Diabetes 3

Question 1

what are the treatments available for diabetes

Answer 1

Oral antihyperglycemic agents Insulin injections Dietary modifications

Question 2

Oral antihyperglycemic agents
how are they taken
What is the exception

Answer 2

usually oral except for GLP-1 RECEPTOR AGONIST

Question 3

Alpha-Glucosidase Inhibitor
generic name
mechanism of action
side effects

Answer 3

Glucobay
decrease CHO digestion/absorption
side effect: fart, bloat diarhea

Question 4

DPP-4 inhibitor

generic name ends with

Answer 4

___gliptin

stimulates insulin synthesis+ secretion

Question 5

GLP-1 Receptor Agonist

Answer 5

ends with tide
stimulate insulin synthesis + secreation
significant weightloss

Question 6

Insulin secretagogue

what are the 2 types

Answer 6

Sulfonyureas (ends with ides) and Meglitinides (ends with nides)
stimulate insulin secreation
risk of hypoglycemia

Question 7

Metformin

Answer 7

decrease amount of glucose being released from liver

GI side effects- B12 DEFICIENCY

Question 8

sODIUM-glucose linked transporter 2 (SGLT2) inhibitor

Answer 8

ends with flozin
increases glucose in urine by decreasing reabsorption
can lead to increased genital infections like UTIs

Question 9

Thiazolidinedione (TZD)

Answer 9

increase insulin sensitivity, especialy in muscles
ends with Azone
weight gain

Question 10

Weightloss Agents

Answer 10

Orlistat

terrible GI side effects

Question 11

INSULIN-TYPES AND MANAGEMENT -

Answer 11

INSULIN-TYPES AND MANAGEMENT -Subcutaneous injection –
-Vials contain insulin in Units/mL
-Review types and actions of insulin (see summary attached)
-All types now are human insulin (recombinant insulin) – no longer pork or beef insulin
understanding when the insulin acts is critical for nutritional care (need food when insulin starts acting or could lead to hypoglycemia)

Question 12

when should insulin be taken

Answer 12

about 15-30 beofre the meal, except less than 5 when taking rapid acting types

Question 13

I. Conventional Schedules e.g. Type 2 DM - not adequately controlled on oral medication alone

Answer 13

1-3 injections/day

Question 14

II. Multiple daily insulin injections or intensive insulin

Answer 14

Several injections of a combination of various types of insulin required in order to achieve good blood glucose control. Insulin taken 15-30 minutes before the meal (except < 5 min with the rapid-acting) Arbitrary definition, but generally > 4 injections/day
- type 1 diabetes

Question 15

III. Insulin pump

Answer 15

• Pump & indwelling needle inserted subcutaneously in abdomen. -Uses rapid-acting insulin infused at a constant rate + a bolus of insulin that is adjusted prior to each meal based on:
• type and amount of CHO
• BG test- what was it before the meal

Question 16

Some considerations in insulin protocol

Answer 16

good control
Lifestyle
- more intense insulin therapy requires patient motivation and blood testing many times a day and increases risk for hypoglycemia
Adequate budget for health care professionals (nurses and endocronologists) for intensive therapy for close patient contact. how much insulin to take?
-

Question 17

how much insulin to take

Answer 17

it is constantly reassess and changes acording to BG results

amonut of cho and type
activity level
psychological stress
body weight (body composition)
own insulin production iin type 2, illness

Question 18

what are the different types of insulin

Answer 18

rapid acting (onset in 10-15 mins), peak at 1-1.5h and duration 3-5 hours

Short acting: onset at 30 mins, peak at 2-3 h and duration 6.5 h

intermediate: onset 1-3hours, peak at 5-8 hours and duration up to 18h

long acting: onset at 90 mins, there is no peak- flat line and duration of about 24 hours