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Diabetes Flashcards

(42 cards)

1
Q

Type 1 Diabetes

A

Autoimmune- born with it
Most diagnosed in childhood
Body does not produce insulin
Can only be fixed with insulin

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2
Q

Type 2 Diabetes

A

Often due to “you” (diet, weight, exercise)
Obesity
Many times over 40 (sometimes children)
Body has insulin, it just isn’t utilizing it correctly

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3
Q

Criteria for diagnosis of diabetes

A

Fasting plasma glucose level of 126 mg/DL or higher (don’t drink or eat for over 8 hours. Test more than once)
HgA1C greater than 6.5%

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4
Q

A1C target levels for normal people

A

Less than or = less than 5.7%

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5
Q

A1C target level for pre-diabetes

A

5.7-6.4%

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6
Q

A1C target level for diabetics

A

6.5% or more

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7
Q

A1C target level for elderly

A

NEVER below 6%

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8
Q

Rapid Acting Insulin - (Clear)

A

Medication end in -log - Humalog, Novalog
Take with or before meals
Onset: 15 minutes
Peak: 1-2 hour

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9
Q

Short Acting Insulin - (Clear)

A

Medication end in -R - Humulin R, Novalin R
SQ, IV is blood sugar is dangerous
Onset: 30-60 minutes
Peak: 2.5 Hours

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10
Q

Intermediate Acting Insulin (Cloudy)

A

Medication end in -N - Humulin N, Novolin N
SQ
You can mix short acting and intermediate insulin (r+n)
Onset: 1-2 Hours
Peak: 4-8 Hours
1x or 2x daily

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11
Q

Long Acting Insulin

A

Medication - Lantus (long for lantus)
1x daily for steady blood sugar
Onset: 1-2 Hours
Peak: No peak
Duration: 24 Hours

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12
Q

Hyper drugs for hypoglycemic (elevate blood sugar)

A

Glucagon - IV, IM ,SQ
50% dextrose (d50) - IV
“Fast 15”

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13
Q

“Fast 15”

A

Only done when patient is awake and alert and hypoglycemic. GIve 4 oz of juice of 15 carbs.

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14
Q

Hypoglycemic and unconscious

A

Give 50 Dextrose by IV
OR
Give Glucagon either IM, IV, or SQ

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15
Q

ozempic-semaglutide

A

FOR TYPE 2 Diabetes
SQ once weekly
Causes increase in insulin release & decreases in glucagon release.
Slows gastric emptying and suppresses appetite.
May alter absorption of other meds

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16
Q

Mounjaro - tirzepatide

A

SQ weekly
Unlikely to cause significant hypoglycemia unless given with other meds.
CONTRAINDICATED - personal/family history of thyroid cancer. Type 1 diabetes.

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17
Q

S/S of diabetes

A

Hunger, sex problems, bad circulation (tingling/numbness), nausea, fatigue, dry skin, slow wound healing, infections, Weight gain for type 2 - obese, weight loss for type 1 - small.
The three P’s - Polyphagia (excessive hunger), polydipsia (excessive thirst), Polyuria (urinating frequently)

18
Q

Hypoglycemia

A

Decrease in blood sugar
Causes: too little food, too much insulin or diabetes medication, extra exercise
Sudden: may progress to insulin shock

19
Q

Symptoms of Hypoglycemia

A

Shaking, tachycardia, sweating, anxious, dizziness, hunger, impaired vision, weakness, fatigue, headache, irritable

20
Q

Hyperglycemia

A

Increased blood sugar

21
Q

Hyperglycemia Symptoms

A

Dry mouth, weakness, blurred, headache, increased thirst, blurred vision, frequent urination

22
Q

Normal Blood Sugar Level

23
Q

Low Blood Glucose

A

Glucagon released by “alpha cells” of pancreas, liver releases Glucose into blood

24
Q

High Blood Glucose

A

Insulin released by “beta cells” of pancreas, fat cells take in glucose from the blood.

