Endocrine Lecture
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Why is C-peptide found in amounts equal to insulin in diabetes? | Because insulin and C-peptide are linked when first made by the pancreas. The level of C-peptide in the blood can show how much insulin is being made by the pancreas.
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| C-Peptide level in type 1 diabetes will be: | low, because no insulin is being produced
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| C-peptide level in type-2 diabetes will be: | normal or high
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| biguanide (Metformin) | gold standard for type 2 diabetes
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| Metformin dosage | 500mg qd to bid up to 2000mg/d
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| Metformin ADR | GI upset, lactic acidosis, 2 week onset
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| Metformin Benefits | decreases blood sugar, weight loss, decreased vascular issues
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| Sulfonylureas (insulin secretagogues) | glipizide (Glucotrol), glyburide (Diabeta), glimerpiride (Amaryl)
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| Sulfonylureas effectiveness | work good for awhile but then start to creep up again
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| Sulfonylureas dosage | most are BID (Amaryl qd, diabenese qod), take 30 minutes before meal. Do not skip meals!!!
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| Sulfonylureas caution | Sulfa allergy, hepatic/renal failure, weight gain, GI distress, malnutrition, eating d/o, adrenal insufficiency.
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| Sulfonylureas benefits | Rapid onset, cheap (generic) effective
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| Meglitinides- Repaglinide (Prandin) Nateglinide (Starlix) | Can skip meals, good for irregular eating habits
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| Thiazolidinediones (TZDS) | Pioglitazone (actos), Rosiglitazone (Avandia)
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| Avoid Avandia in: | CHF and CAD
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| Actos and Avandia major ADR | fluid retention, may give diuretic to overcome
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| Sitagliptin (Januvia) and Sazgliptin (onglyza) | works on carb absorption, increase satiety, slow gastric emptying (expensive)
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| Januvia | 100 mg q day
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| Onglyza | 5 mg q day
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| Fasting glucose should be? | 90-130mg/dl
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| A1C should be | <6.5-7
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