0
Q
what is the most common type of diabetes?
A
type two diabetes
1
Q
what is lipohypertrophy?
A
results in fat accumulation around the injection site
3
Q
define: postprandial
A
after eating
3
Q
how was insulin originally manufactured?
A
-from animal sources; pig and cow
4
Q
how long after consuming alcohol beverages can delayed hypoglycemia occur?
A
24 hours
5
Q
are some adverse reactions of α-glucosidase inhibitors?
A
-most commonly produce G.I. side effects: bloated feeling, diarrhea, stomach or intestinal gas, rumbling stomach and stomach pain or discomfort
6
Q
what is the most effective agent for glycemic control?
A
insulin
-also reduces the hemoglobin A1C level by more than 2%
7
Q
what are the four types of diabetes?
A
- Prediabetes
- type one diabetes
- type two diabetes
- gestational diabetes
7
Q
what is a “diabetes” diet?
A
A diet that is high in fat and carbohydrates
9
Q
_______ are sometimes categorized as oral hypoglycemic agents (OHA).
A
Sulfonylureas
10
Q
which type of diabetes is an autoimmune disease?
A
type one diabetes
11
Q
what types of disease or risk factors for diabetes?(9)
A
- hypertension
- angina
- myocardial infarction
- stroke
- metabolic syndrome
- insulin resistance
- Hyperlipidemia
- schizophrenia
- polycystic ovary syndrome
13
Q
how many diabetes suffers, suffer from type one diabetes?
A
only 5% to 10%
13
Q
______ causes impaired fasting glucose(IFG) and impaired glucose tolerance(IGT)
A
Prediabetes
14
Q
how is insulin administered?
A
subcutaneously
-your insulin may also be administered intravenously
15
Q
of those suffering from diabetes, how many are suffering from type two diabetes?
A
90% to 95%
16
Q
explain type two diabetes
A
- pancreas initially produces sufficient insulin, but the body is unable to use the insulin effectively.
- insulin production eventually decreases; however this may not occur for several years
17
Q
what are the five risk factors of type two diabetes?
A
- obesity
- lack of physical activity
- Family history
- prior gestational diabetes
- increasing age
18
Q
what are the symptoms of type one diabetes?(8)
A
- blurred vision
- Constant hunger (polyphagia)
- diabetic ketoacidosis
- Extreme fatigue
- frequent urination (polyuria)
- Hyperglycemia
- increased thirst (polydipsia)
- weight-loss
19
Q
approximately ____ of persons diagnosed with __________ are overweight.
A
80%
take two diabetes
20
Q
OHAs are only effective for the treatment of __________.
A
type two diabetes
21
Q
what are the causes of type one diabetes?(3)
A
- exposure to environmental factors
- viruses
- genetics
22
Q
what are the dosage delivery systems for the administration of insulin?(3)
A
- insulin pump
- vial and syringe
- insulin pen
23
Q
what was type two diabetes formally called? Why was the term replaced?
A
non-insulin-dependent diabetes mellitus
-this term has been replaced because people with type two diabetes sometimes may be required to manage the condition with insulin
24
what is gestational diabetes?
diabetes in pregnancy
25
how many people suffer from gestational diabetes?
approximately 3% to 8% of all pregnant women
26
what insulin must be refrigerated and discarded after 28 days(5 and 10mL)?
insulin glargine (Lantus)
27
what is a sign of gestational diabetes?
blood glucose levels are normally lower than normal during pregnancy so elevated blood glucose levels as a sign of gestational diabetes
28
_________s lower postprandial blood glucose levels by stimulating insulin secretion from pancreatic beta cells, similar to sulfonylureas. The action on basil insulin is less effective.
meglitinides
29
those who've had gestational diabetes have a ___ to ___ increased risk for the development of ________ within _____.
20% to 50%
type two diabetes
5 to 10 years
30
what are the symptoms of type two diabetes?(8)
- blurred vision
- fatigue
- frequent urination
- Hunger
- Hyperglycemia
- increased thirst
- slow healing of wounds
- weight-loss
31
what is insulin resistance?
