Diabetes and Insulin Quiz

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Questions and Answers

What is the primary function of insulin in the body?

  • Promote the formation of glucose
  • Stimulate glucose and potassium uptake (correct)
  • Facilitate fat breakdown
  • Break down proteins

Which process is responsible for the formation of glycogen?

  • Glycogenesis (correct)
  • Glycogenolysis
  • Gluconeogenesis
  • Glycolysis

Which statement is true regarding brain cells and glucose?

  • They can uptake glucose without insulin stimulation (correct)
  • They require insulin to uptake glucose
  • They do not require glucose for energy
  • They can only use glucose derived from fats

What characterizes Type 1 Diabetes Mellitus (DM)?

<p>Destruction of 70% of pancreatic beta cells (C)</p> Signup and view all the answers

What occurs when there is insufficient insulin in the body?

<p>Fats are broken down to produce ketone bodies (C)</p> Signup and view all the answers

Which process involves the breakdown of glucose to produce ATP?

<p>Glycolysis (B)</p> Signup and view all the answers

What is a common characteristic of Type 2 Diabetes Mellitus?

<p>Insulin resistance and deficiency (C)</p> Signup and view all the answers

Which test is used to determine if there is still insulin production in patients with Type 1 DM?

<p>C-peptide test (C)</p> Signup and view all the answers

Which medication is considered the first-line treatment for gestational diabetes mellitus?

<p>Insulin (D)</p> Signup and view all the answers

What is a common side effect associated with metformin?

<p>Metallic taste (C)</p> Signup and view all the answers

Which of the following medications should be avoided within 48 hours of iodinated contrast administration?

<p>Metformin (B)</p> Signup and view all the answers

Which class of medications includes Tolbutamide and Glipizide?

<p>Insulin secretagogues (B)</p> Signup and view all the answers

What kind of allergy would potentially contraindicate the use of Sulfonylureas?

<p>Sulfa allergy (B)</p> Signup and view all the answers

Which of the following medications is considered safe to use in patients with a history of thyroid issues?

<p>Exenatide (A)</p> Signup and view all the answers

Which drug is known to mask the symptoms of hypoglycemia?

<p>Propranolol (A)</p> Signup and view all the answers

Which of these medications should be monitored for its adverse effects on the thyroid?

<p>Liraglutide (A)</p> Signup and view all the answers

Which DPP-4 inhibitor is associated with the risk of pancreatitis?

<p>Saxagliptin (A), Sitagliptin (B)</p> Signup and view all the answers

Which DPP-4 inhibitor does not require renal adjustment?

<p>Linagliptin (B)</p> Signup and view all the answers

What is the mechanism of action of acarbose?

<p>It delays the digestion of carbohydrates. (C)</p> Signup and view all the answers

What is a potential side effect of Canagliflozin?

<p>Risk of fractures (B)</p> Signup and view all the answers

In the case of a patient with T1 DM, what is the typical insulin dose range per day?

<p>0.3-0.6 U/kg (B)</p> Signup and view all the answers

What should be done for a patient whose blood glucose level is 210 mg/dl with a target of 120 mg/dl, given a correction factor of 30?

<p>Administer 3 U of insulin (B)</p> Signup and view all the answers

Which dosing strategy is indicated for patients with an A1C of 8.5 - 10?

<p>Increase metformin dose (B)</p> Signup and view all the answers

Which of the following medications is indicated to reduce the risk of cardiovascular disease?

<p>SGLT-2 inhibitors (C)</p> Signup and view all the answers

What is the primary characteristic that distinguishes Type 1 diabetes from Type 2 diabetes?

<p>Type 1 diabetes is associated with autoimmune destruction of insulin-producing cells. (D)</p> Signup and view all the answers

Which measurement indicates that a patient has diabetes according to the diagnosis criteria?

<p>A1C &gt; 6.5 (B)</p> Signup and view all the answers

What is the weight category for an adult female with a height of 160 cm and weight of 80 kg?

<p>Obese (A)</p> Signup and view all the answers

When should Type 2 diabetes patients be followed up after diagnosis?

<p>Once a year (C)</p> Signup and view all the answers

What class of diabetes medication is metformin categorized under?

<p>Insulin Sensitizers (B)</p> Signup and view all the answers

Which of the following medications is NOT an SGLT-2 Inhibitor?

<p>Glimepiride (B)</p> Signup and view all the answers

Which is NOT a known risk factor for Type 2 diabetes?

<p>Height over 180 cm (A)</p> Signup and view all the answers

What is the recommended frequency for checking Type 1 diabetes after diagnosis?

