Term
| define impaired fasting glucose: |
|
Definition
|
|
Term
| define impaired glucose tolerance test: |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Aic goal for patients in general: |
|
Definition
|
|
Term
| less stringent A1c goals may be appropriate for: |
|
Definition
1. Pt @ risk for hypoglycemia
2. limited life expectancy
3. chronic DM on multiple Rx and still have A1c>7% |
|
|
Term
| each 1% drop in A1c decreases microvascular complications by: |
|
Definition
|
|
Term
| what was found in the ACCORD Trial? |
|
Definition
pt w microvascular dz and CV RFs who underwent intensive tx to get to A1c<6%
increased the mortality in the group |
|
|
Term
| goal for preprandial capillary glucose: |
|
Definition
|
|
Term
| goal for peak post prandial capillary glucose: |
|
Definition
|
|
Term
| golas for GDM for preprandial, 1&2 hrs postprandial capillary glucose: |
|
Definition
preprandial: <95
1hr post prandial: <140
2hr post prandial: <120 |
|
|
Term
| golas for GDM for preprandial, 1&2 hrs postprandial capillary glucose: |
|
Definition
preprandial: <95
1hr post prandial: <140
2hr post prandial: <120 |
|
|
Term
| a 1% change in A1c above 5% corresponds to an avg BG of: |
|
Definition
|
|
Term
|
Definition
|
|
Term
| 5 studies that have shown that life style changes have the biggest impact on DM: |
|
Definition
1. Da Qing Study
2. Finish Diabetes Prevention Study
3. Diabetes Prevention Program
4. Toranomon Study
5. Indian DPP |
|
|
Term
| 6 studies that have shown that meds can prevent DM: |
|
Definition
1. TRIPOD study
2. STOP-NIDDM
3. Diabetes Prevention Program
4. DREAM Study
5. Indian DPP
6. ACT-NOW |
|
|
Term
which study?
Lifestyle group 58% risk reduction
Metformin group 31% risk reduction
Placebo group 11% risk redcution |
|
Definition
| Diabetes Prevention Program |
|
|
Term
which study:
50% achieved >7% reduction in weight
74% maintained >150min/wk exercise |
|
Definition
| Diabetes Prevention Program |
|
|
Term
| A1c level Diagnostic for DM: |
|
Definition
|
|
Term
| Fasting BG diagnostic for DM: |
|
Definition
|
|
Term
| Random BG diagnostic for DM: |
|
Definition
|
|
Term
| OGTT results diagnostic for DM: |
|
Definition
|
|
Term
| 3 types of autoimmune markers for type I DM: |
|
Definition
1. GAD-65
2. Islet cell Ag-2
3. Insulin autoantibodies |
|
|
Term
| autoantibody that is present with adult onset type I DM: |
|
Definition
|
|
Term
|
Definition
1. IFG/IGT
2. Age >55 (1/2 of DM cases are >55)
3. Race (minority) |
|
|
Term
| Tx of choice for prediabetes: |
|
Definition
|
|
Term
| indications for preventive meds in prediabetes: 7 |
|
Definition
1. IFG/IGT
2. A1c>6%
3. HTN
4. Obese
5. FHx DM
6. <60yo
7. dyslipidemias |
|
|
Term
| DOC for DM prevention in prediabetes: |
|
Definition
|
|
Term
| which study: normalizing glucose control can prevent or delay the progression of diabetic complications |
|
Definition
|
|
Term
| which study: improved glycemic control decreased complication and no one drug combination was found to be better than another: |
|
Definition
|
|
Term
| 3 studies that focused of the prevention or delay of DM COMPLICATIONS: |
|
Definition
1. DCCT
2. Kumamoto
3. UKPDS |
|
|
Term
|
Definition
1. chlorpropamide
2. Tolazamide
3. Tolbutamide |
|
|
Term
| 5 second gen slufonylureas: |
|
Definition
1. Glimepiride
2. Glipizide
3. Glipizide ER
4. Glyburide
4. Micronized Glyburide |
|
|
Term
| list the insulin sectretagogs: |
|
Definition
1. 1st/2nd gen sulfonylureas
2. meglitinide (repaglinide)
3. Phenylalanine derv. (nateglinide) |
|
|
Term
| increases synthesis of proinsulin: |
|
Definition
|
|
Term
| Sulfonylureas affect on weight and A1c: |
|
Definition
| leads to a 20% reduction in weight and decrease in A1c 1-2% |
|
|
Term
| Metformins predominant mechanism of action for lowering BG: |
|
Definition
1. decrease effect of glucagon on the liver
