Diabetes Mellitus Overview
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Questions and Answers

What is a characteristic of glyburide in relation to its pharmacological action?

  • It is a long-acting insulin.
  • Its action duration is prolonged with a half-life over 12 hours.
  • It functions as a secretagogue. (correct)
  • It directly replaces insulin in the body.
  • Which adverse reaction is commonly associated with the use of glyburide?

  • Hypertension
  • Hyperglycemia
  • Hypoglycemia (correct)
  • Weight gain
  • What is the primary condition for which glyburide is indicated?

  • Type 2 diabetes mellitus (correct)
  • Type 1 diabetes mellitus
  • Diabetes insipidus
  • Gestational diabetes
  • How is glyburide primarily eliminated from the body?

    <p>Excreted by kidneys as active compounds (A)</p> Signup and view all the answers

    Which of the following can glyburide be combined with for greater effectiveness in treating Type 2 diabetes?

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

    What is the primary purpose of insulin therapy in diabetes management?

    <p>To provide adequate blood glucose control (B)</p> Signup and view all the answers

    Which type of diabetes is characterized by pancreatic beta-cell destruction?

    <p>Type 1 Diabetes (A)</p> Signup and view all the answers

    What is a common complication associated with inadequate insulin replacement?

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

    What is the role of GLP-1 agonists in diabetes treatment?

    <p>They reduce blood glucose levels (D)</p> Signup and view all the answers

    In managing hypoglycemia, which of the following interventions is recommended?

    <p>Consume fast-acting carbohydrates (A)</p> Signup and view all the answers

    Which of the following is a complication of chronic diabetes?

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

    When is intensive glycemic control recommended?

    <p>In patients with renal disease (D)</p> Signup and view all the answers

    Which of the following represents a major cause of Type 2 diabetes?

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

    How does exercise impact blood glucose management in diabetes?

    <p>It helps lower blood glucose levels (C)</p> Signup and view all the answers

    What is a primary characteristic of gestational diabetes?

    <p>It appears during pregnancy and usually resolves after childbirth (C)</p> Signup and view all the answers

    What should be monitored to manage insulin therapy effectively?

    <p>Blood glucose levels (A)</p> Signup and view all the answers

    Which of the following medications is classified as an oral antidiabetic agent?

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

    What condition is typically characterized by severe hyperglycemia and dehydration?

    <p>Huperosmolar hyperglycemic syndrome (B)</p> Signup and view all the answers

    Which administration method is the standard mode for insulin therapy?

    <p>Subcutaneous injection (C)</p> Signup and view all the answers

    In terms of insulin absorption, what factors can influence the rate of absorption?

    <p>Depth of injection and blood flow to the site (D)</p> Signup and view all the answers

    What is the primary function of Biguanides in diabetes treatment?

    <p>Prevent glucose production in the liver (B)</p> Signup and view all the answers

    Which medication category stimulates the pancreas to increase insulin production?

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

    Which of the following drugs is approved as a first-line therapy for type 2 diabetes?

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

    What is the most dangerous complication associated with insulin therapy?

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

    Which symptom is NOT typically associated with hypoglycemia?

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

    How do GLP-1 agonists primarily assist in diabetes management?

    <p>Stimulate insulin secretion in response to meals (A)</p> Signup and view all the answers

    What is a common adverse effect associated with the use of Metformin?

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

    Which of the following conditions make Sulfonylureas contraindicated?

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

    Which auxiliary diseases can cause insulin resistance?

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

    Which form of administration is NOT typically associated with insulin delivery?

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

    What effect does exercise have on insulin absorption?

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

    What is the primary risk associated with overly vigorous physical exertion in insulin users?

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

    Flashcards

    Diabetes

    A chronic disease where the body either cannot produce enough insulin or cannot effectively use the insulin it produces, leading to high blood glucose levels.

    Blood Glucose Regulation

    The process of maintaining blood glucose levels within a healthy range before and after meals.

    Type 1 Diabetes

    A type of diabetes where the pancreas doesn't produce enough insulin due to the destruction of insulin-producing cells.

