperature for 28 to 42 days, depending on the type of product. |
| insulin MOA | • Identical to naturally occurring human insulin • Allows glucose to be transported into cells |
| Insulin:Adverse Reactions | Hypoglycemia, weight gain, and pain or irritation at the injection site. Patients to rotate site of injection |
| •Lipohypertrophy | fat accumulation around inj site |
| Lipoatrophy | fat loss around inj site |
| Sulfonylureas | For type 2 diabetes, it can reduce the HbA1c level by 1% to 2%. •Glyburide-Diabeta® •Gliclazide-Diamicron® •Glipizide‡ •Glimepiride-Amaryl® |
| sulfonylureas:MOA | Stimulate insulin release from pancreatic beta cells and decrease glycogenolysis, which is the breakdown of glycogen into glucose. |
| Sulfonylureas with the highest risk for hyperglycemia | •glyburide and gliclazide |
| glimepiride | sulfonylureas that has the lowest risk for hypoglycemia |
| Biguanides | Metformin(Glucophage®) |
| hypoglycemia | low blood sugar often due to insulin use, missed meals, or excessive exercise. Symptoms include shakiness, sweating, confusion, dizziness, and in severe cases, loss of consciousness. |
| methods to raise blood sugar in hyperglycemia | consume fast-acting carbohydrates - candy, honey, milk, soda , glucose gel/tabs |
| Biguanide moa | Increases peripheral glucose uptake and utilization in skeletal muscles and adipose tissue. Improves glucose tolerance and insulin resistance treats diabetes mellitus Reduces blood sugar spikes after meals by slowing glucose production and absorption. |
| Biguanides:Adverse Reactions | GI issues Lactic acidosis ( when lactate builds up in the blood due to impaired metabolism) May stimulate ovulation in infertile women who have polycystic ovary syndrome (PCOS) |
| Alpha-Glucosidase Inhibitors | Acarbose(Glucobay®) for type 2 diabetes/ prolongs digestion and delays the absorption of carbohydrates, reduces peak plasma glucose levels, does not promote insulin secretion, no effect on HbA1c levels. prescribed in combo with other antidiabetic agents |
| Alpha-Glucosidase Inhibitors:MOA | Inhibits α-glucosidases, enzymes that break down carbohydrates (slows carbohydrate digestion, delaying glucose absorption into the bloodstream.) must be taken at the start of a meal |
| HbA1c (Hemoglobin A1c) | a blood test that measures the average blood glucose (sugar) levels over the past 2–3 months HbA1c ≥ 6.5% is criterion for diabetes diagnosis. target for most patients is 7% |
| Alpha-glucosidases | enzymes in the small intestine that break down complex carbohydrates (like starch) into simple sugars (like glucose). |
| Alpha-Glucosidase Inhibitors: Adverse Reactions | •Bloating •Diarrhea - gas •Stomach pain |
| Meglitinides | Repaglinide (Gluconorm®) for type 2 diabetes works only in people with functioning pancreatic beta cells. lower HbA1c levels an onset of action 15 to 30 minutes always be taken with meals to prevent hypoglycemia. |
| Meglitinides moa | stimulates the pancreatic beta cells to release insulin/ increases insulin levels in the blood. effect is glucose-dependent, meaning it primarily acts when blood sugar is elevated metabolized by CYP450 therefor high potential for drug-drug interactions |
| Thiazolidinediones | Pioglitazone(Actos®) •Rosiglitazone(Avandia®) |
| Thiazolidinediones moa | improve how the body’s cells respond to insulin (INCREASED TISSUE SENSITIVITY), reducing insulin resistance. By enhancing insulin sensitivity, promote glucose storage and utilization in muscle and liver tissue. |
| Pioglitazone | A Thiazolidinedione Lowers free fatty acids and triglycerides. Reduces plasma glucose concentrations, insulin levels, and HbA1c. |
| Thiazolidinediones:Adverse Reactions | side effects include headache, weight gain, diarrhea, nausea, and vomiting. muscle pain, jaundice, blurred vision, hypoglycemia, and hyperglycemia. Serious side effects can include heart failure, heart attack, and liver failure. |
| Dipeptidyl Peptidase-4 (DPP-4) Inhibitors | END IN -LIPTIN some include metformin for type 2 /preventing the breakdown of incretin hormones (GLP-1 and GIP). This prolongs their action, leading to •increased insulin release •Decrease glucagon levels which lower blood glucose |
| Sodium-glucose cotransporter-2 (SGLT2) inhibitors | end in -lozin Also combined with metformin and a DPP-4 inhibitor |
| Sodium-glucose cotransporter-2 (SGLT2) inhibitors moa | lower blood sugar by blocking glucose reabsorption in the kidney, forcing glucose to be excreted in urine. Since SGLT2 normally reabsorbs about 90% of filtered glucose, inhibiting it is an effective way to reduce hyperglycemia in type 2 diabetes. |
| Sodium-glucose cotransporter-2 (SGLT2) inhibitors adverse reactions | Urinary tract infections thirst, increased urination elevated potassium levels. |
| Incretin Mimetics / Glucagon-like peptide-1 (GLP-1) receptor agonists | ends in - glutide treats type 2 |
| Incretin Mimetics: MOA | Stimulating insulin release (beta cells). Suppressing glucagon (alpha cells). Slowing gastric emptying. Reducing appetite. |
| Incretin Mimetics adverse reactions | nausea |
| Amylin Analog | Pramlintide Synthetic analog of the hormone amylin/ Used with mealtime insulin to control blood sugar levels in people with type 1 or 2 diabetes . Injected subcutaneously immediately before each meal. - slows gastric emptying. + reduce appetite |
| amylin Analog:Adverse Reactions | •Hypoglycemia •Redness,swelling,bruising, itching at the injection site •Lossofappetite •Stomachpain • Indigestion •Upsetstomach •Excessivetiredness •Dizziness •Coughing •Sorethroat •Jointpain |
| Colesevelam | cholesterol-lowering agent (a bile acid sequestrant). It can modestly improve blood glucose levels in type 2 diabetes. |
| Bromocriptine | A dopamine agonist, traditionally used for conditions like Parkinson’s disease and hyperprolactinemia. It has been shown to improve glycemic control in patients with type 2 diabetes, |
| Alpha-lipoicacid (ALA) | Prevent cell damage caused by oxidative stress from substances called free radicals. Elevated blood glucose levels can also cause oxidative stress. |
| Magnesium | levels are often lower in people with diabetes, which can make it harder to control blood sugar in type 2 diabetes by disrupting insulin secretion and increasing insulin resistance. found in nuts, seeds, green leafy veggies |
| Ketoacidosis | diabetes complication When the body breaks down fats to meet its energy needs, it produces ketones. If these ketones build up, it can lead to coma and death. |
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