A condition in which the body does not respond to insulin
| -precursor to type two diabetes
33
The prevailing's of type two diabetes is increased in: (4).
- Aboriginal Canadians
- native Americans
- African Americans
- Mexican Americans
34
what was type one diabetes formally called?
juvenile-onset diabetes mellitus
35
T/F: prediabetes increases the risk of cardiovascular disease
true
36
explain: type one diabetes
- autoimmune disease
- immune system attacks and destroys the insulin producing cells in the pancreas.
- must inject insulin daily
- equal among males and females but, more common in whites than non-whites
38
What are the 4 recommended lifestyle modifications in the treatment of diabetes?
1. Low glycemic index foods
2. engage in physical activity
3. stop smoking
4. lose weight
39
what is the onset of action for long-acting insulin?
90 minutes.
40
is the mechanism of action for an Amylin analogue?
-slows gastric emptying, reduces postprandial glucagon secretion and reduces appetite.
45
meglitinide: ________, is rapidly and completely absorbed from the intestinal track. Peak effect is felt in 1- 1.5 hours
repaglinide
46
what is a common ending for thiazolidinediones?
-glitazone
47
when is rapid acting insulin injected?
5 to 15 minutes before eating, or even after a meal for some individuals
53
T/F: diabetes mellitus causes microvascular and macrovascular damage
true
54
how are thiazolidinediones administered?
-Orally
56
what is ketoacidosis?
A condition in which the body breaks down fats to obtain its energy needs.
ketones are a byproduct of lipid metabolism, and their accumulation can lead to, and death
57
how is insulin stored?
refrigerate unopen vial; do not freeze. Open vials of insulin may be stored at room temperature, but this will shorten the expiry date for most.
58
what types of drugs are associated with hypoglycemia?(4)
1. ASA; salicylates
2. alcohol
3. angiotensin-converting enzyme inhibitors; angiotensin II receptor blockers
4. beta blockers
59
_______ are used in the treatment of hyperglycemia and hypoglycemia.
beta blockers
60
what is the mechanism of action for OHA's?
primarily stimulate insulin release from pancreatic beta cells.
-also decrease glycogenolysis
61
What 4 drugs are sulfonylureas?
1. Glyburide
2. glicazide
3. glipizide
4. glimepiride
62
what is a serious side effect of sulfonylureas?
hypoglycemia
63
what are some side effects of sulfonylureas?
- weight gain
- abdominal pain
- diarrhea
- dyspepsia
- nausea and vomiting
- headache
- dizziness
64
what are biguanides, and what is its mechanism of action?
- Antidiabetic agents; only metformin
- improves glucose tolerance and insulin resistance by increasing peripheral glucose uptake and utilization in skeletal muscles and adipose tissue.
65
food ______ the absorption of immediate-release tablets but ______ the absorption of metformin solution and extended release tablets.
- decreases
| - increases
66
T/F: extended release dosage forms of metformin are not substitutable
true
| -designed to remain in the stomach and deliver metformin to the upper G.I. tract, where absorption is enhanced
67
where some adverse reactions of metformin?
-common GI reactions: gas, heartburn, metallic taste in mouth, mild stomach ache, nausea, weight-loss
68
what are the most common adverse reactions of therapy with thiazolidinediones ?
headache, Wiecking, diarrhea, nausea, and vomiting.
-patient should be instructed to report signs of muscle pain, jaundice, blurred vision, and signs of hypo- or hyperglycemia
69
when is pramlintide administered? how?
with mealtime insulin to control blood sugar levels
| -injected subcutaneously immediately prior to each meal
70
________ may produce lactic acidosis, a rare but potentially fatal condition.
metformin
71
T/F: Met Forman may stimulate ovulation in infertile women that have polycystic ovary syndrome
true
72
what six dietary supplements have been found as adjunctive therapy for people with diabetes?
1. alpha-lipoic acid*
2. magnesium*
3. chromium
4. coenzyme Q10
5. omega-3 fatty acids*
6. garlic*
* most evidence of possible usefulness
73
what is a α-Glucosidase inhibitor?
