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Flashcards in DM II Deck (32)
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1

What is a common finding in patients with DM II (Pathophysiology)?

Insulin Resistance develops causing hyperglycemia in the body.

2

Insulin Resistance can be

Genetically Determined or
Acquired based on Environmental Factors

3

Insulin Resistance has an effect on

Muscle
Liver
Adipose Tissue
Pancreas

4

DM II can cause

Microvascular Complications (Retinopathy, Nephropathy, Neuropathy)
Macrovascular Complications (CVD)

**See DM I Notes**

5

When treating DM II, what should you consider with patients?

Level of patient's interest of involvement!
Shared decision making is important because lifestyle of the patient, and patient control is an important thing to consider.

6

Three common drugs for DM II

1. Metformin
2. Sulfonylurea
3. TZDs

7

Body makes how many units of insulin every 24 hours?

25 units

8

How do you diagnose DM II?

Oral Glucose Tolerance Test (OGTT)

9

Initial Treatment for DM II

Monotherapy: Metformin
2 Drug therapy: Add sulfonylureas, insulin, GLP-1 receptor agonist

10

Common Insulin given

NPH
Levamir
Lantis

11

What is the #1 goal of treatment for DM II

Getting Glucose levels NORMAL

12

The higher the glucose in the blood, the ______ Metformin will work

More

13

Metformin has multiple beneficial effects, such as:

Decreasing blood glucose
Decreasing Insulin Resistance
Lowering Triglycerides
Lowering Cholesterol
Improves Fibrinolyric Defects
Vasculature is benefited

14

Contraindications for Metformin usage?

When Creatinine is Greater than 1.4/1.5 (Female/Male)

This indicated Renal Failure, Heart Failure or Liver Failure

15

Phenoformin

Similar Drug to Metformin

16

Why isn't phenoformin not more commonly used?

Issues with Mitochondria causing a decrease in ATP production

17

Benefit of sulfonylurea

CHEAP

18

Effects of Sulfonylurea:

Hypoglycemia
Weight Gain
Doesn't last very long

19

Sulfonylurea is commonly used in conjunction with what medication for effective DM II treatment?

Metformin (based off the lecture)

20

What is the primary function of TZD (Thaiazolidinediones)?

Improves Fat Metabolism

21

Why does TZD work for DM II

Increased metabolism of fat will cause glucose to go down because fat makes the body insulin resistant, and fat can get into the muscles and liver.

22

Benefits of TZD?

Reduced rate of MI and stroke.
Reduces NASH (fatty liver)

23

When is TZD most commonly used?

Prediabetics to prevent DM onset

24

Side Effects of TZD

Weight Gain
Water Retention in CHF
Bone loss in females
Bladder Cancer in Males

25

What is the GLP-1 Receptor?

Receptor on the B-cells in the Pancreas
Causes the Beta Cells to make more Insulin (via boost of cAMP)

26

When does GLP-1 Receptor not work?

When the blood sugars are low.

Won't activate Beta Cells to make more insulin, so you won't go into hypoglycemic effects.

27

GLP-1 Receptor Medications are commonly used in conjunction with

Metformin (but also used with long-acting insulin)

28

GLP-1 Receptor Meds are limiting because

Expensive

29

Side Effects of GLP-1 Receptor Meds

Nausea
Pancreatitis
C-Cell Hyperplasia

30

GLP-1 Receptor Drugs

Exenatide (Byetta)
Januvia
Liraglutide