<p>Yearly after the age of ten (A)</p> Signup and view all the answers

Which insulin secretagogue belongs to the second generation?

<p>Glipizide (A)</p> Signup and view all the answers

What is the primary mechanism of insulin sensitizers like metformin?

<p>Increase insulin sensitivity (A)</p> Signup and view all the answers

Flashcards

What do beta cells produce?

Beta cells, located in the pancreatic islets, are responsible for producing and releasing insulin into the bloodstream.

What is the function of insulin?

Insulin's primary function is to facilitate the uptake of glucose from the bloodstream into cells, thereby lowering blood sugar levels. It also promotes the conversion of excess glucose into glycogen for storage.

What is glycolysis?

Glycolysis is the metabolic pathway responsible for breaking down glucose into pyruvate, generating ATP (adenosine triphosphate) in the process.

Define glycogenesis.

Glycogenesis is the process of converting excess glucose into glycogen, a storage form of glucose, primarily in the liver and muscles.

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What is gluconeogenesis?

Gluconeogenesis is the process of generating glucose from non-carbohydrate sources, such as amino acids and glycerol, particularly during periods of fasting or low carbohydrate intake.

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Define glycogenolysis.

Glycogenolysis is the breakdown of stored glycogen into glucose, releasing it back into the bloodstream to increase blood sugar levels.

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What is Type 1 Diabetes?

Type 1 diabetes mellitus is characterized by the destruction of beta cells in the pancreas, leading to an absolute deficiency in insulin production. This autoimmune disorder typically develops in childhood or adolescence.

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What is Type 2 Diabetes?

Type 2 diabetes mellitus is characterized by insulin resistance, where the body's cells don't respond effectively to insulin, leading to high blood sugar levels. It's often associated with lifestyle factors like obesity and inactivity, and typically develops in adulthood.

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Metformin Side Effects

Metformin can cause a metallic taste in the mouth, and gastrointestinal upset. It's best taken with food.

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Metformin - Diabetes Medication

Metformin is a medication used to treat type 2 diabetes. It helps lower blood sugar levels by increasing insulin sensitivity and decreasing glucose production in the liver.

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Gestational Diabetes

Gestational diabetes is a form of diabetes that develops during pregnancy. It usually appears between 24 and 28 weeks of gestation.

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Gestational Diabetes Treatment

Insulin is the primary treatment for gestational diabetes. Metformin is a second-line option.

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Glyburide for Gestational Diabetes

Glyburide, a sulfonylurea class drug, is also used to treat gestational diabetes. However, it's less commonly used than insulin and metformin.

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Diabetes Mellitus (DM)

A condition where the body cannot properly regulate blood sugar levels, resulting in high blood sugar.

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Risk Factors for Type 2 DM

Genetic predisposition, family history of type 2 diabetes, age over 35, high BMI (over 25), high blood pressure (hypertension), high levels of fats (lipids) in the blood, and certain medications can increase the risk of developing type 2 diabetes.

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Thiazolidinediones - Contraindications

Thiazolidinediones, like pioglitazone and rosiglitazone, are not recommended for patients with heart or liver issues.

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Sulfonylureas for Diabetes

Sulfonylureas are a class of medications used to treat type 2 diabetes. They stimulate the pancreas to release more insulin.

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Type 2 DM

The most common type of diabetes, characterized by insulin resistance, where the body does not use insulin effectively.

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Meglitinides for Diabetes

Meglitinides, like repaglinide and nateglinide, are another class of insulin secretagogues. They are often used for patients with a sulfonylurea allergy.

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Body Mass Index (BMI)

A calculation used to assess body fat based on height and weight.

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Hemoglobin A1c (A1C)

A test used to diagnose diabetes by measuring the average blood sugar level over the past 2-3 months.

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Fasting Blood Glucose (FBG)

A blood test that measures blood sugar levels after an overnight fast.

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2-Hour Postprandial Glucose (2hrPG)

A blood test that measures blood sugar levels 2 hours after consuming a sugary drink.

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Complications of DM

A condition that can develop as a complication of diabetes, affecting various parts of the body, including the eyes, kidneys, nerves, and heart.

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Insulin Sensitizers

A specialized category of diabetes medications that increase insulin sensitivity, helping the body use insulin more effectively.

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Insulin Secretagogues

A class of diabetes medications that stimulate insulin production from the pancreas.

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DPP-4 Inhibitors

A class of drugs that inhibit the enzyme dipeptidyl peptidase-4 (DPP-4), which breaks down incretin hormones that stimulate insulin release. This helps to lower blood glucose levels.

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Acarbose

A drug that slows down the absorption of carbohydrates from the gut, reducing post-meal blood sugar spikes. It is an alpha-glucosidase inhibitor.