2. decrease the activity of GLu-6-(P)ase in the liver preventing glycolysis |
|
|
Term
|
Definition
1. decrease Glu release from liver
2. increase insulin sens of muscle
3. decrease FA oxidation
4. increase intestinal GLu utilizatoin
5. does NOT increase insulin secretion |
|
|
Term
| name the drug: Biguanide - |
|
Definition
|
|
Term
| 2 alpha glucosidase inhibitors: |
|
Definition
|
|
Term
| alpha glucosidase inhibitors MOA: |
|
Definition
| inhibit starch brush border enzymes |
|
|
Term
|
Definition
1. Rosiglitazone - Avandia
2. Pioglitazone - Actos |
|
|
Term
|
Definition
1. increase syn of GLUT receptors
2. decrease insulin (r)
3. High doses decrease hepatic glu production |
|
|
Term
|
Definition
GLP-1 agonist (Glucagon-like peptide)
GLP-1 slows gastric emptying and stimulates pancrease to produce insulin in response to a meal |
|
|
Term
|
Definition
1. Januvia
2. Janumet (januvia + metformin) |
|
|
Term
|
Definition
| inihbits GPP-4 which inhibits Glucagon like peptide-1 (GLP-1) |
|
|
Term
| 4 contraindications to sulfonylureas: |
|
Definition
1. Type I DM
2. DM due to pancreatic resection
3. pregnancy (not teratogenic but crosses placenta)
4. significant renal or hepatic dz |
|
|
Term
| 7 contraindications to the use of metformin: |
|
Definition
1. CRE>1.4
2. CHF
3. metabolic acidosis
4. Hx of alcohol abuse
5. liver dz
6. septicemia
7. prego/lactation |
|
|
Term
| 6 contraindications for TZD therapy: |
|
Definition
1. Class III/IV CHF
2. anemia
3. impaired liver fxn
4. Type I DM
5. prego
6. insulin therapy |
|
|
Term
| 4 contraindications to alpha glucosidase inhibitors: |
|
Definition
1. hypersensativity
2. DKA
3. GI issues
4. malabsorption disorders |
|
|
Term
|
Definition
1. sulfonylurea
2. metformin |
|
|
Term
| meds that cause fullness: |
|
Definition
1. sulfonylurea (dose)
2. metformin |
|
|
Term
|
Definition
|
|
Term
| meds that cause diarrhea: |
|
Definition
|
|
Term
| meds that cause bloating: |
|
Definition
1. metformin
2. aminoglucosidase inhibitors |
|
|
Term
| DM med: causes rash/pruitis |
|
Definition
|
|
Term
| DM oral med causes hypoglycemia: |
|
Definition
| 1. sulfonylureas (elderly/renalimpaired) |
|
|
Term
|
Definition
|
|
Term
| dm med causes lactic acidosis: |
|
Definition
|
|
Term
| most common predisposing factor to lactic acidosis: |
|
Definition
|
|
Term
| DM med contraindicated when patients are in metabolic acidosis state: |
|
Definition
|
|
Term
| DM med can cause delay in sucrose efficacy in the tx of hypoglycemia: |
|
Definition
| alpha glucosidase inhibitors |
|
|
Term
| for patients tx w alpha glucosidase inhibitors, hypoglycemia should be treated with: |
|
Definition
| glucose or fructose not sucrose since this med inhibits digestion/absorption of this sugar |
|
|
Term
| DM meds cause increase in transaminases: |
|
Definition
1. TZDs
2. AGIs (>600mg/day) |
|
|
Term
| med causes HF and CHF exacerbations: |
|
Definition
|
|
Term
| DM med increases risk of fractures: |
|
Definition
|
|
Term
|
Definition
|
|
Term
| DM med causes stuffy/runny nose & sore throat. |
|
Definition
|
|
Term
| Dm med: serious hypersensativity rxns have been reported |
|
Definition
|
|
Term
| sulfonylureas expect fasting BG/A1c% to drop: |
|
Definition
|
|
Term
| Nateglinides fasting or post prandial effects: |
|
Definition
|
|
Term
| Nateglinide expect A1c to drop |
|
Definition
|
|
Term
| DM med for people who skip meals or have unpredicable meal schedules |
|
Definition
|
|
Term
| metformin lowers fasting BG/A1c% by |
|
Definition
|
|
Term
| AGIs decrease FBG/PPG & A1c% by: |
|
Definition
FBG: 15-30
PPG: 50-60
A1c%: 0.5-1.0 |
|
|
Term
| DPP-4i drop A1c% levels by: |
|
Definition
|
|
Term
| DM meds renally eliminated: |
|
Definition
|
|
Term
| DM meds eliminated via biliary-feces: |
|
Definition
| 2nd gen SUs (20-50%), Nateglinide(10%) & Repaglinide (100%) |
|
|