    Type 2 Diabetes

    A type of diabetes where the body doesn't use insulin effectively (insulin resistance) or doesn't produce enough insulin.

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    Insulin

    A hormone produced by the pancreas which helps transport glucose from the bloodstream to the cells.

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    Hyperglycemia

    High blood sugar levels.

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    Diabetic Ketoacidosis

    A serious complication of diabetes resulting from a lack of insulin.

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    Hyperosmolar Hyperglycemic Syndrome

    A serious diabetic complication characterized by extremely high blood sugar and severe dehydration.

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    Chronic Kidney Disease

    A complication of diabetes that damages the kidneys.

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    Retinopathy

    Damage to the retina of the eye due to diabetes.

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    Nerve Damage

    Damage to the nerves, a complication of diabetes.

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    Heart Attack/Stroke

    Increased risk of heart attack or stroke due to diabetes.

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    Glycemic Control

    Maintaining blood glucose levels within a target range.

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    Insulin Therapy

    Using insulin to manage diabetes, especially when necessary.

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    Hypoglycemia

    Low blood sugar levels.

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    Meglitinides

    Short-acting insulin secretagogues similar to sulfonylureas.

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    Insulin Secretagogues

    Medications that stimulate the release of insulin from the pancreas.

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    Glyburide

    An example of a sulfonylurea.

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    Short Duration of Action

    A characteristic of meglitinides; their effects quickly disappear.

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    Insulin Injection Methods

    Insulin can be administered subcutaneously, intravenously, intramuscularly, or via alternative methods like insulin pumps, transdermal patches, or oral formulations (resistant to digestion in the GI tract).

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    Subcutaneous Insulin Injection

    Standard method using needles and syringes, or portable pen injectors. Absorption varies among patients.

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    Insulin Absorption Factors

    Blood flow to the injection site, site of injection (abdomen, arm, buttock, thigh), injection depth, and exercise/massage affect absorption rates.

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    Goal of Insulin Therapy

    To mimic the body's natural overnight fasting, between-meal, and mealtime insulin secretion.

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    Insulin Therapy Complications

    Hypoglycemia (low blood sugar) is a dangerous complication. Other potential complications include unusual physical exertion, high doses, insulin allergy, or resistance.

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    Hypoglycemia Symptoms

    Symptoms can include tachycardia, palpitations, sweating, tremors, shaking, nausea, and hunger.

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    Biguanides

    A class of diabetes medication that prevents glucose production in the liver.

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    Metformin

    The only clinically approved biguanide.

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    Metformin Mechanism

    Decreases liver gluconeogenesis and increases muscle uptake of glucose, lowering blood glucose levels.

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    Metformin First-line Therapy

    Often the initial treatment for type 2 diabetes; may be combined with other medications or insulin.

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    Metformin Advantages

    Does not cause the risk of hypoglycemia.

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    Metformin Adverse Effects

    Gastrointestinal issues (e.g., diarrhea, nausea), anorexia, metallic taste, and lactic acidosis are possible.

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    Sulfonylureas

    Type of Insulin Secretagogues that acts on beta cells.

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    Study Notes

    Diabetes Mellitus

    • Chronic disease characterized by high blood glucose levels, due to either the inability to produce insulin or the body's inability to use produced insulin.
    • Normal blood glucose levels are below 5.6 in fasting state, and between 6.7-7.8 2 hours after a meal.

    Types of Diabetes Mellitus

    Type 1 Diabetes (Insulin Dependent)

    • Characterized by pancreatic beta cell destruction, leading to insulin deficiency.
    • Affects approximately 5-10% of people with diabetes.
    • Typically develops before age 30.

    Type 2 Diabetes (Non-Insulin Dependent)

    • Characterized by pancreatic beta cell dysfunction, leading to insulin resistance.
    • Affects approximately 90% of individuals with diabetes.
    • Typically develops after age 40 and often associated with obesity.
    • Other causes include pancreatitis and drug therapy.
    • Gestational diabetes is a type of diabetes during pregnancy, affecting approximately 10% of pregnancies, linked to placental hormones and insulin resistance.

