lecture 9

Question 1

what are some of the signs of diabetes?

Answer 1

frequent urination, increased thirst, hunger and tiredness

Question 2

complications of diabetes?

Answer 2

stroke, heart attack, kidney disease, eye disease, and nerve damage

Question 3

3 things used to diagnose diabetes?

Answer 3

fasting plasma glucose test, oral glucose tolerance test and measurement of glycated hemoglobin test

Question 4

explain type 1 diabeties

Answer 4

beta cells produce no insulin. insulin dependent

Question 5

explain diabetes 2

Answer 5

don’t produce enough insulin, insulin resistant. related to obesity

Question 6

Lisper, aspart, and glulisine have what type of time action?

Answer 6

fast acting

Question 7

detemir and glargine have what type of time action?

Answer 7

slow (basal)

Question 8

two functions of insulin?

Answer 8

allow glucose to come into the cell and to inhibit glucose production from pyruvate in the liver

Question 9

what is glitazone?

Answer 9

insulin sensitizer

Question 10

what is metformin?

Answer 10

insulin sensitizer

Question 11

what is a good drug for combination therapy with other drugs?

Answer 11

metformin

Question 12

metformin acts upon what?

Answer 12

AMPK

Question 13

NAME 4 THINGS METFORMIN DOES DEALING WITH LIPID METABOLISM?

Answer 13

decrease Acetyl coa carboxylase, increase FA transport to mitochondria, increase FA oxidation, decrease lipolysis

Question 14

name 4 things metformin does to glucose metabolism?

Answer 14

increase glut 4, increase ate production, increase glycogen synthesis and decrease gluconeogenesis

Question 15

contraindications for metformin?

Answer 15

type 1 dm, renal failure, liver failure, congestive heart failure

Question 16

side effects of metformin?

Answer 16

GI cramping, okay with food. lactic acidosis risk

Question 17

pioflitazone and rosiglitazone (TZD) are what?

Answer 17

sensitizers

Question 18

pioglitazone good for people what what?

Answer 18

renal insufficiency

Question 19

problem when pioglitazone?

Answer 19

delayed action: onset 3 weeks, full effect 10-12 wks

Question 20

side effects of pioglitazone

Answer 20

weight gain, liver function abnormalities ( ALT), fluid retention, anemia and fractures of long bones in women.

Question 21

rosiglitazone may cause what? and should be avoided for patients with what?

Answer 21

angina, or MI. ischemic heart diseases

Question 22

contraindications for pioglitazone?

Answer 22

type 1 DM, prego, liver disease, anyone younger than 18.

Question 23

sulfonyllureas and glinides are what

Answer 23

insulin secreters

Question 24

glucagon like peptide incretins are what

Answer 24

secretors

Question 25

glimepiride, glipizide, glyburide are all what

Answer 25

sulfonylureas

Question 26

disadvantages to sulfonylureas

Answer 26

hypoglycemia, weight gain, secondary failure due to gradual loss of beta cels common

Question 27

contraindications to sulf

Answer 27

type 1 dm, allergy, hyperemia in older its, cautious for woman

Question 28

name some of the effects of incretin?

Answer 28

secreted from GI, decrease appetite, decrease gastric emptying, increases insulin release

Question 29

DPP-4 inhibitors are what

Answer 29

secretors

Question 30

DPP-4 enzymes usually do what?

Answer 30

decrease GLP-1 enzymes which normally would increase glucose

Question 31

Sitaglipin (Januvia®), Saxagliptin (Onglyza®), Linagliptin (Tradjenta®) Alogliptin (Nesina®) are what

Answer 31

DPP inhibitors

Question 32

DPP-4 inhibitors used in mono therapy for what

Answer 32

diet and exercise

Question 33

DPP-4 inhibitors used in combination therapy with what?

Answer 33

metformin, TZD, SU or SU +met and now insulin

Question 34

DPP4 inhibitor should NOT be used for what 2 things?

Answer 34

type 1DM, and for treatment of diabetes ketoacidoses

Question 35

side effects of Gpp4 inhibitor?

Answer 35

few side effects- but GI adverse reactions

Question 36

eventide is what

Answer 36

GLP1 analog

Question 37

adverse effects of exentide

Answer 37

nausea and vommiting, not recommended for renal failure. hypoglycemia only with SU

Question 38

alpha glucosidase inhibitors do what?

Answer 38

limit glucose influx from gut. competitive inhibition of hydrolytic enzymes in git, delay and prolong glucose absorption.

Question 39

acarbose and miglitol (Precose® and Glyset®) are what

Answer 39

alpha glucosidase inhibitors

Question 40

side effects of alpha glucosidase inhibitors?

Answer 40

diarrhea and flatulence

Question 41

Canagliflozin and Dapagliflozin are what?

Answer 41

SGLT-2 inhibitors

Question 42

SGLT-2 inhibitors DO WHAT

Answer 42

decrease renal threshold for urinary excretion of glucose, diuretic effect, lower blood pressure, contribute to weight loss, risk of bladder infections

Question 43

what decreases glucose production?

Answer 43

glitazones

Question 44

what decreases glucose absorption?

Answer 44

acarbose (alpha glucosidase inhibitors)

Question 45

what increases insulin production?

Answer 45

SU, GLP1, and DPP4 inhibitors

Question 46

what increase peripheral glucose utilization?

Answer 46

glitazones

Question 47

what increase glucose excretion

Answer 47

SGLT2 inhibitors= canagliflozin

Question 48

4 steps of type 2 diabetes treatment?

Answer 48

diet and exercise, mono therapy, combination oral agents, and insulin

Question 49

mono therapy is treated with what

Answer 49

metformin and life style

Question 50

combination agents treated with what

Answer 50

metformin + SU, TZD GLP1 analogies or DPP4 inhibitots

Question 51

insulin stage treated with what

Answer 51

insulin and everything from combination stage