25
Biguanide Metformin - Glucophage
Decreases glucose production in liver Decreases intestinal absorption of glucose Significant chance of Hypoglycemia
26
Biguanide Metformin - Glucophage Adverse Effects
Weight loss (6-8 pounds), bloating, nausea, anorexia, abdominal cramping, metallic taste, vitamin b12 & folic acid deficiency
27
Biguanide Metformin - Glucophage Contraindications
Stop for 2 days before Iodine contrast (CT scan) and not started for 2 days after. Monitor kidney function - if creatinine is high, hold med and contact PCP (1.5 mg/dL in males, 1.5 mg/dL in females)
28
Sulfonyureas End in - IDE Glipizide - Glucotrol Glyburide - Diabeta
PO - Give 30 minutes before a meal Stimulates release of insulin from pancreas, decreases secretion of glucogon Works best in early stages of type 2 Can be used w/ metformin or alone Only given to type 2, stop taking if/when insulin is required.
29
Sulfonyureas End in - IDE Glipizide - Glucotrol Glyburide - Diabeta CONTRAINDICATIONS
Advanced diabetes dependent on insulin NPO status - if N/V it will raise insulin and make them hypoglycemic Alcohol use, advanced age Allergic to sulfonamides, may have cross allergy Caution in severe heart or liver disease
30
Sulfonyureas End in - IDE Glipizide - Glucotrol Glyburide - Diabeta ADVERSE EFFECTS
Hypoglycemia (especially if they aren’t eating or are NPO) , weight gain, skin rash, nausea, epigastric fullness, heartburn, some GI disturbances
31
Glinides (meglitinides) DRUG - repaglinide - Prandin
Increase insulin secretion from pancreas Short duration, given at each meal Can be used with metformin Cannot be used with sulfonyureas (they function the same way)
32
Glinides (meglitinides) DRUG - repaglinide - Prandin CONTRAINDICATIONS
Type 1 Diabetes NPO status, alcohol use, advanced age (these will cause blood sugar to drop low or bottom out. With older age, more adverse reactions can occur)
33
Glinides (meglitinides) DRUG - repaglinide - Prandin Adverse Effects
Hypoglycemia weight gain (people stop taking usually if they are already having weight gain issues) Eat w/ dose
34
Thiazolidinediones(glitazones) - like actos
Makes you more sensitive to insulin Decreases insulin resistance by in handing sensitivity of inclusion receptors. Take weeks to monitor for full effect, slow onset.
35
Pioglitazone (Actos)
Type 2 diabetes (contraindicated in type 1) May combine with metformin or sulfonyurea
36
Thiazolidinediones (glitazones)- like Actos
Do not take if you have severe heart failure Caution with liver or kidney disease Causes peripheral edema or weight gain Can cause reduced bone mineral density & increased risk of fractures
37
Alpha-glucosidase inhibitor MED - acarbose (Precose)
Inhibit enzyme alpha-glucosidase in small intestine It is responsible for changing saccharides to glucose. Blocking it causes glucose absorption to be delayed. Because of action it must be taken with food- PO Prevents or reduces postprandial glucose spike For Type 2 diabetes
38
Alpha-glucosidase contraindications (Precose)
IBS Malabsorption syndrome Intestinal obstruction
39
Alpha-glucosidase Adverse/side effects (Precose)
Flatulence (gas), diarrhea, abdominal pain Do not usually cause hypoglycemia or weight gain
40
Alpha-glucosidase drug interaction
Bioavailability of drugs such as digoxin (lanoxin) and propranolol (Inderal) may be reduced
41
Dipeptidyl peptidase IV inhibitors (gliptins) MED - Sitagliptin (Januvia)
Decreases release of glucose, lowers blood sugar for fasting and postprandial.
42
Adverse effects (Januvia)
Significant hypoglycemia can occur when drug is combined with a sulfonyurea Treatment for type 2