    Complications of Diabetes

    Acute Complications

    • Diabetic ketoacidosis (DKA): Caused by insufficient insulin levels, leading to high blood ketone levels and potentially life-threatening consequences. Treatment involves intravenous insulin administration.
    • Hyperosmolar hyperglycemic syndrome (HHS): A severe complication of type 2 diabetes, characterized by extremely high blood sugar and dehydration. Slow rehydration and restoration of electrolyte balance are necessary.

    Chronic Complications

    • Chronic kidney disease
    • Foot problems
    • Retinopathy
    • Nerve damage
    • Cardiovascular disease (heart attack, stroke, and coronary artery disease)

    Benefits of Controlling Blood Glucose

    • Slows the progression of diabetic complications, including eye, kidney, and nerve diseases.

    Treatment of Diabetes

    • Nutrition, exercise, and medication are crucial for managing blood glucose.
    • Self-monitoring of blood glucose is essential for managing diabetes.
    • The choice of treatment depends on the type and severity of diabetes. Oral medications may be used for type 2 diabetes, whereas individuals with type 1 diabetes typically require insulin therapy.
    • Treatment strategies for type 2 diabetes may include lifestyle changes alongside medication, such as oral hypoglycemic agents.

    Insulin Therapy

    • Necessary for type 1 diabetes and sometimes for type 2 diabetes when other approaches are insufficient.
    • Methods include subcutaneous, intravenous, and intramuscular injections, as well as insulin pumps and alternative methods like transdermal devices, and oral formulations that resist digestion in the stomach.
    • Absorption of insulin is affected by the site of injection, depth of injection, and patient-specific factors.

    Complications of Insulin Therapy

    • Hypoglycemia (low blood sugar): The most dangerous complication, often caused by excessive insulin doses or unusual exertion. Symptoms include palpitations, sweating, tremors, and hunger.

    Oral Hypoglycemic Agents

    • Used for type 2 diabetes in situations where diet and exercise aren't enough.
    • Five main categories: Biguanides, Insulin Secretagogues, GLP-1 agonists, DPP-4 inhibitors and SGLT2 inhibitors, each with different mechanisms of action and potential side effects.

    Meglitinides

    • Short-acting insulin secretagogues.
    • Similar function to sulfonylureas but have a shorter duration of action.
    • May be combined with other medications, like metformin.

    Glucagon-Like Polypeptide-1 (GLP-1) Agonists

    • Increase insulin secretion and reduce glucagon secretion, leading to better glucose control.
    • Given as injections.
    • Potential side effects include nausea, vomiting, and weight loss.

    Dipeptidyl Peptidase-4 (DPP-4) Inhibitors

    • Inhibit the enzyme that breaks down GLP-1, thereby increasing GLP-1 levels and improving glucose control.
    • Administered orally.

    Sodium-Glucose Co-transporter-2 (SGLT2) Inhibitors

    • Inhibit glucose reabsorption in the kidneys, increasing glucose excretion in urine.
    • May have potential side effects like increased urination and risk of dehydration.

    Combination Therapy

    • Often a necessary approach in managing type 2 diabetes when a single medication isn't sufficient.

    Other Drugs in Diabetes Management

    • Used as preventative medications, including statins and ACE inhibitors.

    Comparison of Type 1 and Type 2 Diabetes

    Feature Type 1 Type 2
    Abnormality Beta cell destruction, insulin deficiency Beta cell dysfunction, insulin resistance
    Incidence Less common (~5-10%) More common (~90%)
    Age of Onset Usually before age 30 Usually after age 40
    Etiology Often autoimmune Multifactorial
    Body Weight Low Often overweight/obese
    Diabetic Ketoacidosis More common Less common
    Treatment Primarily insulin Primarily oral hypoglycemics, potential insulin

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    Description

    Explore the types and characteristics of Diabetes Mellitus in this quiz. Learn about Type 1 and Type 2 diabetes, their causes, and how they affect the body. Test your knowledge on blood glucose levels and the impact of insulin resistance.

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