- prolong digestion of carbohydrates and delay their absorption in the small intestine
- do not promote insulin secretion like many other antidiabetic agents nor do they cause hypoglycemia
74
what are meglitinides?
- oral antidiabetic agent used in the treatment and management of type two diabetes
75
what are some adverse side effects of meglitinides?
-headache, nausea and vomiting
76
________s should be used with caution in patients with liver dysfunction
meglitinides
77
what is a common ending for meglitinides?
-glinide
78
what is amylin analogue?
- synthetic analogue of the hormone amylin
| - Amylin levels are absent in type one diabetes and decreased in type two diabetes.
79
Thiazolidinediones are also called _______; they are used for the treatment of type two diabetes.
-insulin sensitizers
80
what are some serious side effects linked to thiazolidinediones ?
heart failure, heart attack, and liver failure
81
dipeptidyl peptidase-4 inhibitors, _____ insulin release and ______ glucagon levels
- increase
| - decrease
82
what is ALA? how does it help in the treatment of diabetes?
Alpha-Lipoic Acid
| -and antioxidant
83
pancreatitis is a rare but serious adverse reaction associated with the use of ______.
sitagliptin or liraglutide
84
How does magnesium help in controlling diabetes?
Low magnesium levels may worsen glucose control in type two diabetes by interrupting insulin secretion
85
what is magnesium? Where is it found?
A mineral found it green leafy vegetables, nuts, seeds and some whole grains
86
what is a warning label found on DPP-4's?
take at the same time each day, with or without food
87
what two warning labels are found on meglitinides?
1. take immediately prior to meals( skip if meal is missed)
| 2. take with a full glass of water
88
The warning labels "limit or avoid alcohol" and "take with a full glass of water"are found on what type of drugs?
thiazolidinediones
89
The warning label "store in the refrigerator; do not freeze"can be found on which drug used in the treatment of diabetes?
insulin
90
incretin mimetics mailing be administered for ________ diabetes
type 2
91
he adverse reactions associated with pramlintide?
- Hypoglycemia, redness, swelling, bruising, itching at the injection site, loss of appetite, stomach pain, indigestion, upset stomach, excessive tiredness, dizziness, coughing, sore throat, and joint pain
- nausea and vomiting are dose-dependent
92
what is the most common side effect/s with exenatide and liraglutide?
nausea, affecting up to 50% of patients
93
what is the mechanism of action for thiazolidinediones?
- increased tissue sensitivity to insulin
- do not increase insulin secretion so do not promote hypoglycemia
- increased uptake of glucose in the liver and muscles
94
T/F: it is important to eat a diet rich and complex carbohydrates while taking acarbose and miglitol
true
| -must be administered with the first bite of each meal
97
what drugs are associated with hyperglycemia?(10)
1. atypical antipsychotics
2. beta blockers
3. diuretics, thiazides (>25mg hydrochlorothiazide)
4. glucocorticoids
5. growth hormone
6. nicotinic acid
7. pentamidine
8. phenytoin
9. protease inhibitors
10. sympathomimetics
98
what are some of the symptoms of hypoglycemia?
- anxiety, nervousness, irritability
- blurred vision
- Cold sensations
- confusion
- difficulty concentrating
- fatigue, uncontrolled yarning
- headache
- Hunger
- loss of consciousness
- muscle weakness
- numbness of the mouth
- palpitations, rapid heartbeat
- shallow breathing
- sweating
- tingling in the fingers
100
why is diabetes sometimes classified as a disease of lifestyle?
because lifestyle factors can increase the risk for type 2 diabetes and all types of diabetes can be improved by weight-loss, engaging in physical activity, consuming foods with low glycemic index, quitting smoking, and other lifestyle changes
101
what is the onset of action for rapid acting insulin?
15 minutes
102
how is insulin manufactured today?
genetically engineered using recombinant DNA technology to match human insulin
103
what does insulin do?
helps the body metabolize carbohydrates, fats, and proteins from the diet
126
what is lipoatrophy?
Mountain areas of fat loss around the site of injection, causing depressions.
33: Diabetes Mellitus
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