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SGLT-2 Inhibitors

This class of drugs works by blocking the reabsorption of glucose in the kidneys, leading to increased glucose excretion in the urine.

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Insulin

A hormone produced by the pancreas that helps regulate blood sugar levels by promoting glucose uptake into cells.

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Target A1C

The target blood sugar level that an individual with diabetes aims for.

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Metformin

A commonly used drug for diabetes that improves the body's sensitivity to insulin and reduces glucose production by the liver.

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Correction Factor

A method for adjusting the dose of a medication based on a specific factor, such as blood glucose levels.

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Blood Glucose

A measure of glucose levels in the blood. It is often used to monitor diabetes management.

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Study Notes

Diabetes From Zero To Hero Course

  • Course offered by Dr/ Moaaz
  • Course name: OTC Course from Zero to Hero
  • Contact information provided: +201094718950

Diabetes Mellitus

  • Beta cells in pancreatic islets secrete insulin
  • Insulin breaks down glucose to ATP
  • There are two types: Type 1 and Type 2
  • Risk factors for type 1 DM include: Genetic Predisposition, Decreased Vitamin D levels, Cow's milk consumption, and Medications.
  • Risk factors for type 2 DM include: Family history, Age over 35, BMI greater than 25, High Insulin Resistance

Processes in Diabetes

  • Glycolysis: Breakdown of glucose to ATP

  • Glycogenesis: Formation of glycogen

  • Gluconeogenesis: Formation of glucose from non-carbohydrate sources

  • Glycogenolysis: Breakdown of glycogen

  • Insulin stimulates glucose and potassium uptake in all cells. Brain cells can utilize glucose without insulin stimulation.

Types of Diabetes

  • Type 1 DM: Characterized by destruction of insulin-producing beta cells in the pancreas. A C-peptide test determines if insulin production is ongoing. The body may break down fats to make ketones, which can cause ketoacidosis
  • Type 2 DM: Characterized by insulin resistance and a possible deficiency in insulin production. Insulin sensitivity in body cells can be affected.

Diabetes Insipidus

  • Treated with ADH, Vasopressin and Desmopressin
  • Vasopressin antidote is Phentolamine

Medications

  • Desmopressin Acetate (Omegapress): Dosage and details on container provided.

  • Insulin Sensitizers: Metformin, Thiazolidinediones

    • Metformin: First line treatment for type 2 DM. Monitor kidney function. Avoid with iodinated contrast, drug interaction: topiramate.
    • Thiazolidinediones (Pioglitazone, Rosiglitazone): Contraindicated in heart or hepatic issues
  • Insulin Secretagogues:

    • First-generation SU (Tolbutamide, Chlorpropamide), Second-generation SU (Glipizide, Glimepiride, Glyburide), Meglitinide (Repaglinide, Nateglinide).
  • SGLT-2 Inhibitors: Canagliflozin, Dapagliflozin, Empagliflozin, Sotagliflozin

    • Canagliflozin - Risk of fractures, Urinary Tract Infections (UTIs). New guidelines indicate this class of drug may lower risk of cardiovascular disease
  • GLP-1 Analogues:

    • Lixisenatide, Liraglutide, Dulaglutide, Semaglutide (injections)

    • Liraglutide: Recombinant DNA, FDA approved to decrease weight.

  • DPP-4 Inhibitors: Sitagliptin, Saxagliptin, Linagliptin, Vildagliptin. Saxagliptin not recommended in heart failure.

  • **

Other Diabetes Information

  • Diagnostic criteria: A1C > 6.5, Fasting blood glucose (FBG) > 126 mg/dL, 2-hour postprandial glucose (2hrPG) > 200 mg/dL can all be used to diagnose diabetes.
  • Symptoms of High Blood Sugar (Hyperglycemia): Dry mouth, Thirst, Headaches, Weakness, Blurred vision, Frequent urination.
  • Complications of Diabetes: 1) Microvascular disease (retina, kidney and nerve damage)
    2) Macrovascular disease (coronary artery disease, cerebrovascular disease, peripheral artery disease)
  • Diabetes Treatment Schedule: Type 1 DM: Within 3-5 years for diagnosis, yearly follow-up once over 10 years old. Type 2 DM: Yearly follow-up at diagnosis.
  • Insulin Dosing: T1 DM: 0.3 to 0.6 units per kilogram day, T2 DM 0.1 to 0.2 units per kilogram per day .
  • Insulin Types: List of rapid-acting, short-acting, intermediate-acting, and long-acting insulins detailed.
  • Insulin Considerations: Zinc is important for insulin synthesis and Chromium for insulin action.

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