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Endocrinology > Diabetes Mellitus Type 2 > Flashcards

Diabetes Mellitus Type 2 Flashcards

1
Q

what is waist circumference in a male patient with DM2?

A

over 40 inches

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2
Q

what is waist circumference in a female patient with DM2?

A

over 35 inches

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3
Q

inflammation of penis and foreskin

A

balanoposthitis

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4
Q

a patient has classic symptoms of hyperglycemia; thirst, polyuria, weight loss, and blurry vision. what do we need to diagnose them with DM2?

A

random plasma glucose of 200 or more

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5
Q

a patient presents asymptomatic. what do we need to diagnose them with DM2? (3)

A

fasting plasma glucose over 126
OR
two hour OGTT over 200
OR
HbA1c over 6.5%

must be confirmed with repeated labs

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6
Q

the higher the HbA1c, the higher the ______ has been the last ___ days

A

glucose
90

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7
Q

what class of drugs stimulate insulin secretion by the pancreas? (3)

A

sulfonylureas
meglitinides
phenylalanine derivative

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8
Q

what are the 2 sulfonylureas used to stimulate insulin secretion by the pancreas?

A

glyburide
glipizide

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9
Q

which sulfonylurea is preferred? why?

A

glipizide
shorter duration of action = shorter side effects

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10
Q

how to take glipizide?

A

30 mins before meals

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11
Q

which patients should not receive glipizide?

A

liver failure

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12
Q

which patients should not receive glyburide? (3)

A

liver failure
renal failure
elderly

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13
Q

what are the ADR of sulfonylureas? (2)

A

hypoglycemia
weight gain

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14
Q

what is the name of the meglitinide analog that stimulates insulin secretion by the pancreas?

A

rapaglinide

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15
Q

what is the name of the D-phenylalanine derivative that stimulates insulin secretion by the pancreas?

A

nateglinide

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16
Q

which medications give a brief, rapid pulse of insulin? (2)

A

rapaglinide
nateglinide

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17
Q

which 2 class of medications act on the liver, muscle, and adipose tissue to increase uptake of glucose?

A

biguanides (metformin)
thiazolidinediones (glitazones)

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18
Q

what is the first line drug for DM2?

A

biguanides (metformin)

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19
Q

which drug reduces gluconeogenesis and lipogenesis?

A

metformin

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20
Q

what are the ADR of metformin?

A

GI - start slow
lactic acidosis
diarrhea

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21
Q

which drug class sensitizes peripheral tissues to insulin and decreases hepatic glucose production?

A

thiazolidinediones (glitazones)

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22
Q

how do thiazolidinediones (glitazones) reduce A1c?

A

by 1-2%

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23
Q

what are the ADR of thiazolidinediones (glitazones)? (2)

A

weight gain
fluid retention

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24
Q

which patients should not receive thiazolidinediones (glitazones)?

A

heart failure

25
Q

which drug class decreases glucose absorption from the gut?

A

alpha-glucosidase enzymes

26
Q

what are the 2 drugs in the class alpha-glucosidase inhibitors?

A

acarbose
miglitol

27
Q

how should alpha-glucosidase inhibitors be taken?

A

with first mouthful of food

28
Q

which medications/drug class lowers postprandial hyperglycemia by 30-50%?

A

alpha-glucosidase inhibitors

acarbose
miglitol

29
Q

what are the ADR of alpha-glucosidase inhibitors?

A

flatulence
diarrhea

30
Q

which patients should not receive miglitol?

A

kidney disease

31
Q

what does oral glucose stimulate in the body?

A

the release of GLP-1

32
Q

what does GLP-1 do? (3)

A

stimulate insulin secretion
suppress glucagon secretion
delays gastric emptying

33
Q

-tide

A

GLP-1 agonists

34
Q

once weekly injection of GLP-1 agonists (3)

A

semaglutide
exenatide ER
dulaglutide

35
Q

once daily injection of GLP-1 agonist (1)

A

liraglutide

36
Q

twice daily injection of GLP-1 agonist (1)

A

exenatide

37
Q

once daily oral of GLP-1 agonist

A

semaglutide

38
Q

what are the ADR of GLP-1 agonists? (3)

A

N/V
pancreatitis

39
Q

-gliptin

A

DPP-4 inhibitors

40
Q

ADR of DPP-4 inhibitors (3)

A

pancreatitis
nasopharyngitis
hypersensitivity reactions

41
Q

drug class that increases kidney excretion of glucose, causing glycosuria in people with diabetes

A

SGLT2 inhibitors

42
Q

-flozin

A

SGLT2 inhibitors

43
Q

which patients should not receive SGLT2 inhibitors?

A

renal insufficiency

44
Q

what should we watch out for in patients taking an SGLT2 inhibitor?

A

UTI

45
Q

what are the rapid insulins? (LAG)

A

lispro
aspart
glulisine

46
Q

what is the order of insulin by effective duration?

A

rapid: LAG
human regular
human NPH
insulin detemir
insulin glargine

47
Q

what are the 3 insulin that are considered rapid acting?

A

LAG

lispro
aspart
glulisine

48
Q

what insulin is considered short acting?

A

regular insulin

49
Q

what insulin is considered intermediate acting?

A

NPH

50
Q

which insulin (2) are considered long acting?

A

glargine
detemir

51
Q

in which patients is home glucose monitoring required?

A

patients on insulin

52
Q

how should we do home glucose monitoring?

A

before meals + log in book bid in alternating pattern

53
Q

what is the goal of home glucose monitoring?

A

keep preprandial sugars even during day and bedtime surgars equal to morning sugars

54
Q

what is the ADA recommended foot exam?

A

every visit

55
Q

what is the ADA recommended microfilament test?

A

every 6 months

56
Q

what is the ADA recommended eye exam?

A

yearly

57
Q

what is the ADA recommended urine microalbumin/creatinine ratio?

A

yearly

58
Q

what is the ADA recommended A1c check not at goal?

A

every 3 months

59
Q

what is the ADA recommended A1c check at goal?

A

every 6 months

Endocrinology (17 decks)

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