Chronic Exam #1
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| Beta cells | produce insulin (hormone) that decreases BS
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| Alpha cells | produce glucagon (hormone) that increases BS
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| Primary action of insulin | active transport of glucose into muscle and adipose tissue cells to lower blood glucose
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| other roles of insulin | regulates rate of CHO metabolism, promotes glycogen storage in the liver, inhibits fat breakdown, inhibits protein breakdown
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| action os glucagon | raises BS by promoting conversion of glycogen to glucose
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| Type I Diabetes | IDDM (insulin dependent) "Juvenile diabetes", total lack of insulin production (autoimmune process that destroys beta cells), onset usually younger than 30
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| Type II Duabetes | NIDDM (non-insulin dependent) "maturity onset diabetes" inadequate production of insulin or increased cellular resistance to the body's own insulin, slower onset, tend to be obese
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| signs and symptoms of diabetes | 3 Ps (polydipsia-excessive thirst, polyphagia-excessive hunger, polyuria-excessive urination), weight loss, fatigue, weakness, blurred vision, frequent infections
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| Diagnostics of Diabetes | 1.Fasting Blood Sugar (FBS)- norm 70-110, diagnosis >140 on 2 different occasions2. glycosylated hemoglobin (Hgb molecules combine with glucose to form glycohemoglobin which is stored by RBCs) normal value= 4-7%
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| 6 food groups of the exchange diet | starch/bread, protein/meat, dairy/milk, fruits, vegetables, fats
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| distribution of calories | 50-60% from carbs20-30% from fat20% from protein
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| Type 2 Management | may be controlled with diet and exercise alone, or in combo with oral hyoglycemic agents, 20-30% require insulin during periods of stress
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| Type I Management | require insulin therapy
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| typesof insulin | rapid acting, short acting, intermediate acting, long acting, other
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| Rapid-acting insulin | Humalog (lispro), clearonset- 10-15minspeak- 1hrduration- 2-4 hrs
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| Short acting insulin | Regularonset- 1/2 hr-1hrpeak- 2-4 hrsduration- 5-7hrs
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| Intermediate acting insulin | NPH, cloudyonset- 2-4hrspeak- 6-12 hrsduration- 18-24 hrs
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| Long acting insulin | ultralenteonset- 6+ hrspeak- 18-24 hrsduration- 36 hrs
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| other types of insulin | Lantus (glargine, clear, long acting, basic metabolic needs
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| insulin preparation for mixed dose | 1. add air to cloudy vial2. add air to clear vial3. draw out clear dose4. draw out cloudy dose to reach total dose
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| absorption of insulin | mroe rapid from abdomen, then arms, then legs
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| oral antidiabetic agents (types) | sulfonylureas, meglitinides, biguanides, glitazones, alpha-glucosidae inhibitors
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| sulfonylureas | Glucatrol (Glipizide), Micronase (Glyburide)- stimulate beta cells to produce insulin and increase cellular receptivity
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| meglitinides | Prandin (Repaglinide)- stimulate beta cells to produce insulin
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| biguanides | Glucophage (Metformin)- WORK IN THE LIVER, increasw cellular receptivity to insulin and decrease hepatic production of glucose
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| Glitazones | (Avandia) (Actos)- decrease insulin resistance by increasing receptor sensitivity (sensitizers)
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| alpha glucosidase inhibitors | (work in intestine) (Precose)- delay digestion of complex CHO
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