Term
|
Definition
-Primary for DMI, but can be used for DMII with insulinopenia
SHORT ACTING:
-Regular: Onset 1hr, lasts 5-7hrs
-Insulin Lispro/Aspart/Glusiline: Onset 20min, Lasts 4hrs
LONG ACTING:
-NPH: onset delayed 2-4hrs, Peaks @ 8-10hrs
-Insulin Glargine; 24hrs, no peaks
-Insulin Detemir: 17hrs |
|
|
Term
| Sulfonylurea Receptor Drugs: Sulfonylureas |
|
Definition
-Tolbutamine, Tolazamide, Aletohexamide
-Stimulates Insulin release from B-cell
-Not for type I (absolute failure of B-cells)
-Can cause hypoglycemia |
|
|
Term
| Sulfonylurea Receptor Drugs: D-Phenylalanine Derivitives |
|
Definition
|
|
Term
| Sulfonylurea Receptor Drugs: Meglitinide Analogs |
|
Definition
-Rapaglinide
-Chemically identical to Glyburide, without sulfonic acid moeity
-Less risk of hypoglycemia |
|
|
Term
|
Definition
-1st line therapy for DMII - Start @ time of Dx
-Decreases glucoenogenesis in liver, increases glucose uptake in muscle
SE:
-Lactic acidosis; ARF c contrast dyes |
|
|
Term
|
Definition
-Rosiglitazone, Pioglitazone
-Increased insulin sensitivity
-Decreased fatty acid/glucose output/adipokines/HbA1C 1-2% |
|
|
Term
| Alpha-Glucosidase Inhibitors |
|
Definition
-Acarbose, Miglitol
-Completely inhibit Alpha-Glucosidase Enzymes in gut
-Delays carbohydrate absorption
SE:
-GI problems |
|
|
Term
| Incretins: GLP-1 Receptor Agonists |
|
Definition
-Exenatide
SE: pancreatitis risk
-Liraglutide:
-SE: Thyroid cancer risk |
|
|
Term
| Incretins: DPP-4 Antagonists |
|
Definition
-Sitagliptin, Saxagliptin
-Blocks DPP-4 to allow endogenous GLP-1 to fxn longer
-Decreases Hb1AC 0.5-1.4% |
|
|
Term
| Islet Amyloid Polypeptide |
|
Definition
-Pramlintide
-Delays gastric emptying, suppresses glucagon, decreased appetite
-Type I or II
-Decreased HbA1C 0.4% with 1.7kg wt decrease |
|
|
Term
| Chronic Diabetes Mgmt: Cardiovascular |
|
Definition
-Tx DM pts as if they have already had an AMI
-Aggressive BP mgmt: <130/80
-ACE-i 1st line tx, then CCB, BB, vasodilators
-Decrease LDL <70
-Statins 1st line
-Increase HDL >40
-Decrease Triglycerides <150
-ASA 81-325mg for AMI risk reduction |
|
|
Term
| Chronic Diabetes Mgmt: Diabetic Retinopathy |
|
Definition
-Glucose mgmt
-Yearly ocular exam
Sx:
-Photocoagulation; Vitrectomy
Med:
-Anti-angeogenic drugs |
|
|
Term
| Chronic Diabetes Mgmt: Diabetic Nephropathy |
|
Definition
-ACE-i drug of choice
-Dietary protein restriction
-Strict protein restriction
-Strict glycemic control
-Early Tx of UTI
-Avoid contrast dyes |
|
|
Term
| Chronic Diabetes Mgmt: Diabetic Neuropathy |
|
Definition
-Annual podiatry exam
-Complete neurosensory exam
Peripheral:
-Lyrica, Neurontin, Amytriptilene, Carbamazapine
Autonimc:
-Gastroperesis: small meals, erythromycin
-Neurogenic bladder: Bethanecol, self-cath
-Impotence: Sildanefil, various prosthesis |
|
|
Term
| Hydroxymethylglutaryl-Coenzyme A (HMG-CoA) Reductase Inhibitors |
|
Definition
-Statins
Lipid effects:
-Decreases LDL/Triglycerides
-Increases HDL
SE:
-Mild: muscle aches, GI problems
-Severe: Renal failure, rhabdomyolysis |
|
|
Term
|
Definition
-Decreases mortality
Lipid effects:
-Decreases VLDL
-Increases HDL
SE:
-Flushing, pruritis |
|
|
Term
|
Definition
-Cholestyramine, Colesevelam, Colestipol
Lipid Effects:
-Decreases LDL
-Increases Triglycerides
SE:
-GI symptoms
-Decreases fat soluble Vitamin Absorption |
|
|
Term
|
Definition
-Gemfibrozil, Fenofibrate
-PPAR-alpha
Lipid Effect:
-Decreases triglycerides
-Increases HDL
SE:
-Cholelithiasis
-Myositis |
|
|
Term
|
Definition
Lipid Effects:
-Decreases LDL
-->Long term data still out |
|
|
Term
|
Definition
Lipid Effect:
-Decreases hepatic VLDL production
-EPA and DHA more effective than alpha-linolenic acid
SE:
-Fishy aftertaste |
|
|
