Biguanides

facilitates insulin's action on peripheral receptor sites. It can be used only in the presence of insulin

Biguanide Type

Metformin HCl (Glucophage)

Glitazone

 enhances insulin action at receptor sites without increasing insulin secretions from the beta cells

Glitazone Type

 rosiglitazone

maleate (Avandia)

poiglitazone HCl (Actos)

Alpha-Glucosidase inhibitors

delays the absorption of glucose in the intestinal system thus decreases post prandial gulcose level

Alpha-glucosidase inhibitor type

acarbose (Precose)

miglitol (Glyset)

Repaglinide (Prandin)

lowers blood sugar by stimulating the release of insulin from beta cells

Sulfonylureas

stimulate the pancreas to secrete insulin

1st Generation Sulfonylureas

acetohexamine (Dylemor)

chlorpropamide (Diabenese)

tolazamide (Tolenase)

lolbutamide (Orinase)

2nd Generation Sulfonylureas

glipizide (Glucotrol)

glyburide (Diabeta)

3rd Generation Sulfonylureas

glimepride (Amaryl)

Thiazolidinediones

Increase peripheral gulcose uptake #1

decreae hepatic glucose output #2

meglitinides

Increase insulin secretion

Lispro (Humulog) Insulin

Rapid acting

Short acting Inulin

Regular Insulin "R" or CZI

Regular Insulin Action

Onset - 1/2  to 1hr.

Peak- 2 to 3 hrs.

Duration 4-6hrs.

Intermediate acting insulin

NPH

Lente "L"

Intermediate Acting Insulin Actions

 Onset 3-4 hrs

Peak 4-12 hrs

Duration 16-20 hrs

Long Acting Insulin

Ultralente

 Long Acting Insulin Actions

"peakless"

Onset 6-8 hrs

Peak 12-16 hrs

Duration 20-30 hrs

Technique for drawing up insulin

1) Clear-reg

2) milky- NPH

Flocculation

frosty, white coating on insulin bottle and should not be used

lipodystrophy

localized disturbance of fat metabolism

lipoatrophy

loss of SubQ fat

lipohypertrophy

fiber/fatty masses at injection site

DKA

Diabetic Ketone Acidosis

absence of insulin body

metabolism is disrupted

dehydrated,acidosis, electorlyte imbalance